219 Brook Dr Davie County,NC Tax Parcel Report 06'3 d 66 A' Monday, September 26, 2016
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Parcel Information
Parcel Number: 1400000022 Township: Mocksville
NCPIN Number: 5728791642 Municipality:
Account Number: 82527481 Census Tract: 37059-806
Listed Owner 1: PRIES JEAN CAROL Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: 219 BROOK DRIVE Planning Jurisdiction: MOCKSVILLE
City: MOCKSVILLE Zoning Class: MOCKSVILLE GR
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 1.14 AC BROOK DR Fire Response District: CENTER
Assessed Acreage: 1.01 Elementary School Zone: MOCKSVILLE
Deed Date: 8/2006 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 2006EO269 Soil Types: MrB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: MOCKSVILLE
Building Value: 95290.00 Outbuilding&Extra 190.00
Freatures Value:
Land Value: 25000.00 Total Market Value: 120480.00
Total Assessed Value: 120480.00
I v All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
9 ie,e F Davie County, implied warranties of merchantability 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 claims or causes of action due to
NCor arising out of the use or inability to use the GIS data provided by this website.
Permittee's DAVIE COUNTY HEALTH DEPARTMENT PROPERTY INFORMATION
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Name: �` s Environmental Health Section
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P.O. Box 848 1�
Directions to property: "r, 1� �'� Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
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AUTHORIZATION FOR Section: Lot:
WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION00J
AUTHORIZATION NO: `� A Road Name: IJ Zip: <<�C�
**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 Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article I 1 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
yr'�•'�a'/ `�/ �.1j,r` �''�/ '�/�,j IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS#OCCUPANTS ' GARBAGE DISPOSAL:Yes or No
COMMERCI/AL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or o
LOT SIZE +• / G TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) '' NEW SITE REPAIRS \
SYSTEM SPECIFICATIONS: TANK SIZE AL. PUMP TANK r GAL. TRENCH WIDTH .y �/ ROCK DEPTH ! ' —LINEAR FT.52 7<f
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REQUIRED SITE MO IFICATIONS/CONDITIONS:
IMPROVEMENT PE•MIT LAYOUT /
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT Y� �
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AUTHORIZATION NO. 30 OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
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Permitt"' DAVIE COUNTY HEALTH DEPARTMENT
0 PROPERTY INFORMATION
Name'. Environmental Health Sect
P.O. Box 848
Directions to property: Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
Section:Secti Lot.
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
AUTHORIZATION NO. 003050 Road Name-�_ zip:-",
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**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 Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS > #BATHS� #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFTfwi
#SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE r. r TYPE WATER SUPPLY, DESIGN WASTEWATER FLOW(GPD) 47 NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE --GAL. PUMP TANK—L—GAL. TRENCH WIDTH_ ROCKDEPTH �Ii.,INEAR Fr. 7
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OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
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IMPROVEMENT PE71T LAYOUT
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
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AUTHORIZATION NO.
L-Arc.-PERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME_ an Pries PHONE NUMBER 1761-200
ADDRESS �LI &616A2l V6 /N[IJC�1�✓� l�C, SUBDIVISION NAME
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DIRECTIONS TO SITE (D�� 0/V 7l7
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY f tlS-e- NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING r,(-
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DATE REQUESTED /0'l -/0 INFORMATION TAKEN BY VS(�r�/YW4
This is to certify that the information provided is correct to the best of my knowledg and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ,����
Rev.1/93
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