201 Buddy Trail Davie County,NC Tax Parcel Report Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
P
arcelInformahon
Parcel Number: G70000004002 Township: Shady Grove
NCPIN Number: 5769499424 Municipality:
Account Number: 8305662 Census Tract: 37059-803
Listed Owner 1: STRICKLAND VESTER BLEASE Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 1945 CORNATZER ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 1.25 AC OFF CORNATZER RD Fire Response District: CORNATZER-DULIN
Assessed Acreage: 1.24 Elementary School Zone: CORNATZER
Deed Date: 9/2015 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 010000973 Soil Types: WeC,WeB,RnD
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 68700.00 Outbuilding&Extra 2610.00
Freatures Value:
Land Value: 23790.00 Total Market Value: 95100.00
Total Assessed Value: 95100.00
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County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATION No: '� .DAVIE COUNTY HEALTH DEPARTMENT
., .
Environmental Health SectioYn " PROPERTIRMA
Perm►ttee's /
PO..Box
84&' __
;Name. � �yM[ }r1It / n ►�aA� {� ocksville,NC 27028 . Subdivision Name: Od
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Phone..# 336-751'87
Directions to property: ({CLi. 't O Section Lot:
AUTHORIZATION FOR
`lU1 rs t- U,J �, �C}'� T ► WASTEWATER
L SYSTEM CONSTRUCTION. Tax Office PIN:#
Road Name .�J )D K7)"
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any.Buildin erm►ts.This Form/Authorization Nup
mber�should be resented to the Davie Coun Building Inspections
Office when applying for Building Permits.
(In compliance ith Article I l of ,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.
ENVIRQ�I V ENTAL HEALTH SPECLkl ST DAT ISSUED
_� < 'k.� �•.. � DAME C01YNTY HEALTH DEP` r �(
IMPROVEMENT AND OPERATIONIIITS T, PROPERTY INF•RMATI N
'Perini ttee's Q
Subdivision Name: 4)�fa a
Direction to property: L! 1\-" L` Section: Lot:
z �1 IMPROVEMENT
PERMIT Tax Office PIN:#
P. 7t .�
S t Road Name: At l _ ZIp;'"'"'r '. `d
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation 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)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
G - PLANS OR THE INTENDED USE CHANGEr YOUR WASTEWATER'
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING,THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE_M I-� #BEDROOMS #BATHS _#OCCUPANTS�_GARBAGE DISPOSAL:Yes i Nb
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
7
LOT SIZE TYPE WATER SUPPLYbJ � ' DESIGN WASTEWATER FLOW(GPD) �� NEW SITE REPAIR SITE)
SYSTEM SPECIFICATIONS: TANK SIZEGAL. PUMP.TANK GAL. TRENCH WIDTH 3c/ ROCK DEPTH 1 Z LINEAR FT. C
OTHER FILL 1 ,J I_Otu) o o t3P- -,s-r J 6 &1 L 0Tw
REQUIRED SITE MODIFICATIONS/CONDITIONS: �'t 1 ACC-A t_,nJ"% '1`a'i'r W I LL 7-Z u JD L.IC> &W,Uc>
dFF M �laN•,�
IMPROVEMENT PERMIT LAYOUT
*APPROVED:EFFLUENT FILTER* *RISER(S) IF 61' BELOW FINISHED GRADE*
Rdt-,kc. c.1ar DIEN- .10 {vT awe
Ur.)t)�.TW iS 5;cr►.r1
To S t oLM
X V-12
**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 THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-8760.
XXXXX)(XXX
OPERATION PERMIT
SYSTEM INSTALLED BY; �a1>4u6C4AYro-3
J� •
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AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE S ESCRIBED 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.
DCHD 05/96(Revised)
we's 2; CDO
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section /
PO Box 848/210 Hospital Street
Mocksville,NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT[/ REMODELING ❑ RECONNECTION ❑
Name: v i�kSC�'J `")eCb 4 Phone Number: (Home)
Mailing Address: L S JC,4 el�_> (Work)
Detailed Directions To Site: Le qs —1-b,
b � ��-t 1�� zt> )19 2tJ r�r�� �n Y
2b1L t_ _ L1kST` vIcx)Sz- t�'�'_
Property Address: 1j O y til L_
Please Fill In The Following Information About The Existing Dwelling:
Name System Installed Under: Ct— � Type Of Dwelling: • l` w.
