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919 Peoples Creek Rd �.. , � . . .� Davie County Health Department ��s j� .�CE��nvironmental Health Section � _ , r � x�� P.O. Box 848 Dar�; p� , 1 � _ � � ,�'�,,, Da�: ' 210 Hospital Street RQ�Q� '`�"/_3 ` ' �� v�d , � O� �'t Courier# : 09-40-06 ` � -� Mocksville, NC 27028 �r Phone:(336)-753-6780 Fax:(336)-751-8786 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) Replacement Remodeling Reconnection Name:�IDI?p� �,��/1� PhoneNumber 33� • �y�' �� (Home) Mailing Address: �q �eo .e �Q� , o��- �3 7� (Work) � L � ` G"l� O . � 7 Email ��z. al �1� SJDP��/ � C�f I —�T—i— Detailed Directions To Site: �`o i S -� �Pl es �'re�k ��, o h l e �-- (��i 000- . -o� Property Address: �' � tT� Please Fill In The Following Information About The EXISTING Facilityc Name System Installed Under: Type Of Facility: �1��nC�' Date System Installed(Month/Date/Year): �� Number Of Bedrooms:�o _Number Of People:� Is The Facility Currently Vacant? Yes No If Yes,For How Long? Any.Known Problems? Yes No If Yes,Explain: Please Fill In The llowing Information About The NEW Facility: Type Of Facility: V 1�/1 1�' � �O�N�� Number Of Bedrooms: Number of People Requested By: Date Requested: 71 Z� 73 - (Signatur For Environmental Health Office Use Only Approved Disapproved omments: Environmental Health Specialist Date: l� *T'he 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. Payment: Cas Check Money Order # QS Amount:$ IO O- Date: 7j Paid By: Received By: Account#: � ��9 Invoice#: _�Q C�� I ZZZ�3 v,�.�.�. � � ti. � \ �� O � f ��z.�`n�G ��,� �� T� ,��'9� �--� , r i to' � �, � �� J � ��a.��w. � � ,l� � � .z � � 3 � I >� � '� � N � � +G' "� � .�- � ' � � �-- $ � . -S ' � Z '� Q � -� � 7�oi��' _��'] �, � � ��h�Pdi�.'j �.,, .- ✓ � (� � � ' ' � i �� t�J' '` 72� r � �' ✓ �.1 � ��:y-=� � - -' _ � � � � � ,.. . ,� . ,. � , . .� • � � ` � , � , �f� �` ` �ip�...a�'1 t bs�. ' \ J J � \ / . . �'+ �... � J . �^^�k � �,�b� � � �'�� . N � � p��'� . O W . �� P �- ` • � r ,� , • � 2 � - t. �t1..� .___ . _ Appraisal Card Page 1 of 1 DAVIE COUNTY NC 7 2 2013 12:16:29 VM ARNER DEBBIE 5 GARNER WARREN C Re[urn/Appeai Notes: H9-000-00-005-01 19 PEOPLES CREEK RD UNIQ ID 14190 300327 RESB-6-11-4561 ID N0:5799045544 C COUNTY TAX(100),FIRE TAX(100) CARD N0.1 of 1 � Reval Year:2013 Tax Year:2013 1 LOT OFF PEOPLES CREEK 8.540 AC SRC=Inspectfon roised b 19 on 10/06/2008 07203 MARCHMONT TW-07 C- EX-AT- LAST ACTION 20110712 � CONSTRUCTION DETAIL MARKET VAWE DEPRECIATION CORRELATION OF VALUE t Foundatlon-3 Eff. BASE StandarA 0.32000 � on[inuous Footin 5.0 USE MO Area UA RATE RCN EYB AYB REOENCE TO MARKET �,`� ub Floor System-4 I ood 8.0 Ol 01 1 408 120 84.00 118272 19811981 %GOOD 68.0 DECR.BUILDING VALUE-CARD 80 43 xterior Walls-15 TYPE:Single Family Residential Single Famlly Residen[lal DEPR.OB/XF VALUE-CARD 67 - MARKET LAND VALUE-CARD 61,48 Board&Batten 12'/Lo 31.0 �" STORIES:1-1.0 Story OTAL