120 Holy Cross Church RdDavie County, NC Tax Parcel Report L 1 Thursday, September 29, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
WARNING: THIS 15 NOTA SURVEY
Parcel Information
L502OA000701
Township:
Jerusalem
5746182324
Municipality:
No
61806000
Census Tract:
37059-807
ROBERSON JOHN M SR
Voting Precinct:
JERUSALEM
120 HOLY CROSS CHURCH ROAD
Planning Jurisdiction:
Davie County
MOCKSVILLE
Zoning Class:
DAVIE COUNTY R-20
Land Value:
Total Assessed Value:
NC
Zoning Overlay:
27028-0000
Voluntary Ag. District:
No
LOTS 69-72 R L FOSTER
Fire Response District:
JERUSALEM
0.86
Elementary School Zone:
COOLEEMEE
9/1994
Middle School Zone:
SOUTH DAVIE
001760427
Soil Types:
GaD,CeB2
0002
Flood Zone:
086
Watershed Overlay:
DAVIE COUNTY
65130.00
Outbuilding & Extra
1570.00
Freatures Value:
14510.00
Total Market Value:
81210.00
81210.00
1—&
All data Is provided as Is without warranty or guarantee of any Idnd 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 Davie Countys GIS website shall hold harmless the
County of Davie, NorthCarolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
NCor arising out of the use or Inability to use the GIS data provided by this website.
AUTHORIZATION NO: e 617 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee 's\Q y P.O. Box 848
Name:1, 1i'cvON Mocksville NC 27028 Subdivision Name:
4 Phone # 336-751-8760
Directions to property: (oulS tiolSection: Lot:
AUTHORIZATION FOR
-
,Gb . WASTEWATER 'Tax Office PIN:#
�^ SYSTEM CONSTRUCTION
�r RoadN�im e: 2�02,�
**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 ith Article 11 of . 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.
+4AA4f✓ALTH SPIWIALI85' DATEISSUED
� v
"i 6 DAVIE OUNTY HEALTH DEPAYtTENT y'v o
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
NamePermittee s
C ftS 0 A
Directions to property: (001'�) Tt Oa U{
Subdivision Name:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# - -
Road
e: ( CSS ip: wZ�S
**NOTE** This Improvement 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�S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
y PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
DA ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS S # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPL DESIGN WASTEWATER FLOW (GPD) :5& V NEW SITE REPAIR SITE f/
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH _ LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
F2o�
(AW
000, OFFICE IF CORAYAm
`0 -kw 0MU-1-16TOM
"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 5' � &A.+
SS SYSTEM INSTALLED BY:
N
Vi it SS
5�
AUTHORIZATION NO. I io OPERATION PERMIT BY:Z
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED BOVE HAS BEE41NALLED 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 05/96 (Revised)
1
' DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
PHONE NUMBER '75- -']y Z
ADDRESS 120 40L� 01069!�' l L SUBDIVISION NAME
LOT #
DIRECTIONS TO SITEttf7l <3 `To kLY 0055 CA4o0LcA+ eQ
V -1005;e 1�> PNNAlo C_44 v
DATE SYSTEM INSTALLED � ? NAME SYSTEM INSTALLED UNDER
TYPE FACILITY- q005a NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY 1 SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge/Cn3f that I understand I am responsible_Jor all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT,
Rev. 1/93
�' ! `7q