187 Spring Valley Lane Lot 10Davie County, NC Tax Parcel Report Wednesday, November 9, 2016
9h,.y,.r8M data Is provided as Is without Mnnudy or guMMW of my kind either expressed wimplled Including but not limited to the
Davie County, Implledmi a, as a nnetlily chardabwfihiees Toro particular um Ali users of Gavle Counlys GIS website mall held ha.Im the
County of Dawe, North Carolina, Its agents, wmohants, contractors oremployees from any and ag ciaims orcauses of action due to
Opti 2 NC wadsing out ofthe use or lnabllhytu use the 613 data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Information
_
Parcel Number:
170000004307
Township:
Fulton
NCPIN Number.
5778150719
Municipality:
Account Number:
56329000
Census Tract:
37059-804
Listed Owner 1:
PERKINS MICHAEL L
Voting Precinct:
FULTON
Mailing Address 1:
187 SPRING VALLEY LN
Planning Jurisdiction:
Davie County
City: ADVANCE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-7342
Voluntary Ag. District:
No
Legal Description:
LOT 10 CARTERS COURT
Fire Response District:
FORK
Assessed Acreage:
4.96
Elementary School Zone: CORNATZER
Deed Date:
1112001
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
003950646
Soil Types:
WeC,PcB2,RnD
Plat Book:
0007
Flood Zone:
Plat Page:
084
Watershed Overlay:
DAVIE COUNTY
Building Value:
181680.00
Outbu ldi Va ue�a
FreaturesLand
24660.00
Value:
41410.00
Total Market Value:
247750.00
Total Assessed Value:
247750.00
9h,.y,.r8M data Is provided as Is without Mnnudy or guMMW of my kind either expressed wimplled Including but not limited to the
Davie County, Implledmi a, as a nnetlily chardabwfihiees Toro particular um Ali users of Gavle Counlys GIS website mall held ha.Im the
County of Dawe, North Carolina, Its agents, wmohants, contractors oremployees from any and ag ciaims orcauses of action due to
Opti 2 NC wadsing out ofthe use or lnabllhytu use the 613 data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #:
990000776
Tax PIN/EH #:
5769A4-0708
Billed To:
Michael Perkins
Subdivision Info:
Carters Court Lot # 10 P
Reference Name:
Michael Perkins
Location/Address:
Williams Road -27006
Proposed Facility:
Residence
Property Size:
420 x 520
ATC Number: 2171
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and
Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any
given period of time.
!1 K
/aA,
Septi System Installed By:
Environmental Health Specialist's Signature: Date:./t!>
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT Pd /I- Z-011
Environmental Health Section
I �a P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
990000776
Tax PIN/EH #:
57694140708
Billed To:
Michael Perkins
Subdivision Info:
Carters Court Lot # 10 a
Reference Name:
Michael Perkins
Location/Address:
Williams Road -27006
Proposed Facility:
Residence
Property Size:
420 x 520
71
**NO'I'E�*'I Is�iiiprovlement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater
system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this
Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type vSE #People_ #Bedrooms3 #Baths �.
