1364 Davie Academy Rd Davie County, NC Tax Parcel Report �� Monday, September 26, 2016
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Pa_rcel Information
Parcel Number: J200000061 Township: Calahaln
NCPIN Number: 5717186923 Municipality:
Account Number: 43492000 Census Tract: 37059-801
Listed Owner 1: KOONTZ SAMUEL A Voting Precinct: SOUTH CALAHALN
Mailing Address 1: 1364 DAVIE ACADEMY ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-8201 Voluntary Ag.District: No
Legal Description: 52.41 AC DAVIE ACADEMY RD Fire Response District: COUNTY LINE
Assessed Acreage: 57.07 Elementary School Zone: COOLEEMEE
Deed Date: 6/1989 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 001490225 Soil Types: PaD,ApB,WeC,PcC2,RnD,ChA,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 117780.00 Outbuilding&Extra 5020.00
Freatures Value:
Land Value: 322780.00 Total Market Value: 445580.00
Total Assessed Value: 168920.00
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 ue 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
�'p UN44 NC or arising out of the use or inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**MOTE** This improveaent 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)
NAMEPROPERTY ADDRESS _���v�r�sl.�� ! DATE
LOCATION
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE y # BEDROOMS s� # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes6
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE/Od GAL. PUMP TANG GAL. TRENCH WIDTH k ROCK DEPTH '! LI R FT. 11
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BY -Ai!/
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN
8:30-9:30 A.M. OR 1:x-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED BY
�ro q
AUTHORIZATION NO. OPERATION PERMIT BY C�.(I DATE Q�
**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.
DCHD 10/95
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_ '� arra DAVIE COUNTY HEALTH DEPARTMEN
IMPROVEM(EMIT PERMIT and OPERATION
IMpROVWNT;PERMIT
#ATE** This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater
syst#m. _AN AUTHORIZATION( FOR WASTEWATER SYSTEM CONSTRUCTION oust 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 13OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME PROPERTY ADDRESS '/'I��%, .�?.; if� DATE
LOCATION J��,/� l� /i!'c'- /,�/?'a•r � i' .'�ll.,r �l/f1/! f ✓ r-F✓y /D IJ��JJdw.r�
./
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE `IF # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISO : Yeq_
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIIE/C4 GAL. PUMP TANK GAL. TRENCH WIDTH _?G 4 ROCK DEPTH /LINEAR FT. r''ed
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
k.
m*THIS PERMIT IS SUBJECT TO REVOCATION IF SITE'PLANS OR THE INTENDED USE CHAFE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BYlj'//
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN
8:30-9:30 A.M. OR 1:N-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED BY
in ro �
AUTHORIZATION NO. f i7 OPERATION PERMIT BY Z&W 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 13OA, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS', BUT SHAT IN NO WAY BE TAKEN AS A : -
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/.95
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Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 21028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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
Officewhenapplying for Building Permits.***
NAME Gl���I!? y`7D/h DATE .(��/ AUTHORIZATION ®R
MANE ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION 4L;11
COM ENTS/CWITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
**0GTICE*§* &S AUTHORIZATION R WASTEWATER SYSTEM CONSTRUCTION I5 VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE
DCIiD 10/95
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME 0 yi, rdO�s PHONE NUMBER 10463
ADDRESS 6:z D�2i�i �� SUBDIVISION NAME
LOT#
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY /L{ NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRINGY
DATE REQUESTENFORMATION TAKEN BY �C;►�
This is to certify that the information provided is correct to the best of my knowledgeknd that I understand I am responsible all charges incurred from this application.
j%.
SIGNATURE OF OWNER OR AUTHORIZED AGENT /
Rev.1193