134 Blaise Church Rd/
Dav.ie Cauntv. NC
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Tax Parcel Report
Wednesdav. October 12. 2016
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Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1: BLAISE BF
Mailing Address 1: 134 BLAI
City: MOCKSVILLE
State:
Zip Code: 270�
Legal Description: 17.629 AC BLI�
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
WARNING: THIS IS NOT A SURV�Y
Parcel Information
H400000007 Township: Mocksville
5729748796 Municipality: MOCKSVILLE
7155000 Census Tract: 37059-806
'TIST CHURCH Voting Precinct: NORTH MOCKSVILLE COUNTY
�E CHURCH ROAD Planning Jurisdiction: MOCKSVILLE
Zoning Class: MOCKSVILLE HC,OSR
NC Zoning Overlay:
-0000 Voluntary Ag. District:
SE CHURCH(16.860 AC) Fire Response District: MOCKSVILLE
16.86 Elementary School Zone: WILLIAM R DAVIE
6/1998 Middle School Zone: NORTH DAVIE
002030352 Soil Types: PcC2,MsD
10 Flood Zone:
399 Watershed Overlay: MOCKSVILLE
2695950.00 Outbuilding & Extra 42990.00
Freatures Value:
547950.00 Total Market Value: 3286890.00
3286890.00
9��°'F Davie County,
�o�,K�j NC
No
AII data is provided as is without warra�ty ar guarantee of any klnd either expressed or implied Including but not limited to the
Implled warrantles of inerchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all clalms or eauses of actlon due to
or arlsing out of the use or fnability to use tho GIS data provided by this webslte.
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
� 5—�— �`�.�,7` C��c�t uC PHONE NUMBER
ADDRESS �3 � B�4-�- �`Y • SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
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DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
This is to certfy that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred irom this application.
.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Fisv. 1/93
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•. AUTE�ORI��'A1"I'I� a���. �� ����DAVIE COUNTY HEALTH DEPARTMENT :�� o _
+, Environmental Health Section PROPERTY INFORMA4t'iON� —
Permit�ee's ,/� ^'' ��,� n__ ^ P.O. Box 848
L���n
Name: �A:� �- .�--�'� �.Un'I��ksville, NC 27028 Subdivision Name:
' . � ° �u' � /;�.�.�. Phone # 336-751-8760
Directions to property: t� Section: Lot:
AUTHORIZATION FOtt
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SYSTF.M CONSTRUCTION —
Road Na�me! � LQ i�. G'. !-lv�� Zi'� �"7 CJ �
P � .�:_
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSCJED by the Davie County Environmentai Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(ln compliance with Article 11 of�i'.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
ik�ALTH
""'"'�- ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
.--' � I Z a i IS VALID FOR A PERIOD OF FIVE YEARS.
IST DA E ISSUED
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�;�.,� r i P:� s;��'�' a'�Y. �� IMPROVEMENT AND OPERATION PERMITS
Perm�ttee�s r ;':� � � .-�. � �,,,, -� , :,
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PROPERTY INFORMATION -�-• -- �-��
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Natr�e:� I �;�1 `= '�..- �-''�-�'. � � �,; + � � �? ti�=.,..�'�'� Subdivision Name: �
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Directions`to property: �''t }� n� d'� 'w � ! Section: Lot:
,�� " F ��1 � .,..a t � �-� `.' C t: �t +�j �PERMIT �
' lu '< <_}-� ,.1 �.= R � Tax Office PIN:# -
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Road Name� �,' �.. � 1 "' b - Zlp -.v"� i:, %' '✓
**NOTE** This Impmvement Pernut DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUT'HORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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._,�..--•�- �r:.. r' �.._.�....._ *** ***
,, ,� NOTICE THLS PERNIIT LS SUBJECT TO REVOCATION IF SITE
''`"� , iu t �: � �,�5 �--�, _. .n ��r + PLANS OR Tf� INT'ENDED USE CHANGE. YOUR WASTEWATER
� � SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
ENVIR�NMENTAL �i���EatLTH SPECIAf.IST DA 'ISSUED �STALLING THE SYS7'EM.
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RESIDENTIAL SPECIFICATION: BUILDING TYPE ��"'�"-F�# BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE ����`�# PEOPLE �# PEOPLE/SHIFI' # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE 1� �"""T PE WATER SUPPLY `�""'�fi� DESIGN WASTEWATER FLOW (GPD) 7/��� NEW SITE REPAIR SITE �
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SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH <� � 1 ROCK DEPTH �Z„ LINEAR Ff. � p
OTHER �2 �1 S�{ � 1%� I v .J �Oy , t- � .