Dishwasher: 0 Garbage Disposal: ❑ Washing Machine: 0--�Basement w/Plumbing: M Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People _ #People/Shift #Seats Industrial Waste: ❑
Lot SizeSizJ+roS Type Water Supply Design Wastewater Flow (GPD) j16D Site: New ® Repair ❑
System Specifications: Tank Siz%6t9 GAL. Pump Tank _ GAL. Trench Width rr Rock Depth �o� LineaFt
6 /
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 a BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.****
OIM.� /C¢//�`sio�t, — ��/���eP�/ � G'losz �o G✓•.ew o� s����'x'�e �
Environmental Health
DCHD 05/99 (Revised)
Signature:
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APPLICATION FOR SITE EVALUATION/IMPROVEMENF PERMIT & ATC
Davie County Health Department 1
�D Environmental Health Section , I JUN 2 3 1999
P.O. Box 848/210 Hospital Street
Mockaville, NC 27028
(336)751-8760 11, i, I W11i+
'T**IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Nems to be Billed �G--_ Kal I� Contact Person
Mailing Add reaa (1 Q (,� �L(- ) .� yy✓� /La/ Homs Phone
City/state/ZIP �,y�/--�l-t'� i (�% L., ;� ? d d6 Business Phone
2. Nacos on Permit/ATC if Different than
Nailing Address
City/BGG/zip
611/JI
Yl'�= y/moo
3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC Doth
4. system to service: AHouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
s. If Residence: # People # Bedrooms 3 # Bathrooms Z
Il Dishwasher P Garbage Disposal II Washing Machina ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Industry/Other: specify type
# Commodes
# showers
# Urinals
# People # sinks
# water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: ❑ County/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
-5 ° Iq ` �% bl,145
Properly Dimensions: lsC t WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # S 7 7 S' - o 6 - %(� 7.0 p7 b Li �a : �a �+ ✓�
Property Address: Road Name
City/Zip; i c _ 2706
r �-
If in a Subdivision provide information, as follows:
Name: C nt�- -.S
tour -F
l ,
Section:
Block:
Lot: d
I�' Date Property Flagged:
'Chis is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the Information
snh:nated i:. <::is :(,plica: a : ie �9eie=ed ar ens :fee. !, also, understand that I an c!: e.'vzrg^s in:un•ed from
this application. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures asnecessaryto determine the site suit bility.
DATEb 3 �/ /�� SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Client Notification Date:
EHS:
Revised DCHD (07/99)
Account No.
Invoice No. ���
rj. R ILA 100
1 0.
c 1
I,o.
P� )
it
lee
i
I ' ♦Q. LL
44
rf 99 /
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APP6.ICAI4T INFORMATION
Account #:
Billed To:
Reference Name:
Proposed Facility:
Water Supply:
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
. SoiVSite Evaluation
PROPERTY INFORMATION
989900562
Gray Carter
Gray Carter
Residence
Tax PIN/EH #: 5778-06-7187.07
Subdivision Info: Carters Court Lot $* IV
Location/Address: Williams Road -27006
Property Size: 5.1306 Acres Date Evaluated:
On -Site Well
Community Public
Evaluation By: Auger Boring Pit L/ Cut
FACTORS I 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH "
Texture group
Consistence i
Structure i /G
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure .
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:_
REMARKS:
LEGEND
EVALUATION BY:
OTHER(S) PRESENT:
Landscape Position
R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope
CC - Concave slope CV - Convex slope T - Terrace FP - Flood plain H - Head slope
Textu
S - Sand LS - Loamy sand, SL - Sandy loam L Loam SI - Silt
SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
CONSISTENCE
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
3e
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP -Non plastic . SP - Slightly plastic P - Plastic VP - Very plastic
Structure
.
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineraloev
1:1, 2:1; Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2
UCHD (Revised 05/99)
Dav
!U16
9syrdAll data Is provided as Is without wm
enty or guarantee of any kind ether expressed or Implied Including but not limited to the
Davie County, Implied wam idea of merchantability or gthessfor a particular use. Ali users of Delve Counlys GIS website shall hold harmless the
County of Dawe, North Carollna, Its agents, consubma, contract on oremployees from any and all claims orcauses of actlon due to
�ptl 4 NC or arising out ofthe use or Inability to "a the GIS data provided by this arebslla
WARNING: THIS IS NOT A SURVEY
Information._.
..Parcel
Parcel Number.
170000004307
Township:
Fulton
NCPIN Number:
5778150719
Municipality:
Account Number.
56329000
Census Tract:
37059-804
Listed Owner 1:
PERKINS MICHAEL L
Voting Precinct:
FULTON
Mailing Address 1:
187 SPRING VALLEY LN
Planning Jurisdiction:
Davie County
City: ADVANCE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-7342
Voluntary Ag. District
No
Legal Description:
LOT 10 CARTERS COURT
Fire Response District:
FORK
Assessed Acreage:
4.96
Elementary School Zone: CORNATZER
Deed Date:
11/2001
Middle School Zone:.
