2183 Cornatzer RdDavie CGanty, NC
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Tax Parcel Report
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Wednesdav_ October 12. 2016
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WARNING: THIS IS NOT A SURVEY
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' Parcel Information
Parcel Number: G700000080 Township: Shady Grove
NCPIN Number: 5860916073 Municipality:
Account Number: 82522077 Census Tract: 37059-803
Listed Owner 1: WOODRUFF CHRISTINE H Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 478 WILKESBORO STREET Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20,H-B
State: NC Zoning Overlay:
Zip Code: 27028-2030 Voluntary Ag. District:
Legal Description: 27.50 AC CORNATZER RD Fire Response District: ADVANCE
Assessed Acreage: 25.15 Elementary School Zone: SHADY GROVE
Deed Date: 12/1999 Middle School Zone: WILLIAM ELLIS
Deed Book / Page: 2000E0002 Soil Types: GnB2,GnC2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value:
Land Value:
Total Assessed Value:
0.00 Outbuilding & Extra 4500.00
Freatures Value:
263760.00 Total Market Value: 268260.00
35570.00
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�.v� All tlata Is provided as Is without warranty or guarantee of any kind aither expressed or Implled Including but not Ilmlted to the
O�" ` F Davie County� Implied warranties of inerchantability or fitness for a particular uso. All users ot Davie County's GIS websito shall hold harmless the
County of Davie, North Carolina, its agents, consultants, eontractors or employees from any and all claims or causes of action due to
np�, x.�i NC or arising out of the uso or inability to use the GIS data provlded by this website.
6
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIRI
HONE NUMBER � ! � '- � �� Z
UBDIVISION NAME
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DIRECTIONS TO SITE � � � � �"� ��-�- �-v �-/1. ��2- 6'� �ti��'�.�r�.•-u-
(' o re � a..�-z�it. `�.( . rY�.o % �/ e, � a n..e_ f5 �-, ce. 1 a-cro .rs �c d�.. �✓t �e, 6� L-
DATE SYSTEM INSTALLED ��` s NAME SYSTEM INSTALLED UNDER C7 �r�e.- {�e-n.�`[c.�r
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED �
TYPE WATER SUPPLY "�.J l%�-V SPECIFY PROBLEM OCCURRING �i ���-S /�e����erl
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DATE RE�UESTED l l�/O a INFORMATION TAKEN BY,
Thls is to certify that the information provided is correct to the best of my knowledge, an�t I u�de
SIGNATURE OF OWNER OR AUTHORIZED AGENT.
Rev. t/93
for all chargys incurred }rom this application.
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auTx��azATlotv�vo: `}� �� DAVIE COUNTY HEALTH DEPARTMENT
� Environmental Health Section PROP�RTY INFORMATI
Permittee's ^, -�c�. � � �
, �,.,� ,,,,. �/'� P.O. Box 848 � �S"`N—
Name: ��,+ 1;�-1 +" 1Vi'.�t'�CZ,� Mocksville, NC 27028 Subdivision Name:
/ Phone # 336-751-8760
Directions to property: l/,�� �� Section: Lot:
,n AUTHORIZATION FOR
t�...���'�� �-�'' � C., C.{a t`1��.`j� �L�""� WASTEWATER
T Off' PIN•
,,.� ; ' ,� SYSTF.M CONSTRUCTION ax � e .# - - _
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**NOTE** T'his 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.
(ln compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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� ***NOTICE*** TH1S AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�!' � 7 IS VALID FOR A PERIOD OF FIVE YEARS.
EI 1ED
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�` �; f{ ��� .� » �, � � � r �% +�� DAVIE COUNTY HEALTH DEPARTMENT ; . ,
�, �`• ,�' . r� • TMPROVEMENT AND OPERATION PERMITS PROPF�RTY INFORIVIATION�""!"�'
: Perpitttee s : , , ;; CJ'��- �S"`f�— � �
� ~ ��am�: - �.. s, :�..�,�1._ 1 �" 1 \� , ...;:. t; �;'` Subdivision Name:
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� Directions to property: "� . r-�t �� ���" Section: Lot: '
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_ r , IlVIPROVEMENT '
,r '> "',� (:�`i � "�.::,�� j;;..j"� t,,.)'' "1 � :".., " PERMIT Tax Office PIN:#
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**NOTE** This Improvement Pernut DOES NOT authorize the construciion or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWAI'ER 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, Sec6on .1900 Sewage Treatment and Disposal Systems)
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�` " ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE .
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,_ ,� _ �, �-'�w r'r' :"' ,.,;'� PLANS OR TFIE INTENDED USE CHANGE. YOUR WASTEWATER
EI�iVIRONM$ TAL EALTH SPECJALIST D� TE SSUED SYSTEM CONT'RACTOR MUST SEE TI�S PERNIIT BEFORE
t�-,,_.. •.. .- i INSTALLING THE SYST'EM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE M� # BEDROOMS �# BATHS �_ # OCCUPANTS �_ GARBAGE DISPOSAL: Yes or No
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COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY � DESIGN WASTEWATER FLOW (GPD) ���� NEW SITE REPAIR SITE �"'�
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SYSTEM SPECIFICATIONS: TANK SIZE �ct�O GAL. PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTH � 2 LINEAR FI'. =4p �
OTHER � � ! �I�j IL�(��i( D� �Q}C
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REQUIRED SITE MODIFICATIONS/CONDITIONS: '�C�P ��'�" ��"' "���^ �'"
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�R9�AFcIIUED E�FLU�P3T �ILTEft� �RIS�Rt�) I� 6" E2�'.� FINI5]�wr-.A CF��D��
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**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.
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OPERATION PERMIT
CEM INSTALLED BY: t�� LLIA '1�— '�' L-��L S
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, AUTHORIZATION NO. �"� OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED A O HAS BEEN INSTAj.LED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .19Q0 "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 OS/96 (Revised)