MARKET VALUE-CARD 162,58 N Roofing Structure-03 able 8.0 oofing Cover-03 OTAL APPRAISED VALUE-CARD 162,58 s halt or Com si[lon Shin le 3.0 OTAL APVRAISED VALUE-PARCEL 162,58 nterior Wall Construction-5 D wall/Sheetrock 20.0 OTAL PRESENT USE VALUE-PARCEL n[erlor Floor Cover-OB heet Yn I/Lamina[e 6.0 OTAL VALUE DEPERRED-PARCEL nterior Floor Cover-14 OTAL TAXABLE VALUE-PARCEL 162,58 a et 0.0 +- ----3 2------+ PRIOR Heating Fuel-04 I P T� I BUILDING VALUE 83,94 Eiedri[ 1.0 p � BXF VAIUE 95 ea[ing Type-04 +- ----3 2------+ LAND VALUE 81,48 orced Air-Dutted 4.0 =F g M I PRESENT USE VALUE ir Conditioning Type-01 I I DEFERRED VALUE One 0.0 1 I OTAL VALUE 166 37 Bedrooms/Bathrooms/Half-Bathrooms 2 2 3/2/0 12.00 4 4 � 2 I edrooms I I - BAS-3 FUS-0 LL-0 = I PERMIT °' Ba[hrooms +- ----3 2------+ CODE DATE NOTE NUMBER AMOUNT ^_ BAS-2FU5-OLL-O �Ce +- --2 2----+1 0-+ ROUT:WTRSHD: I W D D I P T O I SALES DATA � OTAL POINT VALUE 6.00 1 1 1 FF, c INDICATE BUILDING AD]USTMENTS O 0 0 RECORD ATE DEED SALES - uali 3 AVG 1.000 +-1 2--+---2 2----+1 0-+ BOOK PAGE M R IYPE / / PRICE y ha e/Desi 4 FACTOR 4 1.050 I B A S I � g I 0858 752 5 O11 WD• U I 11350 � ize 3 Slze 1.160 +-1 2--+ I 0127 189 6 198 W D E I 6200 ' c OTALADJUSTMENT FAGTOR 1.22 I F C P I 2 0124 195 8 198 WD U I 5723 r� OTAL QUALttY iNDEX 12 I I < I 1 I 2 6 I 2 I I I +- ----3 2------+ HEATED AREA 1,632 I 6FOP 6 +-12"�""';2"""} NOTES 11-BASEMENT REMODEI SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPR. GS ODEDESCRICTIONLTH HUNIT PRICE COND BLDG#L/BAYBEYB RATE V COND VALU TYPE AREA %RPL CS 1 TORAGE 1 1 30 15.0 10 _ L 194 199 S 4 64 BAS 6 30 7257 24 HED 1 1 10 5.1 10 L 194 199 S 2 BM 76 4 2906 OTAL OB/XF VALUE 671 CP 2 2 554 OP 792 3 562 PTO 42 0 176 DD 22 2 369 FIREPLAGE 1-None UBAREA Z��Z 118,27 OTALS BUILDING DIMENSIONS BA5=W4458FCP=522E12N22W12$E12516FOP=56E32N6W32$E32N24S�0=N10W10WDD=W22510E22NIOESIOEIOE�R=N20 FBM=N24 PT0=N10W32S10E32 W32524E32 520$. LAND INFORMATION IGMEST THER AD)USTMENTS TOTAL ND BEST USE LOCAL FRON DEPTM/ LND COND ND NOTES ROA LAND UNIT LAND UNT TOTAL ADlUSTED IAND LAND SE CODE ZONING TAGE DEPT SIZE MOD FACT RF AC LC TO OT TYPE FRICE UNITS TYP AD75T UNIT FRICE VALUE NOTES RURAL AC 0120 0 0 1.1760 4 0.7000 30-15-OS+00+00 PD 11 600.0 8.53 AC 0.82 9 546.8 8148 OTAL MARKET LAND DATA 8.53 81 48 OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNeVAppraisalCard.aspx?parce1=H90000000501 7/2/2013 . DAVIE COUNTY HEALTH DEPARTMENT � ' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name Date ' , j ; Location _ _ � `'- __ P �. �� Subdivision Name Lot No. Sec. or Block No. Lot Size House • Mobile Home _ Business Speculation No. Bedrooms No. Baths — No. in Family _ Garbage Disposal YES ❑ NO p - Specifications for System: ,',: Auto Dish Washer YES ❑ NO p � Auto Wash Machine YES 0� NO 0 ' . Type Water Supply ___ `This permit Void if sewage system described below is not installed within 36 months from date of issue. 