WILLIAM ELLIS
Deed Book/Page:
003950646
Soil Types:
WeC,PcB2,RnD
Plat Book:
0007
Flood Zone:
Plat Page:
084
Watershed Overlay:
DAME COUNTY
Building Value:
181680.00
Outbuilding & Extra
Freatures Value:
24660.00
Land Value:
41410.00
Total Market Value:
247750.00
Total Assessed Value:
247750.00
9syrdAll data Is provided as Is without wm
enty or guarantee of any kind ether expressed or Implied Including but not limited to the
Davie County, Implied wam idea of merchantability or gthessfor a particular use. Ali users of Delve Counlys GIS website shall hold harmless the
County of Dawe, North Carollna, Its agents, consubma, contract on oremployees from any and all claims orcauses of actlon due to
�ptl 4 NC or arising out ofthe use or Inability to "a the GIS data provided by this arebslla
DAVIE COUNTY HEALTH DEPARTMENT
! Environmental Health Section
Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
'Account M 990000776 Tax PIN/EH M 5769-44-0706.02 �3)
Billed To: Michael Perkins Subdivision Info: Carter's Court Lot # 10
Reference Name: Michael Perkins Location/Address: Williams Road -27006
Proposed Facility: Residence Property Size: 5 Acres
ATC Nummber: 2237
**NOTE**' his Improvement/Operation Permit DOES NOT authorize the construction of aseptic tank system or any wastewater
system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this
Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THI
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM
Residential Specification: Building Type D #People 3-- #Bedrooms #Baths_
Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: -X Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People_ #People/Shift #Seats Industrial Waste: ❑
Lot Size ��G� i eS Type Water Supply Design Wastewater Flow (GPD�n'O Site: New Et Repair ❑
i
System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width, 36' Rock Depth��'Linear Ft.:�06
Other
Required Site Modifications/C
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.****
f1En/�D L. ir�r_
4Pfog poi
C--ASO(6N7-
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
Date: /
Account M
990000776
Billed To:
Michael Perkins
Reference Name:
Michael Perkins
Proposed Facility:
Residence
ATC Number: 2237
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
MockrAlle, NC 27028
(336)751-8760
Tax PIN/EH M
Subdivision Info:
Location/Address:
Property Size:
5789-44-0708.02
Carters Court Lot # 10
Williams Road -27006
5 Acres
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWA e9NSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:
CERTIFICATE OF COMPLETION
Date:
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
has been installed in compliance with Article I 1 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and
Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any
given period of time. I
e
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
.ZAbd rl �
,_TaI�� q
V'k%I nef in AII�FX
Date: 5'� —OD
APPLICATION FOR SITE EVALUATION/IMPROVFMENi PERMIT & ATC D [] U
Davie County Health Department
Env/ronmenfal flealfh Section
P.O. Boa 849/210 Hospital Street NOV 21M
Mookaville, HC 27028'
(336)751-8760
***iMP=TAMT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL TSH REQUIRED
nUViMATION IS PROVIDED. Refer to the INFORKRTION BULLETIH for instructions
1. name to be Billed
milling Address
city/state/zIp
2. 'name on permit/ATC ii Different than Above
Contact
/J1 e-
Rams phone ,4? -
Business phone —%Z s •2134
Meiling Address Cit/y/state/sip
3. Application ror: 0 Site Evaluation L7 improvement Permit/ATC O Both
4. Bratsm to serviost O House .`A Mobile Home O Business O Industry O Other
s. If Residence: Y People # Bedrooms 3 ' # Bathrooms
O Dishwasher O Garbage Disposal )L^ehing Machina O Basement/plumbing 0 Basement/No Plumbing
6. If Business/Industry/Othert apecier type
i Commodes
i showers
# urinals
# people # Slake
� Water Coolers
Ir froODS mcz: # Seats Estimated hater Usage (gallons per day)
7. Type of Water supply: O county/City 11 Well O community
e.. Do you anticipate additions or expansions of the facility this system is intended to serve? O Yes O No
Hyes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUB6f IM by the client with THIS APPLICATION.
