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667 Deadmon Rd �avie County, NC Tax Parcel Report 4<{a Monday, October 3, 201 E - �, � ` 1 ,� l �1.�i �r f j�� f` 633 � E67 ' , '� r 6 5 5 rr + � . ..,.,,_� �.,,.,,�� , r � ; "�-�•.,,.�� _--�.y,_1 r"'''1 �' ^^-.,� "-�,,.,,,_ '',k � �+ '}�.,,� ��``�--�'�^�.,,,� i '' J ( t �^�-."^y� „T'^,-_ ��",._ \ � � 7 j+ —.,,,,,, -)� �-�.,,��"�"'�-__ '1 � I ..0 r ^'?-�..,..,.�_ '�'_.,,,�DL�,/�� r;' �~� � !r ' � �___ ~-�--��'�_�,,� � r1' 673 '� E 4 CI ! ` `� ' `".- � � `,`--�.,_ r y 1""'t�- -``-�=.,,,�,ti `"�-.,,,,ti( f �4� � � f `�'_`".,�- `' "`'- , �`.�!` "�-� � Jr�.,.,� "'^�-.ti j ! . '; � ""�-.,'""',--.,,.j.� � '^^- ��`-�.,. r + ,..,. I � �,�. �� - -�. - ,"'�.. � �� h r --+,. ^-ti �- r t ^^„�._ 5,�' �� f ''t ""'_-�,. "`"--_•,,,..Y"`1y-,. � r _ ........:................__._................_...................................................._..-'-'---------------��-`"-----..............._......-------..__._............................_.__.�_....i..:e.�D......................�t...._!:.1.....-----�----....................":.t-�..__.._............:.......ti..............._'.'�,..---------�-�--�----�--.._......_..._...................------'--.._... WARNING: THIS IS NOT A SURVEY �,_�r _ �a,� .� _._m.__,��,,. .... � �a,,�.,� ._ . , ,v,�n �__�___, ,��v�x__.__ .__.�._ __ _. _____ ... __.,,________ . _____._..._,_.__. __.._. �, ,. � �� Parcel Information � � � > Parcel Number: K50000004901 Township: Jerusalem NCPIN Number: 5747830366 Municipality: Account Number: 8301401 Census Tract: 37059-807 Listed Owner 1: MATLOCK JONATHAN M' Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 825 GREENHILL 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: LOT 43 D F MCCULLOUGH Fire Response District: JERUSALEM Assessed Acreage: 0.82 Elementary School Zone: CORNATZER Deed Date: 1/2002 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 2002E0028 Soil Types: CeB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 34180.00 Outbuilding&Extra 330.00 Freatures Value: Land Value: 17840.00 Total Market Value: 52350.00 Total Assessed Value: 52350.00 D�t All data is provided as Is wlthout warranty or guarantee of any kind either expressed or Implied Including but not Ilmited to the 9�A'"� Davie County� implied warranties of inerchantability or fltness for a particular use.All users of Davie County's GIS website shall hotd harmless the �T County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes oi action due to �'OUN�C� 1�C or arising out of the use or Inability to use the GIS data provided by this websile. . . * Davie County Hea.lth Department q�i$j� Environmental Health Section ' �,�_,{, . � � P.O. Box 848 . '"� �� ";�, 210 Hospital Street ^� If p. �... Courier# : 09-40-06 1�i i U � Mocksville,NC 27028 � Phone:(336)-753-6780 Fax:(336)-753-1680 ON-SITE WASTEWATER CERTIFICATIO (Check One) Replacement Remodeling Reconnection Name•.r�n�60�,Q,� I 1\C�� Phone Number o�c�to� r (Home) Mailing Address:��_�,r-�,7��,N J`��—��,�-d,� S �/ (Work) A�O� �SUI�� C EmailAddress: . � �a� Detailed Directions To Site: Property Address: ( C�i� (1 � Please Fill In The Following Information About The XIST G Facility: Name System Installed Under• Type Of Facility��l.�.(,J��.Q. Date System Installed(Month/Date/I'ear): �`�c� ��' Number Of Bedrooms:�_Number Of People:�_ Is The Facility Currently Vacant? Yes No If Yes,For How Long? Any Known Problems? Yes No If Yes,Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility:�� (�Q Number Of Bedrooms:y�_Number of People � Pool Size: Garage Size: Other: Requested By. 1 Date Requested: '7�� Signature) � For Environmental Health Office Use Only Appro ed Disapproved ,�/J � � � � �/ / �� 7 � omments: // ls(! f! -e� !��C�C � Environmental Health Specialist Date: Z� � '-'- � *The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee (extended or limited)that the on-site wastewater system will function properly for any given period of time. Payment: Cash Check Money Order # Amount:$ Date: Paid By: Received By: Account#: Invoice#: �� , `- � � DAVIE COUNTY HEALTH DEPARTMENT � Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (33G)751-8760 �� Account #: 990003388 Tax PIN/EH#: 5747-83-0366 Billed To: Alexander Carswell Subdivision Info: Reference Name: Rex Location/Address: Deadmon Road-27028 Pro osed Facilit : Residence Pro ert Size: .0948 acres ATC Number: 4426 AUTHORI�ATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MLJST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). 'This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATE CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: / Date:��/�`Lf�� CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit has been installed in compliance with Article 11 of G.S.Chapter 130A, Section.1900"Sewage Treatment and Disposal Systems,"but sh �n a u �ee that t e st 1 function satisfactorily for any given period of t� e. � ��'��hl h /`'�'s�� ' �.��i3XlV� j� _ � � l�/�� r C��,� --�....� - �' �, ��"� Septic System Installed By: �� l`�'G'� � �. Environmental Health Specialist's Signature: ,/`�"/�9'�� Date: �` 9 DCHD OS/99(Revised)