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. �- , , t ��..�•.,i f::,,.,s..`;�;�.. Final Installation Diagram: System Installed by��'� ' ' �� + i t... �. ; � n�....-- ----- ��, ( t t��'_:'L' ;/. ��: . f,..�, '�� ,. _ , _ �`� ��----••-__.__..___ - `i t;�� i ,:. ;t.� ` . i � . (�r��,i i i'4.� �..) /,. (i :1� '�•�. ��,��'�•�...../� t� � r . �1 . ,_ � . ,. � r.� �. . ..i 1' 1\�i' `�' . , ` - �`- :`��''t` i ' � _.1 . 1 . .. . �. . , r•__ .i -------- - — - -- _-- _,_.._. t i i i � � 4 _ -__.,_.�_._.__.___._._...._! I�-> - '> - �-�� ' �_ _ ,�` . ,, , Certificate of Completion � �� - � Date ° � , i. _�The s gning of this certificate shall indicate that the system described above has been installed in compliance with s set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function iod of time. � �` , . DAVIE CQUNTY HEALTH DEPART��ENT PE�tCOLATION TEST RESULTS DATE J- S- g� Q�C�'r�� ,�,o,L'a r� !'.,�3 �'7`�` " e�t';,y��st� 4r d`',,;�_`a►• NAI�'iE C��c�rlcs � rnw{:n'� f�rlua��cc,�tr. LOCATION �c�aQ�es �'rte.�' 1��• Ne'w �r7�� o �-� ,�uS� '�aF'��. '�C',n:.1"�,.. car,�, 2.'�N��G ' T� Q.�. 1�.�u `"b r',.-. c,.`E` �wa�..� ""'�on..�a.,.. FINDINGS: HOLE N0. COTIT�NT5 ,� .. _ Uo„��,. �'�c3.; �w. .. �,•�g, ;-; . ��a � ;��a��l S'�.. 1. 3/(�/��jhl �j'O M:n�'J�Gs' L� }� , 4 f_4Y�i! � �S,.Y\.:��t.�.�. rJUN.�A�i ` � U[�.:Q'L �Ih. C17��=C ,C 1 �� M�71t��O�•v� 2. '/i��a�" = IA,sLn ��Mr/. �u1`•.=l./aa.,�.. _ �opw•�_ �tB� . � -� �_ I�' \V�� '(�a C��Ar..er •'� �.1��,t 3 �+r��tL (� �t//� � 4� 3. � ll�li'�" ' �Zf� /'11%M�I�'� Sa�lvC��G � �Fs " � la�� "o.a"tr�l� ��yI�P`�ti`\ ,hi14.� � 4. �w� �y� P�c+na C y,�,ti�.a� �.�7� �+4'��C. +� ��f� E.�c��•�.. n Qti,.h �»� cwt`�•,rc. cJ. �3. J/�'!'.��)p4� ��N6.tTpiC^�� 6. FiY• a.,., t'"!"'4 C.t�..c�...� � ' a`l� �6-�� . LOT DIAGRAt�f �`�r�i� ; x �L: ��. ��' �_�'"' JI F �� X � � � J�� `` r /` ��, �� f�� Y ti �1� /f __.; hA� x�d ,,,� �i�� ( �t D �r`1� �D r r � �l ''.'� ..'�\� '�� 9� p. �,.�1� ��I 1 �� <, � � � �� l� Q N �� 7 ti � � Q '7 �a� 1J�-� � �% �� --- -. _..__ ._ -�___ _ _. _--._..._._ F � a __�_ ._._._--. c A :�i -_~-. _ �� .�.A/ J +�� . � cn� IP DAVIE COU:ITY HEALTH DEPARTMENT - � �` . �� : E:IVIROI�].+IEYd'�'AL IiEP.LTA SECTIO�d �,,, �/" . , P.O. BOX 57 �� .�� MOCKSVILLE, I1.C. 2702Ei �' � (704) 634-5�85 � n � 't1 STATE:�2dT FOR S�PTIC TAtdK IP�'ROVEMEcdTS PER�?ITS �1D/OR SITE FVALUATIONS , NAP'!E C�cx y.�t S e r�w Fv-�-Q DATE S- 7 —�( ADDRESS �-c'�. . ��,�, �(o`� PERMIT I�TO. �l-'Ic� �' ��u _ EXPLANATIOId OF Cf''.ARGE S'�� uassC_ �1- 5 v• ltti... c+.�.`� A��IOUNT DU� �.. b.clD 5�11�?ITARTAN 4 � ��,�,�� PL�ASE RE_�TIT TEiE ABOVS At�IOtTiVT OF REC�IPT OF TEiIS aTATEA1EIdT. �NOTICEe Evaluation(�) can n�t b� compl�t�d until payment is rec�iv�d. Imarov�m�nts P�rmi�is) can nat bs issued until pay�ent is received. . , _.�._.. . ...............__.._.... . _......._ ..... .._----..... ..__....._...------�---- - -..._..._._. . .. ' � ' •`�Qs.Q; C /T �.rv�+�Cif.,�-P.