Property Dimensions: C/V (3YP--<WRITE DIRECTIONS (from Mocksviffe) to PROPERTY:
Tax Office PIN: a 3-76 Lu�-a7oR('// ° //i,�J �oa d/Property Address: Road Name i
City/Zip _I'TO '94C
Hin a Subdivision provide Information, as follows:
Name: G�����s GGUlvll-
Section Block Lot: -�
O
Date Property Flagged:
This is to certify that the information provided Is correct to the beg (if my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, H the site plans or intended ase change, or if the Information
submitted is this appRcadon b falsified or changed 1, also, understand that I am responsiblefor all charges incurredfrom
this app/icadon. I, hereby, give consent to the Authorized Representative of the Davie County Health Department
to enter upon above described property located In Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability..
DATE 44
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include
property Maes and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/99)
following: Existing and proposed
Site Revisit Charge
Date(s):
Client Notification Date:
Account No.
Invoice No. /
I
I_
'8i C,
R�
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APPUCATION FOR SFFE EVALUATION/IMPROVEMENT MMIT & ATC
Davie County Health Department
Ent omnentsiNesltbSectfon
P.O. Sox 868/210 Hospital BtrNt 11
Mootaville, NC 27028 fill (336)751-8760 1
***IjBORVMT*** THIS APPLICATION CANNOT BR FROCZ911= UHLE88 AIS+ THE REQUIRED
IIrf IMMION 18 PROVIDED. Refer to the IHiTOMION SULLETIH for instructions.
1. naso to be ai11W c n Contact peeaon 9 '���
If—
NaiUpq addross q' ae.e nona�"b'--
cit=/state/aIr % J business ahonax— ✓ �7/ oC.c ��O
2. wase on pecait/1,SC is Dietecant than
10ailinq address =covenant
sip
3. Application. For: 0 Bite 1iValaatiOA Permit/ATC D Roth
•. Isatea to Na710e: ;6 House O Mobile Rome O Business 0 Indus
a. If Residanoa: a People 7 6 Bedrooms
Industry
DUshaaehes O Oar6ago Diaposal Waning Ifachina
6. i! swinen/reWustsy/Othee, @paolLy typo
a CossoGs
e ahoaess
saawnt/pl:shinq
I usual,
0 Other
s Bathrooms 671 L
0 aaaanant/uo plumbing
people a /Lake
e water Cooler.
IP IPOO ORMCE: ti seats Eatimated Nater Usage laauons.per day)
7. Type of water supply: 0 Conaty/City Nall 0 Community
s. Do you anticipate additions or expansions of the facility this system Is Intended to serve? 0 Ya "a
If yea, what type?
CLIEM'S UMTCOMPLEMTHE
INFORMATION REQUESTED
Property Dimensions k S2 WRIT`E`DIRECTIONS (from MockrAlie) to PROPERT
�iY:�
Tax Olice PlNt N /Tw l/ D I�Y'�� /Zei'O`Q ,
.1-7469 7
Property Addrens Rad Name
If In a Subdivision provide lahrmadon, a follows::
Name: (J!l!'/C/�S Co&,�,-4-
Section: Blocks Lot: Date Property Flagged: ! _ 11
This Is to certify that the Information provided Is correct to the bat of my knowledge. I understand that any permll(s)
Issued hereafter are subject to suspension or revocations if the site plans or Intended an change, or If the Information
submitted ID this application is falsified or changed, It also, understand that Ian responliblefor all charges Iscarnd Jhors
this applIcados. Ip hereby, give cannot to the Authorized Representative of the Davie Canty Health Department
to enter upon above described property located in Davie County and awned by
to conduct all testing procedara a necessary to determine the site suitability.
DATE S'•' / �' • F9 SIGNATURE --,III
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property Una and dimensions, otroctara, setbacks, and septic loatlons). '
Site Itnwt Charge
Date(@): //- 9
—00 Client Notification Date:
1,�. Account No. �C
Revised DCIID (07/99) (%Wti' - f V' Invoice Na �
r��� �a'• Ing j 1
I I