578 Junction RdHEALTH DEPARTMENT RELEASE
dsr �o Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: Tommy Harris
Address:
City:
State2ip: NC
Phone #: (336) 909-4027
For Office Use Only l
*CDP File Number 137037 -1
K3 -130 -BO -001
County ID Number.
valuated For. HDRIMC
PERMIT VALID 0 4/ 0 1 1 2 0 1 9
UNTIL
,/'Property Owner. Teresa M Couch
Address: 578 Junction Rd
City: Mocksville
State2ip: NC 27028
hone #:
Property Location & Site Information
Address578 Junction Road Subdivision: Phase: Lot
Road # Mocksville NC 27028
*Structure:
SINGLE FAMILY
# of Bedrooms: 3
'Water Supply: PUBLIC
Basement: ❑ Yes No
'Proposed Improvement:
Pool
# of People:
Township:
Directions
By South Davie Jr. High to Junction Road on left. the property on right
just past SM Whitt Road on left.
Type of Business:
Total sq. Footage: No. Of Employees:
If the pool is not going to be placed 15 from any portion of the septic, kill and seal off any portion of the septic not meeting the setbacks and
replace using the attached repair permit.
This release in no way expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site Will continue to function for any period of time.
Applicant/Legal Reps. Signature Required? OYes ONO
Applicant/Legal Reps. Signature: *Date: / /
*Issued By: 2140 -Nations, Robert *Date of Issue:. 0 4 / 0 1 / 2 0 1 4
Authorized State Agent:
**Site Plan/Drawing attached.**
O Hand Drawing OlmportDrawing
CAi
R.
5t
HEALTH DEPARTMENT RELEASE
Davie County Health Department
210 Hospital Street
P.O. Box 848
CDP File Number: 137037 -1
County File Number: K3 -130 -BO -001
Mocksville NC 27028 Date: 04 / 0 1/ 2 0 1 4
0 Inch
Scale: QBlock '- ft.
Drawing Type: Health Department Release QN/A
HEALTH DEPARTMENT RELEASE
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC ` 27028'
Drawing Type: Health Department Release
Page 2 of 2
CDP File Number: 137037 -
County File Number: K3-130-130-001
Date: .0.4 / 0 1/ 2 0 1 4
Davie County Health Department
O hi8361 Environmental Health Section
P. Box 848...
210 Hospital Street®�
a 1� Courier # : 09-40-06 ,
U Mocksville, NC 27028
Phone: (336) - 753 - 6780 Fax: (336) 751- 8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Name: rl'I a Phone Number 3 3 2 7 (Home)
Mailing Address: % �c�(c S✓� Ar" d� (Work)
C X702.8' Email
Detailed Directions To
Property Address: al C �- i o iJ c+.�
Please Fill In The Following Information.About The EXISTING Facility:
Name System Installed Under: Type Of Facility:
Date System Installed (Month/Date/Year): 7 Number Of Bedrooms -3' Number Of People -.—
Is The Facility Currently Vacant? Yes If Yes, For How Long?