Date System Installed(Month/Day/Year): tan Number Of Bedrooms: 3 Number Of People:
Is The Dwelling Currently Vacant? Yes❑ No U,---If Yes,For How Long?
Any Known Problems?Yes 2""No Oe�'4 If Yes,Explain: i3 �A L Ll
Please Fill In The Following Information About The New Dwelling:
Type Of Dwelling- 5 o� M t� N r Of Bedrooms: Number Of People:
Requested By: ao Date Requested: �Z
A(Signure)
For Environmental Health Office Use Only
Approved ❑ Disapproved
Comments:
Environmental Health Specialist Date
''The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a
guarantee(extended or limited)thatihe on-site wastewater system will function properly for any given period of tirpe.
Payment: Cash❑ Check Money Order❑ # 7 0 /0 d 3 Amount: $ Date: b J
Paid By: ) / Received By:
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Account #: / 3 Invoice #:
3142u`k�
FS DAVIE COUNTY HEALTH DEPARTMENT d X'�¢�?
Environmental Health Section
• " PO Box 848/210 Hospital Street
a. Mocksville,NC 27028
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Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT REMODELING ❑ RECONNECTION ❑
Name: v��'J ��'� 4 Phone Number: (Home)
Mailing Address: I G r� +r 3 (Work)
Detailed Directions To Site: (4-4L 7b
'Property Address: _-
Please Fill In The Following Information About The Existing Dwelling.
Name System Installed Under: °_ 5ar.�D CA Type Of Dwelling: k �'�t7►�..5
�S� 3 Number Of People
Date System Installed(Month/Day/Year): Number Of Bedrooms: p
Is The Dwelling Currently Vacant? Yes❑ No®/ If Yes,For How Long?
Any Known Problems?Yes 2-.*'No 41"""If Yes,Explain:
.1
Please Fill In The Following Information About The New Dwelling:
,;Type Of Dwelling: ' ''L xb M A•N r Of Bedrooms: Number Of People:
7�
Requested By: WQ Date Requested:
(Sign tore) t'
r
For Environmental Health Office Use Only
Approved ❑ Disapproved
Comments: Ct d!f
Environmental Health Specialist Date
*The signing of this form by the Environmental Health Staff is in no way intended,ih bind be taken as a
guarantee(extended or limited)that eon-site wastewater system will function properly for any given period of e.
Payment: Cash❑ Check oney Order❑ # !70 /00 3 Amount: $ Date: v dPaid By: Received By:
Account #• q3 s t'. ;i Invoice #:
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DAVIE COUNTY rHEALTK DEPARTMENT,,
IMPROVEMENTS PERMIT,AND CERTIFICTE�OF-COMPLETION
•N07E:Issued in Compliance With Article II of G.S.Chapter!30a'
anit ry Sewage Systems Permit Numb-or
/ /e 2
Name.�Jp �t �•�I'Ald� XS �����Date• �,.�lG= ,.� M.�: NO: 685 —
`Location �O .0 .�i"1�f Oir/ �Fi�,�72�i i•G.rs AD�=rtdh d�r_ /
i i C� /`/C!!rC O/1 f�f G!L /l'.✓..1�i� �.'✓ C ' O I(O stJ �C chi! C!"
t Subdivisiorl Name Lot No. Sec..br'�Block No. '
_Lot Size � House Mobile Home':=���'- ---•—Businesses Speculation
y No. Bedrooms No:Baths'.__2 No. in Family .. —
j;Garbage Disposal; l .YES O Nd ?
x ;-Specifications-.tor System.,.,,...._
.Auto Dish Washer YES �] NO p r• _._, /
Auto Wash Ma^pine YES (Fj NO p '.••• ----- i- 17
-
.:TYPe.Water Supply �� �0�.�•S'���. :� ,:._ � I. .
-'This permit Void if sewage system described below Is not installed within 5 years from date of issue -•* -
-
+This permit is subject to revocation if site plans or the Intended use change:'"- - - -
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Improvements permit by
'Contact a representative of the Davie County Health Department for final inspection of,:this,,system_between.8130-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985.
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Final Installation Diagram: ,±�'� System Installed by
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Certificate of Completion:• 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 funct:an
,satisfactorily for any given period of time.
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