222 Whitaker Rd .•�= :��;� . � � �
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Da�ie County Health Department ��
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�OPs I�' Environmental Health Section ' ,, ,
�� : `� ' P.O. Box 848 •
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� ,�s„ 210 Hospital Street :��,,
O U �'� Courier# : 09-40-06 �' 1911
Mocl:sville, NC 27028 . �
Phone:(336)-753-6780 ON-SITE WASTEWATF���TIFICATION "i Fax:(336)-753-1680
(Clieck One) Replacement _,Remodelin� Reconnection
Name: ��h h V L ��/i�r S Phone Number C � „J 1 �lv� /G 7 (Home)
Mailing Address: ..2�,� C.J11� ��y r ��. yS/h��ake2 "�`��� /G� � �� 7� �Work)
/�(�'C(���./'�� �� �,7p.2{j' Email Address: �
Detailed Directions To Site: - _O C.�V1 ►" [-..�1 � G C� � f"� � G� �e
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Property Address: � ���� r� O _ ''C. /11 _ 7G �-�
Please Fill In The Following n drm 'ti6�1"Abou he EXISTING Facility: ,:,
Name System Installed Under: Type Of Facility:'" �,h(}�,j�
. Date System Installed(Month/Date/Year): /��� Number Of Bedrooms: -3-: Number Of People: �
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Is The Facility Currently Vacant? Yes No If Yes,For How Long? �'( �/�,',T_y"� -,��
Any Known Problems? Yes No If Yes,Explain:
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Please Fill In The Following Information About The NEW Facility: �j�����J��N�' {��1 r)s/�'�Z� I����'/t/��/�/�al���,,!
Type Of Facility: C��� i '� � �r .S Number Of Bedrooms: � Number of People��
Pool Size: Garage Size: ��� � � Other: - �'
Requested By: � ,v(/' Date Requested: /- 3�- /3
(Signature) '
1,�..`"�"''•�, For Environmental Health Office Use Only
�J�pproved ' Disapproved
`�Comments: _
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Environmental Health Specialist � ,. ' , ; i i. 1 (�,(, � Date: �)%;'�(�:/;IC�1�
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*The signing of this form by the Environmental Health Staff.js in no way intended,nor should be taken as a guarantee
. (extended or limited)fhat the on-site wastewater system will function properly for any given period of time.
Payment: Cas � Check MoneyOrder # '�Amount:$ �UU Date:
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Paid By: �,�l�(//���,Cy Received By: �f`���J:!�(
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Account#: ��2� Invoice#: 7�y �
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ti Printed:Jan 17, 2013 '
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied warranties
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its age�ts,consultants,contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use
the GIS data provided by this website.
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t Apphaisal Card Page 1 of 1
DAVIE COUNTV NC 2 11 2013 11:40:22 AM
MYERS KENNY L Retum/Appeal Notes: GS-000-00-128
22 WHITTAKER RD UNIQ ID 10921
2520604 D215-F6 ID N0:5749493235 C
COUNTY TAX(100),FlRE TAX(100) CARD N0.1 of 1 �
eval Year:2013 Tax Year:2013 0.573 AC WHITAKER RD 0.650 AC SRC=]nspedion
raised b 19 on 07/14/2008 06004 ELISHA CREEK TW-06 C- EX-AT- LAST ACTION 20110712
CONSTRUCTION DETASL MARKET VALUE DECRECIATION CORRELATION OF VALUE -c
m
oundation-3 Eff. BASE Standard 0.4300 —
ontlnuous Footin 5.0 US MO Area UA RATE RCN EYB AYB REDENCE TO MARKET `��
ub Floor System-4 Ol 01 1 528 112 76.40 11979 197 194 °o GOOD 57.0 DEPR.BUILDING VALUE-GRD 68 28
. I ood 8.0 DEPR.OB/XFVAWE-GRD '
u[erior Walls-08 T'PE:Single Family Residential Single Family Residen[ial ?�
MARKET LAND VALUE-CARD 15,43
. asonite on Sheathin 29.0 $TORIES:5-Ranch w/basement OTAL MARKET VALUE-CARD 63,71 �
oofing Struc[ure-03
able 8.0
oofing Cover-03 OTAL APPRAISED VALUE-CARD 83,71
5 hal[or Com osltlon Shin le g,0 OTAL APPRAISED VALUE-PARCEL 83,71
n[erior Wall Construction-5
wall/Sheetrock 20.0 OTAL PRESENT USE VALUE-VARCEL
nterior Floor Cover-OB OTAL VALUE DEFERRED-PARCEL
heet Vin I/Laminate 6.0 OTAL TAXABLE VALUE-VARCE� 83,71
nterlor Floor Cover-14 VRIOR
r et 0.0 +-1 2-+ BUILDING VALUE 70,10
IUST I
eating Fuel-03 1 1 B%F VALUE
as 1.0 6 5 LAND VALUE 14,69
eating Type-SO I I RESENT USE VALUE
eat Pum 4,0 +-1 2-+--1 9---+ EFERREO VALUE
ir Conditloning Type-03 I B V G I I - OTAL VALUE 84 79
entral aA I = I
drooms/Bathrooms/Half-Bachrooms Z Z 2 ,
/1/0 8.00 6 6 6 PERMIT
drooms f I I
S-3 FUS-0 LL-0 I I I CODE DATE NOTE NUMBER AMOUNT �
throoms I I I '
AS-1 FUS-0 LL-0 +-3 2-+--1 9---+ ROUT:WTRSHD:
SALES DATA -
OTAL POINT VALUE 6.00 +- -1 6--+
FF. INDIGTE
BUILDING AD7USTMENTS I WD D I RECORD ATE DEED SALES
ize 3 Size 1.060 1 1 BOOK PAGE M R TYPE PRICE
uali 3 AVG 1.000 Z 2 �
+- -16--+----27----+ 0473 393 3 00 WD Q I 8300 v
ha e/Desi 5 FACTOR 5 1.100 I g A S I 0432 113 8 00 WD Q I 6900 0
OTALAD]USTMENTFAGTOR 1.17 I I 0310 139 9 199 WD Q I 6100
OTAL QUALTTY INDEX Il I I 0116 719 4 199 WD Q I 4200 �'
2 2 r.
6 6 0386 725 9 001 WD E I
2 I
2 I
I I
+7-+--20---+--16--+ HEATEDAREA1,118
BFOP 8
i--2 0---+ NOTES
SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPR
GS ODE ESCRIPTIONLT HUNIT VRICE COND LDGJt B AYB EYB RATE V COND VALU
TYPE AREA % RPL t5 2 ARAGE 2 2 40 I5.0 10 _ L 197 197 5
AS 1 11 10 87651 1 TORAGE 1 1 14 15.0 10 L 197 197 S
UG 31 2 611 OTAL OB XF VALUE
OP 16 3 439
BM 80 2 1262 �
ST 192 4 603
DD 19 2 297
IREPLACE 1-None
UBAREA
OTALS 2,78 119,79
UILDING DIMENSIONS BA5=W27WDD=N12W16512E16SW16526E7FOP=58E20N8W20$E36N26;PTR=N55512 UBM=W33U5T=N16E12516W12$BUG=E12526W12N26$526E31N26
SSSN12§.
ND INFORMATION
IGHEST THERAD]USTMENTS LAND TOTAL �
ND BEST USE LOCAL FRON DEPTH/ LND COND ND NOTES ROA UNIT LAND UNT TOTAL ADJUSTED LAND LAND
SE CODE ZONING TAGE DEPTN SIZE MOD FACT RF AC LC TO OT TVPE PRICE UNITS TYP AD75T UNIT PRICE VALUE NOTES
� URAL AC 0120 182 203 2.7740 4 1.0500+30-OS+00+00+00 RG B 200.0 0.69 AC 2.91 23 886.6 15431.646 AC
OTAL MARKET LAND DATA 0.64 15,43
OTAL PRESENT USE DATA
I
http://maps.co.davie.nc.us/ITSNedAppraisalCard.aspx?parce1=G500000128 2/11/2013