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1862 Yadkin Valley Rdi Davie Countv, NC S T.,., D.,....ol D o..,,..� Wednesdav, October 12, 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: WAl�1VllV(T: "1'H15151VU1' A SUItVL+'Y Parcel Information C60000010701 Township: Farmington 5862199397 Municipality: 82526740 Census Tract: 37059-802 BECK ANDREW S Voting Precinct: FARMINGTON 1862 YADKIN VALLEY ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: DAVIE COUNTY QD 27006-0000 Voluntary Ag. District: 1,434 AC YADKIN VALLEY RD Fire Response District: 9"�'�' Davie County, �o��,�� NC 1.44 Elementary School Zone: 7/2006 Middle School Zone: 006720447 Soil Types: Flood 2one: Watershed Overlay: 103590.00 Outbuilding 8 Extra Freatures Value: 39820.00 Total Market Value: 154820.00 FARMINGTON PINEBROOK NORTH DAVIE GnC2,CeB2 DAVIE COUNTY 11410.00 154820.00 No � ar 29 12 0�38p Iriformation Services I 1 , , , . . -- � 3387531880 p.1 � ��� ��� � ���-� �� ..�� . N Davie County Health Departmcnt ��; 6Ic� � ' onmental Health Section .- : �� �','�� P.C). Box Kd� � �� Q � - � 2I0 Ho�pit�� Sa•ec� � � (11�1;� �' �'la`( 1 p 2Q12 Coutier # : 0�-�1.0-Qti �� "i,'iy+1 I �� � � 1911 Mocksville, NC 2702fi �; (� � `���t,' 1 � , � � j%� . A� _, .._. t�honc: (33G) - 753 - s��� ON-S�� WAS�'EWAT -CER11�1CATION - -'- i'�: cy�6� -� 5,�-iu�o (Check One) Replacement Remodel� - �teconnection . Namc: �nc�ni,.� s l�P(' I� PhoncNumbcr�6 %y� -l1099 (k{omc) Mailing Address: ��6� �n���n VS ��ty ��. �33�� 3� ~ Z�`�d (Work) Ac��ync� NG �,7�06 LmailAddress: none Detailed Dircctions To Site: �,�� � �urn. ' � o� d�. Property Address: �.7vv� neai4�� aa. qo �a .�� . _.._. Pleuse Fill !n The Following Information About T �XISTING Facility: Namc Systcm Installcd Undcr. 6'L OYZ�iCC7� Typc Of Fxcility: (1 c�v�� Datc Systcm In�tallcd (Montli/Dste/Year): / �l b0 Number OfBedrooms: 3 Number Of People: 5 [s Thc Facility Currcntly Vscsnt7 Ycs No If Ycy, For How Long? � Any Known Problcros� Ycs No If YcB, Explain: _ ._,�� plcasc Fill in Thc F llowiQ� Intormation About c N.EW Facility_ Typc Of Facility: � Numbcr Of Beclrooms: N�mber oFPcoplc + �� ['ool Size: Garage Size: 2� "' 0 Other: Requested By: ��iYvLi•-^� ���� , Dnte ltcque�tcd; r._..._.. ---- (Signnturc) ..----�----�., For Environmenta! Nealth Of�ce Use Only �pprovc;d �Disapprovcd _/ Environmental Health Specialist i� '"The signing of this form by the Environmental Health Staff i in no way intcndcd, nor should be taken as a guarantee (cxtended or limited) that the on-site wf►.stewater system w•ill function properly for any given period o,f time. Payment; Cash Check Money O �# Amount:$_ Puid By: �'I NWt��w ��= ��- R�x:cived By:_ Arrnilttt f1� /, j /�/�jl in.rnirnlf• ./ �.J O aG. ! �.,� ° 6 i���ti� A '��f i' 'a � .' ' t r �'$°t7Nl�'�'ii's,di!�ki�K�a� a�z�IDL'�� il��vP_�hhl��h t�hw�q�rtara�.�.i.� ,� J „(Ilba�tl% �a�"`�r�..n (i�.;S�",i,��"a � . , �&ro�'1i i ti� �.9 � ,�t�na r��"ty�i� 5a IN�1°�� � �� �.�: as�-.„ . wfl���� °a �� � � nikd�p�'�=,ri.,i k ti�c � � �8���tl`�rca`�����. Y .i. � '3" �.d +�..?e ."� �. 1��6�f � U�'i � t.. 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I B a lj�� . . � �'i � .} g_�� m i, x �� ��_� � : i a { r � � �i� �;�7,���� - *a�'T' Sw,�, �„�; �„ �u,�. � �i �" ��-' � : � i . �89�� ����� ��a� a �., ��. � �i �,i �, .�-� �,.��3��. �a.a� p � 1 ' u � �' 1 �' ' ���{���.�REDJ `w;��v,,r � 4 ° r �; , � az � � '� ,,� �''''���ir., avs'`z: a� *7� d?t���9 ��� ��"^�d9� �� �k d � 9 �s u� 1i ��k �:� w.. .0�§.t «.,.�< � .d �_,.. . �`"�i�.x �., . ... `�"�,'�:a'�" „ . � . . . � �A.I��.�I�E� � - � -- : DAVIE COUNTY HEALTH DEPARTMENT ,,a� "�. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION �NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatme�t and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number ` Name ' �.': � �-' r; Date , . . /�� - ' . Location _ . � r{. � .,�' �% .�' _ i;� 6�6� , , . � , , . . . , __ ,, __ . . % �; i �' i,. ; - ,' � �liti Subdivision Name Lot No. _���- -' ' Sec. or Block No. Lot Size `� ��%� �% House �nf , Mobile Home _ Business -- Speculation No. Bedrooms ��— No. Baths _�!'