588 Cedar Grove Church Rd Davie County,NC Tax Parcel Report a��3 Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
+ LL_Parcel Information
Parcel Number: K700000068 Township: Fulton
NCPIN Number: 5767748082 Municipality:
Account Number: 82519751 Census Tract: 37059-804
Listed Owner 1: MYERS WILLIAM DAVID Voting Precinct: FULTON
Mailing Address 1: 588 CEDAR GROVE CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-7116 Voluntary Ag.District: No
Legal Description: LOT 1 WILLSTONE PLACE Fire Response District: FORK
Assessed Acreage: 0.84 Elementary School Zone: CORNATZER
Deed Date: 11/2002 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 004480857 Soil Types: PcB2
Plat Book: 0007 Flood Zone:
Plat Page: 240 Watershed Overlay: DAVIE COUNTY
Building Value: 63600.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 18220.00 Total Market Value: 81820.00
Total Assessed Value: 81820.00
I vi All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
O1 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 Davis,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.
-Permittee's ,DAVIE COUNTY HEALTH DEPARTMENT .
Name: % .->•� �'�.1. mental Health Section PROPERTY INFORMATION
`r P. ox 848
Directions to property: �' r /s'or't f'h9ocksv' e,NC 27028 Subdivision Name:
one#: 336-751-8760
r r� ,-;✓r Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION - -
AUTHORIZATION NO: 2473 A Road Name: Zip:
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie Countv.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 DA E ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS #OCCUPANTS J GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILT TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WAT . UPPLY'-0 ',DESIGN WASTEWATER FLOW(GPD) �✓(�'� NEW SITE - REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ~ ROCK DEPTH / v LINEAR FT"'W
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
t
IMPROVEMENT PERMIT LAYOUT 1
r
r
'*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 (336)751-8760.
OPERATION PERMIT /
SYSTEM INSTALLED BY:
IV
�41
AUTHORIZATION NO. J� rSHALL
: DATE: G/ �✓
**THE ISSUANCE OF THIS OPERATIONATE 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.
ncrrn ovoz(Re viseO • _ �/o
a'-Permitfee's f J ` DAVIE COUNTY HEALTH DEPARN1
Nage--•a % f "" oC? "'-E�nr�i mental Health Section lr PROPERTY INFORMATION
P. ox 848
Directions to roe ; Mocksv' e,NC 27028 Subdivision Name:
P P rt3''
P one#::336-751-8760
Section: Lot:
AUTHORIZATION FOR
' WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION -
AUTHORIZATION NO: 247,6 A Road Name: 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 Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article I I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
� w�< �, r! f r ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
i. r �'• IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST D&E ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE /}%,"/- #BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACIL14TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
t
LOT SIZE TYPE WATflR kPPLY `: DESIGN WASTEWATER FLOW(GPD) # NEW SITE REPAIR SITE_
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR Fr--2✓`0
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
EE D
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY 115A1rTV�PARTMENT FOR FIN4L 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 (336)751-8760.
OPERATION PERMIT s
SYS)TM INSTALLED BY:
AUTHORIZATION NO.� �rTIONPERM,
DATE:IV
**THE ISSUANCE OF THIS OPERATIONATE 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.
DCHD 07102(Revised)� G•�"=L /�� �1 �, //J 5 V`-'„-.� � ���J . M
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME � �`
PHONE NUMBER
ADDRESS ✓� CY D SUBDIVISION NAME
LOT#
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY LIZ SPECIFY PROBLEM OCCURRING
DATE REQUESTED /XS�INFORMATION TAKEN BY �l
This is to certify that the information provided is correct to the best of my knowle and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT i
Rev.1/93
✓ / ��