355 Hall Walker Ln (2) Davie County,NC ` + Tax Parcel Report l q a lt !� Tuesday, October 4,2016
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WARNING: THIS IS NOT A SURVEY
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Pazcel Information
Parcel Number. C70000011603 Township: Farmington
NCPIN Number: 5872183789 MuNcipality:
Account Number. 53014000 Census Tract: 37059-802
Listed Owner 1: MYERS PANSY HOWARD Voting Preclnct FARMINGTON
Mailing Address 1: 355 HALL WALKER LANE Planning Jurisdiction: BERMUDA RUN
City: ADVANCE Zoning Class: BERMUDA RUN OS
State: NG 2oning Overlay:
Zip Code: 27006-7903 Voluntary Ag.District: No
Legal Description: 2.000 AC OFF HWY 801 Fire Response District: SMITH GROVE
Assessed Acreage: 2.�0 Elementary School 2one: PINEBROOK
Deed Date: 8/1999 Mlddle School Zone: NORTH DAVIE
Deed Book!Page: 003110875 Soii Types: PcB2,PcC2,ChA,WATER
Plat Book: Flood Zone:
Plat Page: Watershed Ove�lay: BERMUDA RUN
Building Value: 48150.00 Outbuilding 8 Extra 1370.00
Freatures Value:
Land Value: 54440.00 Total Market Value: 103960.00
Total Assessed Value: 103960.00
9��v��, All data is provlded u Is wBhout warra�r or puaraMee W any Idnd dtha e�►esaed w Implled includlag but not Iimked to the
Davie County� Implled wanaotles of inercha�kability or fttnesa fa�particular use.All usera of Davie Cowrty's GIS websRe ahall hold harmless the
Caunty oT Davle,North Carvlina,its�geirts,consukaMs,coMractas or employees irom airy arM all clalms or uuses of actlon due to
�'pUN�'� NC or arlsing out of the use w Inablllty to use the GIS dah provlded by fhis websMe.
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Au�HORIZATION NO: � �� ;� �DAVIE COUNTY HEALTH DEPARTMENT �
- _ �, `, Environmental Health`Section . PROPERTY IIVFORMATION
PErmittee's . , : ; , P.O. Box 848 r;
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Name: � dJ[,� ,�;,� : . Mocksville,�NC 27028 Subdivision Name: �
, � , Phone# 336-751'8760
' Directions to property: "�� r! � ' l . Section: Lof:
� f � AUTHORIZATTON FOR ,
.`.. t , .ri� { t: . ,., ` {�. . � .. WASTEWATER
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� J. ,��- � � � ..� SYSTF,M CONSTRUCTION Road Name: �'��11 �. L,-?,F-i.1L. �.Z�'r�t "Op fp„
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**NOTE**This Authorization fo�Wastewater System Consuuction`MUST BE ISSUED by the bavie County'Environmental Health Section prior
� . ;to.issuance of any Building�Permit�.This Form/Authorization Number should be presented to the,Davie Counry Building Inspections
Office when applying for Building Permits:, , ; .. - ,' ` ' :
(ln compliance,with icle 11 of G .Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)� �
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;�. � ( ' / " � ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
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: ENVIRONMENTi�L,H,fCL�i'H SPECIdLiST DATE I SUED� . '
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' ° ' � : ' � IMPROVEMENT AND OPERATION pE�f1`S�. PROPERTY INFORMATION
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Name: ��� ��FE L��=� ,,_;� Subdivision Name:
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� Directions to property: , ; ; : Section: Lot:
� IlVIPROVEMENT
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. .. . �� a PERMIT Tax Office PIN:# - _ ; -
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**NOTE**This Improvement Permit DOFS NOT authorize the construction or installation of a sep6c tank system or any wastewater system.An
AUTHOR7ZATION FOR WASTEWATER SYSTEM CONSTRUGTTON must be obtained frc�m this Department prior to the
constr�ction/installation of a system or the issuance of a building pernut.
(In compliance withP�lrticle 11 of G,S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
' � e' { ' .� 1 : **sNOTICE***THLS PERMIT IS SUBJECT TO REVOCATTON IF S1TE '
r�^°^.,. �""`�._ r;` ;�'/';. ! PLANS OR Tf�INTENDED USE CHANGE.YOUR WASTEWATER
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ENVIRONMENTAI;�HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMTI'BEFORE
. , INSTALLING THE SYSTEM. � ..