_' No. in Family _ Garbage Disposal YES � NO ❑.= Specifications for System: Auto Dish WasHer YES ❑ NO 0 t- Auto Wash Machine YES ❑ NO ❑ � � ` ` � ,-- , . , Type Water Supply � � --- � - %� �' . "This permit Void if sewage system described below is not installed within 36 months from date of issue. � _- . �� ^� ` '6" . 1 ' ' t �.._...._.._.. . .. .. .. .. ....... . _. .. . _.._...___.._.. ......., � 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. �� r .�' - Final Installation Diagram: System Installed `1 . ( � " F �,. 1 � / ;< ;; _,-'� �;�� . , � � _. , �; �"�_ �' i ���,- � � _ ;%, . � ,'' ���. ..- �:: � t , � _ � � _� ��� j� � . � , �_.L.�` i./..�'"f''��"� .i - .1 ,.� _�i` r, � �;,,-. ��_,`,� / " � % Certificate of Completion _ - Date � __ 'The signing of this certificate shall indicate that the system described above has been installed in compliance 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. S •+'�' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT �` � Davie County Health Department a Environmental Health Section P. O. Box 665 ��C,�6��� d"l�i� � Q j�� Mocksville, N.C. 27028 � CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone �3`�- 5 3►0 1. Permit Requested By �lasap�. Sr..: ��. Business Phone 2. Address 31'1 w•,�Ye,�,U„ S�• vK��ra„���c 3. Property Owner if Different than Above Address 4. Permit To: a) Install �--� Alter Repair b) Privy Conventional ✓Other Type Ground Absorption c) Sub-Division Sec. Lot No. 5. System used to serve what type facility: House Mobile Home �-- Business Industry Other b) Number of people � 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions Bed Rooms a Bath Rooms ��rz- Den w/Closet b) If Business, Industry or Other, State: fVumber of persons served What type business, etc. '--- Estimate amount of waste daily (24 hours) 7. Number and type of water-using fixtures: commodes urinals garbage disposal `� lavatory showers washing machine `� dishwasher Y sinks 8. a) Type water supply: Public ✓ Private Community b) Has the water supply system been approved? Yes `� No 9. a) Property Dimensions 1'•�1� Iess L� 2- �•�.- b) Land area designated to building site c) Sewage Disposal Contractor �_ 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. I S- z� -� 6 Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: 1 S-�- �2 .�.��SL ��- � old 3^'=� ^ 1c1 vvt r t CT.. 1 e. {'r '} . � i. Ic F�- �fa ► — T� Cz�- `'to-.QG„va�ly �- ��.:.._.Q d � � h �.,� ,,-` OCHD (6-82) � " . . , .. � •�. �•1 May 20, 1986 To Whom It May Concern: This is to certify that the house on our property located on Yadkin Valley Church Road ( Tax Map C-6, Parcel Number 107.01) is not and will not be used for rental purposes as long as we both shall live. � . � ,��,� , � 2, Joseph H. Smith ��� .�2�r' � . L , ���'I,c�� Geneva C. Smith NORTH CAROLINA DAVIE COUNTY I, Pamela S. Purvis, a Notary Public for said County and State, do hereby certify that Joseph H. Smith and Geneva C. Smith personally appeared before me this day and acknowledge the due execution of the foregoing instrument. Wit:zess my hand and official seal, this the 20 day of MaX, ?986. _ G.�JLo- � . `� L�7 � � ' Notary Public My coTM►.;►issz.on expires June 25, 1990. DAVIE COUNTY HEA�TH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 - SOIL/SITE EVALUATION Name ,e ��1�°�/• c-S Date ��lj_.T�� Address Lot Size 1) Topography/Landscape Position 2) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) 3) Soil Structure (12-36 in.) Clayey Soils 4) Soil Depth (inches) 5) Soil Drainage: Internal External 6) Restrictive Horizons 7) Available Space 8) Other (Specify) 9) Site Classification U—UNSUITABLE Recommendations/Comments: AREA 1 �`�U `� SS �. � � S � S � � PS U S PS U S—SUITABLE Described by "����,L Title SITE DIAGRAM DCHD (6-62) l..r�../ U PS S S ._._�� SC�rJ� U� � AREA 3 S US S PS U S US S PS U S PS U S PS U � S PS PS U U S S PS PS U U /PS—Provisionaliy Suitable C Date AREA 4 S US S PS U S PS U S PS U S PS U S US PS U S PS U