673 Deadmon Rd Davie County,NC Tax Parcel Report a3 91 Monday, September 26, 2016
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Parcel Number: K500000049 Township: Jerusalem
NCPIN Number: 5747830267 Municipality:
Account Number: 8304080 Census Tract: 37059-807
Listed Owner 1: ROLOFF ROBERT J Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: 673 DEADMON 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: 0.582 AC DEADMON RD Fire Response District: JERUSALEM
Assessed Acreage: 0.59 Elementary School Zone: CORNATZER
Deed Date: 9/2014 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 009670782 Soil Types: CeB2
Plat Book: 0010 Flood Zone:
Plat Page: 107 Watershed Overlay: DAVIE COUNTY
Building Value: 113100.00 Outbuilding&Extra 7850.00
Freatures Value:
Land Value: 12150.00 Total Market Value: 133100.00
Total Assessed Value: 133100.00
t.v r All data is provided as is without warranty or guarantee of any kind either expressed or Implied including but not limited to the
Davie County, implied warranties of merchantability or fitness for a particular use.All users of Davis County's GIs website shall hold harmless the
NCounty of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
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etmlttee s ^� f,_' DAVIE COUNTY HEALTH DEPARTMENT, ' 7 �
Nike. �.' �s Environmental Health Section PROPERTY INFORMATION
P.O.Box 848
Direcproperty: 't Mocksville,NC 27028 Subdivision Name:
1 - '' , Phone#:336-751-8760
�R,/SA/d V-5 3 Section: Lot:
AUTHORIZATION FOR
�'.D,/LHC�.� i•/I.r �s ,; ,✓�Ifsl1 r•�� WASTEWATER Tax OfficePIN:#
�y SYSTEM CONSTRUCTION
AUTHORIZATION NO: 2 3 8 4 A Road Name: Zip: 1
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior r n�
to issuance of any Building Perntits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permit-,, w Y
(In compliance with Article I I of G.S.Chapter 130A.Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
/ u ✓ ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�. IS VALID FOR A PERIOD OF FIVE YEARS. ,
ENVIRONMEN AL HEALTH SPECIAL IS r DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS/#OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION:FACILITY TYPE #PEOPLE #PEOPLF/SHIFT t #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPDj,�V NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS:TANK SIZE GAL. PUMP TANK GAL. TRENCH WID ���ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYou t
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF TRIS 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:
CX
AUTHORIZATION NO. 1OPERATION PERMIT BY: DATE. `
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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.
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•Fermittee's ---ff DAVIE COUNTY HEALTH DEPARTMENT
Name: J�J%' rS Environmental Health Section PROPERTY INFORMATION
1 ' P.O: Box 848'
Directions to property: Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
A-S1 41 Section: Lot:
' �^, ) �/ AUTHORIZATION FOR
//'Q/l%ni�•���/I C �,':i`% f�/;',SiC$(1 WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION � /�
AUTHORIZATION NO: iD 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 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! DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE .#BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
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
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTHSSF -'ROCK DEPTH LINEAR FT. �
OTHER
REQUIRED SITE MODIFICATIONS/CONDMONS:
IMPROVEMENT PERMIT LAYOUT
**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:
AUTHORIZATION NO: OPERATION PERMIT BY: 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 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 02A2(Revised
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