1723 Farmington Rd Davie rount � NC Tax Parcel Report � Friday, September 30 2016
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WARNING: THIS IS NOT A SURVEY
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: Parcel Information -
Parcel Number: D500000093 Township: Farmington
NCPIN Number: 5842657847 Municipality:
Account Number: 25066370 Census Tract: 37059-802
Listed Owner 1: FARMINGTON COMMUNITY ASSOC INC Voting Precinct: FARMINGTON
Mailing Address 1: %LAURA MATHIS Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-12,R-20
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 7.29 AC FARMINGTON RD Fire Response District: FARMINGTON
Assessed Acreage: 7.03 Elementary School Zone: PINEBROOK
Deed Date: 1/1900 Middle School Zone: NORTH DAVIE
Deed Book/Page: 000840411 Soil Types: AaA,EnB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 186260.00 Outbuilding&Extra 13000.00
Freatures Value:
Land Value: 80720.00 Total Market Value: 279980.00
Total Assessed Value: 279980.00
�,��� All data Is provided ae Is without warranty o�guarantea of any klnd either expressad or Implied ineluding but not Ifmited to the
O��e F Davie County� implied warranties of inerchantability or ftness for a particular use.All usen of Davie County's GIS website shall hold harmless the
�T County of Davle,North Carotina,its agents,consuttants,contractors or employees from any and all claims or causes of aetion due to
n�U N�i 1�� or arlsing out of the use or inability to use the GIS data provided by this website.
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�``'�-`�`_.`�����"`� �'y� Mocicsville, NC 27028 ����;��,.��'°�
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Phone:(336)-753-G780 P'az: (336)-753-1680
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Re onnection
Name: I�/II' l�'��II"v''�� ber �"!� ( �Iome
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Mailing Address: � G � (Work)
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Detailed Directions To Site: �D��`�
Property Address:
Please Fill In The Fol owinginformation About The EXISTING Fa�ileity:
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Name System Installed Under: � �-d��;r-ti�i�1 �a`C/ �a1'� Type Of Facility: � 1
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Date System Installed (Month/Date/I'ear): v� 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:
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Please Fill In The ollowing Information Ab he cility: '"e����'� � � k��� �d M;�� ��t,�
Type Of Facility: ber f Bedrooms:� '� Number of Peo le�
• Requested By: Date Requested: ,_r� � �" ,�,�� 1
(S ture) �—
For Environmental Health Office Use Only
Approve isapproved
Comments:
Environmental Health Specialis L_,., Date: G��
*The signing of this form by the Environmental Health Staff is ' 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 ieck Money Order # � I Amount'$ (���(,� Date: ` �Z��V
Paid By: Received By:
ACCOLlIlt#; �,��)J Invoice#: ����i