�Q+.v�.t-,p D'sED 800K 1�MG[� � (. . � � . I •F-�.S J�.�cQ. (�..Q.�-�4.. Pcubw � i . t.J.,,,.o�..-✓• �slo.p.s�-,--• Jl1,C : .�7 i 3 . � • . . • � . I., ' .• I THIS DOCUMENT PREPARED BY CEORCS'ti. HARTIlY, Bo: 606� Nocksville, HC � �. ' _I � NORTH CAROLINA • � 6 ' I. � ... ' . DAVIE COU�iTY . ; , f ( • �• THIS DEED� mede and entered into thls 30 d�y of August , j ' j 1984� by and betveen GEORCH W. HARTIN of Davia Couatr, porth Cero- ' , I � . i lina� acting aa Truetee aa hereinafter etated� party of Ehe first �.I .. • ' � • ' . ' part= and CIT PINANCW. SERVICES� INC.� d/b/a CIT HORTGIiGS C04�PANY� ; . � r Corporation haviny an office and plsce of bwinesr in itiastoa-Saleey � i • . • North Carolina� party of the recond part{ • i . � � � ti2TN8888TN t , � • •THAT WkiEREAS, CFIARI.ES L. CRAWFORD� JR. and wife� LINDA 8. CRAW- I '. , i POAA� executed,.to the �aid GEOACE W.•HARTIN� Trustee, upon the land� . j • hereinafter deecribed� .a deed of truet dated the 2$th day of June� � i � � . 1982� and recorded irt Daed of Truat Sook 119� page 417� Ua�ia County i ' . Regiatry; and whereaa� the indebtednese thereby eecured beina overdue i i and unpaid and the holder vf the indebtednese having called upon the � said Truetee eo forecloee the said deed ot trust. The eMid 7xustee� ' after due eoCiee, hearing and advertiaement •s required by lav and • � � � the terms of the deed of trust. offered said lend fot asle at the. : • . door of the Courthouse� Davie County. Noxth Carolina� on tha 23rd day , . � . . ' of July� 1984, when and whera CST 9I1iANCIAL SERVICES, INC., d/b/a CIT MORTCAGE COMPANY. became the last and higheat bidder at the price of. ' ' FIF1'Y SEVEN THOUSAND-TWO }iUNDRED-Tk1IRTY Al3D tI0/100 ($57�230.00) ' DOLSAItS; and whereae� on the day of eaid sale� a report [hereoF was � made to the Clerk of Superior Court; and whereae� said bid raneined ' - open for more Chaa .ten days and no advanca bid vaa offered and no ob- . ' jection made., . NOSJ, THEAEFORE. the said GEORGE W. MARTIN� acting as Trustee ar ' , � aEore�aid� in consideration of the pramieei and of the •ns of•FIFTY , • � � SL'VE:J TNOUSAND-THO HUNDRED-THIRTY AND NO/100 (557�230.00) DOLI.ARS : ��MARTIN ANO VAN MOY.� �� EO hia in haad�paid, hae bar�ained-and �old and bp thes� pre�ent• doer . AT1011MEYf 11T 41M� . . . � . � � � � � . 110Ct3YILLt.K G ' � . - . . '� � . � � . . , . . '. . . , . . . . . . . . . . . . . . ; , ' . . � . . , � ' . . � . � 1 . ' .. � � � .. � . � . . . � . . ' . • � ( . , . , � . . . .. � . ! ' � � . . . � . ' ' . . . .. . . . � ' ' � . � . . ' ' . � . • . . .. Appraisal Card Page 1 of 1 . . . DAVIE COUNTY NC 7 10 2013 8:18:57 AM ARNER DEBBIE 5 GARNER WARREN C Return/Appeal Notes: H9-000-00-005-01 19 PEOPLES CREEK RD UNIQ ID 14190 300327 RESB-6-11-4561 ID N0:5799045544 C COUNTY TAX(100),FIRE TA%(100) CARD NO.1 of 1 eval Year:2013 Tax Year:2013 1 LOT OFF PEOPLES CREEK 8.540 AC SRC=Inspection � reised b 19 on 