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7255 Hwy 801Sa�+� a. x, y. m'._:. a�..l,`.ma.c :n,.:..r Hwt.Xr.r. 3.:., .a+.r� u"+>: n'ei. "t.u`i'iq t rv.,,r3 r V.: s:.y.%t..... ^i �.. i'�� •�s fr9-:;z a a, r.: i. t , y - ..(', n.,- ..ti. 2:�e.r.,. �: .,. ., .. rY. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules 0 NCAC 10A .1934-.1968) Permit Number Name < 4o�A0Date N2 tia 55 Location Subdivision Name f fl'-- / "Iol�_ I . Lot No. Sec. or Block No. Lot Size ��c7 ' � D' /� House Mobile Home Z Business Speculation No. Bedrooms – No. Baths No. in Family — Garbage Disposal. YES p NO 0 Specifications for System: Auto Dish Washer YES p NO ❑ �D�v�! �s Auto Wash Machine YES d NO Type Water Supply *This permit Void if sewage system described below is potfinValled within 36 months from date of issue. r Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. It, L 1 Certificate of Completion Date- -*The signing of this certificate shall indicate that the system described above has been installed in co pliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department O 1 Environmental Health Section R O. Box 665 oc C Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. 1. Permit Requested By 2. Address 3. Property Owner if Different than Above Address 4. Permit To: a) Install Alter Repair b) Privy Conventional--ZOther Type Ground Absorption Home Phone 998*7'fT Business Phone c) Sub -Division Sec. Lot No. sines 5. System used to serve what type facility: House Mobile Home Bus IndustryOther b) Number of people I- 6. 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions Bed Rooms— Bath Rooms Z Den w/Closet ✓ b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures:_ commodes Y urinals garbage disposal lavatory showers washing machine dishwasher sinks 1 8. a) Type water supply: Public Private Community b) Has the water supply system been approved? Yes No 9. a) Property Dimensions 1 I V A V r A 10 r x 117 b) Land area designated to building site A?" c) Sewage Disposal Contractor T 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?-� What type? This is to certify that the information is correct to the best of my knowledge. Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: 6 0 _ S „ �!, avt. ff 0 y fL �,5' p0 tp K, 'e Z_ 0�� "e'7' DCHD (6-82) Address DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date S�S Lot Size a �G FAr.Tr PRQ APPA i AREA 9 ARFA 3 ARCA A t) Topography/ Landscape Position 9) ©� PS PS PS PS U U U U ?) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) "� U U U 3) Soil Structure (12-36 in.) Clayey Soils S S Tj U I) Soil Depth (inches) i) Soil Drainage: Internal External P9C rsj - PS i) Restrictive Horizons 'j Available Space u 1) Other (Specify) S PS U S PS U S PS U S PS U Site Classification U—UNSUITABLE Recommendations/Comments: S—SUITABLE PS—Provisionally Suitable e.� Described by / Title J Date- SITE DIAGRAM DCHD (6-82) Parcel #: M5030A000105 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: M5030A000105 Account #:9502500 Owner Information Tax Codes I IC ADVLTAX - COUNTYT FIREADVLTAX - FIRE TAX BRACKEN KAREN WOOTEN 255 NC HIGHWAY 801 SOUTH MOCKSVILLE NC 27028 BXF• Property Information Township Land (Units/Type): 0.500 [Address: 7255 S NC HWY 801 JERUSALEM 64 20 ssessed• 64,20 Deed Information Local tonin Date: 08/1997 Book: 00196 Page: 0660 Plat Book: Page: 00190 0202 10 1996 WD Unqualified Legal Description PIN 1.5 AC HWY 801 5746402178 Property Values Building: 51,67CI BXF• 71CI Land: 1182 Market: 64 20 ssessed• 64,20 eferred: 0 Sales Information . No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00186 0410 04 1996 WD Unqualified Vacant 0 2 00190 0202 10 1996 WD Unqualified Improved 5,000 3 00196 0660 08 1997 WD Unqualified Improved 5,000 4 00148 0659 05 1989 WD Qualified Vacant 5,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 '� °°vK'1 -1- Davie County Web Site All Information on this site is prepared for the inventory of real property found within Davie County. All data Is compiled from recorded deeds, plats, and other public records and data. Users of this data are hereby notified that the aforementioned public Information sources should be consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County, Its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or Implied, in fact or in law, including without limitation the Implied warranties of merchantability and fitness for a particular use. If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120. 1.5.9 http://maps.daviecountync.gov/itsnet/View.aspx?prid=1460077 8/31/2016