REQUIRED SITE MODIFICATIONS/CONDITIONS: l�!�'� n�. I.- d� �''J TU U`�
IMPROVEMENTPERMITLAYOUT '�H����LED E�FLl1�i�T FILTER'+ +�-�I�EE�t3i IF 6�! �c�0�d FIt1IS3-icD GRRDE�-
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEP„ARz'MEAIT-�El� FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 63� �7fid° f' x�t x
(335)751-87b&}
OPERATION PERMIT i �% ( J L
�C.-l.D L/ Nvr SYSTEM INSTALLED BY: � �`�
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AUTHORIZATION NO. �\ OPERATION PERMIT BY:
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**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH�SYSTEM DESCRIBED
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREAT ENT AND DI OSAL ;
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GI� OF
DCHD OS/96 (Revised)
G- U G
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DATE: �
HAS BEEN INSTALLED IN COMPLIANCE
5", BUT SHALL IN NO WAY BE TAKEN AS A
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.-� IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
' TE:`lssued in Compliance..with;G.S. of North Carolina Chapter� 130 Article 13c
ewage Treatment and Disposal Rules� (10 N�C��A�C 10A :1934-:1968) � 1- Pel'mlt Number .
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Subdivision Name Lot No. _ Sec. or Block No. '�
,: � Mobile Home _ Business S� e ,�
Lot Size � Hous ��� �' � p culation
No. Bedrooms ��J No. Baths �= No. in Family r�/ �
Garbage Disposal YES p NO p' Specifications for System:,
, Auto Dish Washer YES p NO p� "� ��� ,� �<,�
Auto Wash' Machine YES ❑ NO .�p� �� a��
Type Water Supply %�r� ` .��- �J l>0. i(.� x/,,.%. ��
*This permit Void if sewag syst describe be w-is-not irt5tal4 with� �. months from date of issue.
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' '9:30 A.M. or .1:00-1:30 P.M. on day of completion: � Telephone Number. 704-634-5985 ' � � � -: �- - � � � � . � � �+
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"The signing of this�certificate shall indicate;that,the system described above has been installed'in compliance with��
�� :4the standards set forth in the above-regulation,�but shall in N0 way be;taken as a guarantee,that the'system will function . �'
satisfactorily for any given period of time. :-
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DAVIE COUNTY HEALTH DEPARTMENT
iMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
,• Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) r Permit Number
Name - ._ , � " , • , -
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Location' . , . ; - . r .` . ,.
Subdivision Name Lot No. Sec. or Block No.
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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 0'� ,:,: ,_
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Auto Wash Machine YES ❑ NO �"� ____ ._
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Type Water Supply � __— � `
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'This permit Void if sewag�yst described below is not" installed. within :36 months from date of issue.
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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.
Final Instaliation Diagram:
System installed by � _� � -� � �-=��
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Certificate of Compietion �'_ 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.
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- ; -"= :- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
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= NpTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c �
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
� Name � ,- y �- ; ,,-� , - ;� ;,Date ,� . , , _ . : .� `-i
Location'� ` � � " '� ' � �� - ., i . f � ; � - ; -
Subdivision Name Lot No. Sec. or Block No.
Lot Size House� r� r� '� Mobile Home _ _ Business _— Specuiation
No. Bedrooms ' � _ No. Baths _ �-r� No. in Family -' ` �' _
Garbage Disposal YES � NO �' Specifications for System:
Auto Dish Washer : YES ❑ NO p' ,, ,
Auto Wash Machine YES ❑ NO p� �' `
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Type Water Supply _ - "
`This permit Void if sewag��'system described�below-is not installed within` 36 months from date of issue.
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Improvements permit by —_ `w' ���'--'� �
*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.
Final Installation Diagram:
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System Installed by` `_� ` ��
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Certificate of Completion �-- -_ Date� - f�" �' ��
- �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. -
/
� < � DAVIE COUNTY HEALTH DEPARTMENT
� •.,'
- '�. �IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
�• Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name _ ;! ; ; % _ ,�; ._ Date � :. - - _ . . . .
� - ���. =�, ,- ����i �y�� r , �� ,,. r �
Location �'� � ` � ' � _
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Subdivision Name Lot No. Sec. or Block No.
Lot Size __ House %'� f'' `' Mobile Home _ Business _— Speculation
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No. Bedrooms No. Baths _%��! No. in Family _
Garbage Disposal YES ❑ NO Specifications for System:
Auto Dish Washer YES ❑ NO � ' "
Auto Wash Machine YES ❑_ NO �] , ��
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Type Water Supply ! - ___ �
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
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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.
Final Installation Diagram:
System Installed by
Certificate of Completion '�`'`G i�Q Date , `✓ ' ` �_
_-��_"C�
'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.
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' � ` � �'� • �IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
,
�• "NOTE: IsSued in� Compliance with G.S, of North Carolina Chapter 130 Article 13c .i �. r
�• Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name � — % % � ' Date � " ' � �� . -
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Location - '
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Subdivision Name Lot No. _ Sec. or Block No.
Lot Size __ ,House _ -' �' � Mobile Home _ _ Business __ Speculation
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No. Bedrooms __ No. Baths _. � No. in Family _
Garbage Disposal YES � NO [j Specifications for System:
Auto Dish Washer YES ❑ NO [j
Auto Wash Machine YES ❑ _ NO � � _ , , �
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Type Water Supply ___
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
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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.
Final Installation Diagram:
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System Installed by _.'' �' ��� � � � �'- �
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Certificate of Completion =� '���'� Date � ���' �l `__
'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.