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RESIDENTIAL SPECIFICATION:BUILDING TYPE�� #BEDROOMS --'� #BATH3 �' #OCCUPANTS ''�'^� GARBAGE DISPOSAL:Yes or No
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COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFT �SEATS INDUSTRIAL WASTE:Yes or No ,
fLOT SIZE r �C t=-'C�fYPE WATER SUPPLY �'"-`C-�'� �DESIGN WASTEWATER FLOW(GPD)i��NEW SITE ' REPAIR SITE i/'"r ,
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SYSTEM SPECIFICATIONS: TANK SIZE I�V�`GAL. PUMP TANK GAL. TRENCH WIDTH---��' ROCK DEPTH I .�.- LINEAR FT.��'�-�
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REQUIRED SITE MODIFICATIONS/CONDTTIONS: ' ' "' � `
', IMPROVEMENTPERMITLAYOUT#��RDVED EFFL��FI�'FEE��RIS t�{i_5�_______I .F b" �HEL4'�'FI�JISHEI? GRADE�;
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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,1'ELEPHONE#IS(�t?EQ4E�A66[x `
t336)751-876Q
OPERATION PERMIT ��M c4...i �rs"�
SYSTEM INSTALLED BY: *
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AUTHORIZATION N0. ( 1�A` OPERATION PERMIT B • DATE: I I 'O t �i
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SY EM DESCRIBED AB HAS BEEN INSTALLED IN COMPLIANCE '
WITH ARTICLE 11 OF G.S.CHAP'TER 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 OS/96(ReviseA)
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�� �' � DAVIE COUNTY HEALTH DEPARTMENT —Z 5/ ,
D �-,01 Environmental Health Section �},���
SEp 2 6 L� PO Box 848/210 Hospital Street � ��
� � Mocksville,NC 27028
Et�- �--y4��"•,,.�N�����ti��j� Phone• (336)751-8760
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ON-SITE WASTEWATER CERTIFICATION FOR DWELLING .
(Check One) REPLACEMENT❑ REMODELING ❑ RECONNECTION ❑
Name:��,p . �6�1� o��,e�.rrL� , Phone Number: �.3��S�`�oZ b (Home)
Mailing Address:a.2.S �'�,�LC(� a�4 1�. � � �,,,�,�,�,�„o/ (Work)
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Detailed Directions To Site: 0
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Property Address:��,�(�(f�t.C,K:�JL d a-r.s�.
Please Fill In The Following Information About The Existing Dwelling.
.S4�nc�.L �`���� T Of Dwellin �'S�
Name System Installed Under: �i,w.,��� ype g: -
Date System Installed(Month/Day/Yeaz):"��' ��3-�y Number Of Bedrooms:�_Number People: �
Is The Dwelling Currently Vacant? Yes C�10❑ If Yes,For How Long?
Any Known Problems?Yes❑ No{7 �I#Yes,Explain:
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Please Fill In The Following Information About The New Dwelling.
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Type Of Dwelling: , � Number Of Bedrooms: Number Of People: �
Requested By: �6-P.t.s� t-f � 1 . Date Requested: � �� � � ~�l
(Signature) `
For Environmental Health Office Use Only
Approved ❑ Disapproved ❑
Comments: ���L� �-�i'�-�'�� ��1� �`� ���"�/
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Environmental Health Specialist Date
'�The signing of this form by the Environmental ealth 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 #: � ! �7 b Invoice #: � � �
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� �� ,:� , '� ar� �~ DAVIE COIJNTY HEALTH DEPARTMENT � � 1
M1 �'�yS `�'a �,' -�`''�"��,��'�'�1 Environmental Health Section f '
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PO Box 848/210 Hospital Street ; �
�` •` .' Mocksville,NC 27028 '•
Phone: (336)751-8760 �_ . ��
. �' '`�` `�`"i�'`� �'��'0�1T=SITE WASTEWATER CERTIFICATION FOR DWELLING ' ° �.
. (Check One) REPLACEMENT❑ REMODELING ❑ RECONNECTION ❑
Name:��*��; . N�r 1 J Dcn� �pg.D�.,-,-�_� � Phone Number: I..���S S`I cZ h (Home)
Mailing Address:,�.�2 5 �-p�[� c��� .:�::>�����,, � � L�a tz� � (Work) ,
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Detailed Directions To Site: _i�;� ) j
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Pro Address• / n XlLP_n. d 0�-v�A.. � �
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Please Fill In The Following Information About The�ExisHng Dwelling. ,
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�, � � S4 rn cu.L � ,�v��� Type Of Dwelling: � �.,� �
Name System Installed Under: m��,�.
Date System Installed(Month/Day/Year):"�� �� 3'�`� t � Number Of Bedrooms:�_Number People:. �
f Is The Dwelling Currenfly Vacant? Yes f�l/N o❑.`� If Yes.For How Long? .
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Any Known Problems?Yes 0 _No�f7 �If Yes,Explainr�' .. , . _.. ; ,
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;Please Fill In The Following InformaHon About The New Dwelling. �- -
,:
' TYPe Of Dwelling:�) 1 � 1Vumber Of Be�rooms: Number Of People: ��� -
: :_ ..,.
" Requested By: �@-P�.sr� � � � �it ... .. ... . � � � �,-=��
�P �m_c�-h Date R uested: ' '��±�
(Signature) _ . r '
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For Environmental Health Office Use Only �'� '�=��'��`��`
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APProved ❑ �isapproved ❑ ,
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Comments: - i�J V�s� K—�1'h�� ��1 � . �� f,�L�' r�!
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Environmental Health'Specialist ' 'y ` Date "
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,, '"�The signing of this form by the Environmental ealth 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 0 Mq,��CJrder,❑ # Amoun� $ Date: *� � l '
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Paid By: Received By: - '-` ,,..i��``' • -
Account #: 'l �Cl d �Iiivo�� �,,.,�.�.��P `7 �'�—��3�t�. � '
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