Any.Known Problems? Yes If Yes, Explain:
�:3(00A '.7
Please Fill In The Following Inforrmation About The NEW.Facility:
Type OfFacility:' /(/ces Number Of Bedrooms: Number of People
Requested By: Date Requested:
(Signature)
For Environmental Health Office Use Only
pproved Disapproved
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way, intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Money Order #
I I - — — _—
Paid By:
Received By:
Account #: Invoice #:
Appraisal Card
DAVIE COUNTY. NC
Page 1 of 1
3/28/2014 4:31:03 PM
OUCH TERESA M Retum/Appeal Notes: Parcel: K3 -130 -BO -001
578 JUNCTION RD PLAT:/ UNIQ ID 20324
18203000 ID NO: 5726682932
COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1
eval Year: 2013 Tax Year: 2014 LOTS 11-12 LONGVIEW 1.360 AC SRC- Inspection
Appraised by 55 on 09/2912008 06005 JERICHO TW -06 CI- FR -04 EX- AT- LAST ACTION 20110712
CONSTRUCTION DETAIL MARKET VALUE
DEPRECIATION CORRELATION OFVALUE
oundation - 3Ery
Standard 0.0900
ntinuous Footing5.0
BASE
S MO
ub Floor System - 4
Area QUA
RATE
RCN EYB AYB
CREDENCE TO MARKET
1 720 102
171.4011228081200420041
% GOOD 1 91.0 DEPR. BUILDING VALUE - CARD 111 76
ood 8.0 59 01
xterior Walls - 30 TYPE: Modular Single Family Residential DEPR. OB/XF VALUE - CARD 70
luminum/Vin I Siding 29.00 MARKET LAND VALUE -CARD 21,98
cofing Structure - 03 STYLE: 1 - 1.0 Story TOTAL MARKET VALUE - CARD 134,44
ble 8.0
toofing Cover- 03
s halt or Composition Shingle 3.00 TOTAL APPRAISED VALUE - CARD 134,44
nterior Wall Construction - 5 TOTAL APPRAISED VALUE - PARCEL 134,44
)rywall/Sheetrock 20.0
nterior Floor Cover - 12 TOTAL PRESENT USE VALUE - PARCEL
Hardwood 10.0c TOTAL VALUE DEFERRED - PARCEL
nterior Floor Cover - 14 TOTAL TAXABLE VALUE - PARCEL 134,44
:arpet 0.0
eating Fuel - 04 PRIOR
Electric 1.0c BUILDING VALUE 114,45
eating Type - 10 BXF VALUE 84
eat Pump 4.0 ND VALUE 21,98
it Conditioning Type - 03 RESENT USE VALUE
ntral 4.00 DEFERRED VALUE
edrooms/Bathrooms/Half-Bathrooms TOTAL VALUE 137,27(
/2/0 12.00
edrooms
AS-3FUS -0 LL -0
athrooms - PERMIT
AS - 2 FUS - 0 LL - 0 CODE DATE NOTE NUMBER AMOUNT
It -Bathrooms + -----------------60-----------------+
AS-0FUS- 0 LL -0 IBAS +4+
ifice I W D D ROUT: WTRSHD:
I +4+ SALES DATA
I I FF. INDICATE
OTAL POINT VALUE 104.00 I 1
RECORD AT DEED SALES
BUILDING ADJUSTMENTS I I
2 1 BOO PAGE R TYPE PRICE
ize 3 Size 0.980 8 2 0174 299 5 199 WD Q V 1500
ali 3 AVG 1.000 I 2 0175 832 8 99 WD X I 1500
hape/Desigr4 3 1 FACTOR 3 1 1.000C I
OTALADJUSTMENT FACTOR 0.98 I I
TOTAL QUALITY INDEX 10 I I
I I
+---17----+------26-------+----17----+ HEATED AREA 1,680
4FOP 4
+------26-------+ NOTES
SUBAREA
UNIT
ORIG %
ANN DEP
%
OB/XF DEPR
GS ODE
DESCRIPTION
OUN LT NIT PRICE
COND LDG:F
AYB EYB RATE V
GOND
VALUE
RAGE
1 6 15.0
10
199 199 S
5
69
TYPE AREA % RPLCS 1
AS 1,681'
68 10 11995 OTAL OB XF VALIE 69
OP 10 3 257
DO 2 2 28
FIREPLACE 1 - None 0
UBAREA
1180 122,80
OTALS
BUILDING DIMENSIONSBAS=W60S28E17FOP=S4E26MW26$E26E17N22Wm=E4N5W4S5 t,6$.
ND INFORMATION
HIGHEST
THER ADJUSTMENTS
LAND
TOTAL
D BEST USE
LOCAL
FRON
jDEPTH/
LND
COND ND NOTES
OA
UNIT
LAND LINT TOTAL
ADJUSTED
LAND OVERRIDE LAND
SE CODE
ZONING
TAGE
EPT SIZE
MOD
FACT RF AC LC TO OT
TYPE
PRICE
UNITS TYP AD3ST
UNIT PRICE
VALUE VALUE NOTES
RURAL AC 0120
220
0 2.0990
4
1.18001+08 +10 +00 +00 +00
1 PW
1 6,500.04
1.365 AC 2.47A
16,100.5
2197
OTAL MARKET LAPD DATA 1.365 21698-01
OTAL PRESENT USE DATA
Ownt
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=K3130B0001 3/28/2014