121 Adams RdDavie Countv, NC Tax Parcel Renort 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:
MOCKSVILLE
Land Value:
Totai Assessed Value:
WAKNING: TH1S 1S NO1 A SUlZVEY
Parcel Information
K300000029 Township: Mocksville •
5727255832 Municipality:
62814250 Census Tract: 37059-801
SAFLEY NOVELLA Voting Precinct: SOUTH CALAHALN
121 ADAMS ROAD Planning Jurisdiction: Davie County
�
2702&5166
7.129 AC DAVIE ACADEMY RDLIFE ESTATE
7.12
°" °'�' Davie County,
"oUN�� NC
1/1997
001920271
28890.00
54960.00
86480.00
Zoning Ctass: DAVIE COUNTY R-A
Zoning Overlay:
Voluntary Ag. District: No
Fire Response District: CENTER
Elementary School Zone: COOLEEMEE
Middle School 2one: SOUTH DAVIE
Soil Types: MrB2,EnB
Flood Zone:
Watershed Overlay: DAVIE COUNTY
Outbuilding 8� Extra 2630.00
Freatures Value:
Total Market Value: 86480.00
Permittee's ; i, ';� DAVIE COUNTY HEALTH DEPARTMENT
Name: '!� �-��L � 1 t� ' � �f � �•� `- � Environmental Health Section PROPERTY INFORMATION
- ,-;� : ti r� P.O. Box 848
Directions to property: ��`... �%� ��� t�� r�-�' �`� Mocksville, NC 27028 Subdivision Name:
Phone #:336-751-8760
AUTHORIZATION FOR
WASTEWATER
SYSTF,M CONSTRUCTION
AUTHORIZATION NO: � � � �' � �� A
Section:
Lot:
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Tax Office PIN:# � ` � -: j- - `�� . � .`: ; c'. _
Road Name: �_ 1 �'? r-, �`C�Zip: �`� 41%'<�'
'**NOT'E** This Authonzation for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Perrnits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Pennits.
(ln compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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' a ,`,�;�' j ,% ***NOTICE*** THIS AUTHORI7ATION FOR WASTEWATER CONSTRUCTION
�'`�i�l,!4„J� �J�(.�,:"f �:.1'���IL �`;;! =�; �-- ,"(� r;' IS VALID FOR A PERIOD OF FIVE YF.ARS.
EI�IVIRONMENTfKL HEALTH SRE 'fALIST DATE ISSUED
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RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEUROOMS �_ # BATHS �# OCCUPANTS
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS
GARBAGE DISPOSAL: Yes or No
INDUSTRIAL WASTE: Yes or No
'1 c':�'} a �? � ✓"
LOT SIZE TYPE WATER SUPPLY �N � DESIGN WASTEWATER FLOW (GPD) �:'`�� ��� NEW SITE REPAIR SITE
r �� �
SYSTEM SPECIFICATIONS: TANK SIZE �-l4�`l `t�.'G'�L!' pUMP TANK ��GAL. TRENCH WIDTH "�� �' ROCK DEPTH ��. /A LINEAR FT. 1 OD
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J�s �tateti in 15;� ►�f;t':C 1t3A.1�3Ei��5',
REQUIREDSITEMODIFICATIONS/CONDITIONS: �'-C�C1tSd SVt*tF?t"+lw r�73`, r,l�;;, �., ,��4�4
IMPROVEMENT PERMIT LAYOUT
2 �/ ('�—.
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FOR FINAL INSPECI'ION OF TH1S SYSTEM PLEASE CALL BETWEEN 830 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT
I �
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AUTHORIZATION NO�� `d�' OPERATION PERMIT BY:
SYSTEM INSTALLED BY: 1�. / til/ i �A �!M1t..-�
DATE: l %/`� lr'( •%/ /
"'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABO�V� HAS�EEN jNSTALLED IN COMPLIANCE
WTI'H ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL��YSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 07/02 (Revised) t i . .r�� ! y "'T'.-�v� 4 ��' (7 �;� /�. � j l
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Permittee's DAVIE COUNTY HEALTH DEPARTMENT
- � '" ' � �' � ` '''f '' Environmental Health Section PROPERTY INFORMATION
y Name: a �. t l� , �' �
- - P.O. Box 848
Direcdons to property: '� `t ;': i=�° r r: t-�C.� Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
AUTHORI7,ATION FOK
WASTEWATER
SYSTF.M CONSTRUCTION
AUTHORIZATION NO: � � � � � � A
Section:
Tax Office PIN:#
Lot:
Road Name: ' 1 �. Zip: < <
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Fonn/Authorization Number should be presented to the Davie County Building Inspections
Office when applyina for Building Permits.
(ln compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
;, ! ***NOTICE*** THIS AUTHORI7.ATION FOR WASTEWATER CONSTRUCTION
; '`- �'� �'+`..'i.f�-ii� -"° ,_ . �� • t - . ; -' IS VALID FOR A PERIOD OF FIVE YEARS.
ENV(RONMENTAL HEALTH SPE IA� LIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE ? r-; r�. # BEllROOMS �# BATHS �_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFI' # SEATS INDUSTRIAL WASTE: Yes or No
� _ :� �;��� ✓
LOT SIZE TYPE WATER SUPPLY �� �' �i i' I(� DESIGN WASTEWATER FLOW (GPD) ��'�: !/ NEW SITE REPAIR SITE
. • �. �
SYSTEM SPECIFICATIONS: TANK SIZE � 4`' ��G`AI/.' PUMP TANK ��GAL. TRENCH WIDTH ''�-��' ROCK DEPTH :1'•��� i'�� LINEAR FT. ' L'�—�
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OTHER ': � I' �S°C�l.ti yti;y� +�;}:t� .�. �,;t� t.%�.C<l.
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REQUIRED SITE MODIFICATIONS/CONDITIONS:
I IMPROVEMENT PERMIT LAYOUT
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 830 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
I OPERATION PERMIT
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AUTHORIZATION NO.�-��-' � OPERATION PERMIT BY.
SYSTEMINSTALLEDBY: I��� -�. ��� �i�` il,+i .�E..-' � �
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'*THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED A]
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL''SY�
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TI
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% t� , � DATE: �' ��f F f.%� �
-� � : ;�.
'E HAS BEEN I�VSTALLED IN COMPLIANCE
MS", BUT SHALL IN NO WAY BE TAKEN AS A
DCEID 02/02 (Revised) .,..'r �" U ' �"� � ' - ; ``� F j��,I
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