10/06/2008 07203 MARCHMONT TW-07 G EX-AT- lAST ACTION 20110712 �:,, CONSTRUCTION DETAIL MARKET VALUE DEVRECIAttON CORRELATION OF VALUE �, Foundatlon-3 ER. BASE Standard 0.3200 1 on[inuous Footin 5.0 US MO Area UA RATE RCN EYB AYB REDENCE TO MARKET m ub Fioor System-4 PI ood 8� 01 Ol 1 408 120 84.00 11827219811981 %GOOD 68.0 DEPR.BUILDING VALUE-CARD 80 43 EMerior Walls-15 TYPE:Singte Family Residentlal Single Family Residen[ia�DEPR.OB/XF VALUE-GRD 67 Board&Batten 12'/L 31.0 MARKET LAND VALUE-CARD 81,48 �, STORIES:1•1.0 Story OTAL MARKET VALUE-GRD 162,58 oofing Structure-03 ` abie 8.0 oofing Cover-03 OTAL APPRAISED VALUE-CARD 162,58 s halt or Com osition Shin le 3.0 OTAL APPRAISED VALUE-PARCEL 162,58 nterior Wall Construttion-5 wall/Sheetrock 20.0 nterior Floor Cover-08 OTAL PRESENT USE VALUE-PARCEL hee[Vin I/Laminate 6.0 OTAI VALUE DEFERRED-PARCEL nterior Floor Cover-14 OTAL TAXABLE VALUE-PARCEL 162,56 a et 0.0 �- ----3 2------+ CRIOR ea[ing Fuel-04 i P T O i BUILDING VALUE 83,94 Electric 1.0 � � BXF VALUE 95 ea[ing Type-04 +- ----3 2------+ ND VALUE 81,48 Forced Air-Ducted 4.0 I p g M I PRESENT USE VALUE ir ConCitloning Type-01 I I DEFERRED VALUE one 0.0 I I OTAL VALUE 166 37 drooms/Ba[hrooms/Half•Bathrooms 2 Z /2/0 12.00 4 4 I I drooms I I — AS-3 FUS-0 Ll-0 I = PERMIT Ba[hrooms +-----3 2------+ CODE DATE NOTE NUMBER AMOUNT �^ AS-2FU5-OLL-O ffice +-- -2 2----+1 0-+ ROUT:WTRSHD: I W D D I P T O I SALES DATA c OTAL POINT VALUE 8.00 1 1 1 FF. - INDICATE BUILDING AD7USTMENTS 0 0 O RECORD ATE DEED SALES �� ualf 3 AVG 1.000 +-1 2--+- --2 2----+1 0-+ BOOK vAGE M R TYPE / / VRICE J ha e/Desi 4 FACTOR 4 1.050 I B A 5 I o g 1 0858 752 5 011 WD' U I 11350 �i ize 3 Size 1.160 +-1 2--+ I 0127 189 6 198 WD E [ 6200 ' 0 OTAL ADJUSTMENT FAGTOR 1.22 I F C P I 2 0124 195 8 198 WD U i 5723 '- OTAL QUALIN INDEX 12 I = < I 1 I 2 6 I 2 I I I +- ----32------+ HEATEDAREA1,632 I 6FOP 6 +-12--+- ----32------+ NOTES I1-BASEMENT REMODEL SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPR. GS ODEDESCRIPTIONLT HUNIT PRICE COND BLDGftL/B AYB EYB RATE V COND VALUF TYCE AREA %RPl CS 1 ORAGE 1 1 10 15.0 30 _ L 194 199 5 4 64 BAS 86 30 7257 24 HED 1 1 10 5.1 10 L 194 199 5 2 FBM 76 4 290 OTAL OB/XFVALUE 671 FCP 26 2 554 OP 192 3 562 PTO 42 0 176 DD 22 2 369 FIRECLACE 1-None UBAREA OTALS 2,72 118,27 BUILDING DIMENSIONS BA5=W4458FCP=522E12N22W12$E12516FOP=56E32N6W32$E32N24$PT0=N10WIOWDD=W22510E22N10$S10E10$PTR=N20 FBM=N24 0=N10W32510E32 W32524E32 520$. ND INFORMATION MIGMEST TMER AD7USTMENTS TOTAL ND BEST USE LOCAL FRON DEPTH/ LND COND ND NOTES OA LAND UNIT LAND UNT TOTAL ADJUSTED LAND LAND SE CODE ZONING TAGE DEPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TVG AD]5T UNIT VRICE VALUE NOTES URALAC 0120 0 0 1.1760 4 0.7000 10-IS-OS+00+00 PD 11 600.0 8.53 AC 0.82 9 546.8 8148 OTAL MARKET LAND DATA 8.53 81 48 OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNedAppraisalCard.aspx?parce1=H90000000501 7/10/2013