255 Eatons Church Rd Davie County, NC Tax Parcel Report Wednesday, February 15, 2017
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WARNING: THIS IS NOT A SURVEY
ParcelInformation
Parcel Number: E400000009 Township: Clarksville
NCPIN Number: 5821959147 Municipality:
Account Number: 8305925 Census Tract: 37059-801
Listed Owner 1: FRACK KEVIN C Voting Precinct: CLARKSVILLE
Mailing Address 1: 410 BISCAYNE STREET Planning Jurisdiction: Davie County
City: WINSTON SALEM Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27104 Voluntary Ag.District: No
Legal Description: 21.92 AC OFF RICHIE RD Fire Response District: WILLIAM R.DAVIE
Assessed Acreage: 22.49 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 1/2016 Middle School Zone: NORTH DAVIE
Deed Book/Page: 010090153 Soil Types: EnB,MsC,ChA,MsD
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 137830.00 Outbuilding&Extra 15520.00
Freatures Value:
Land Value: 105740.00 Total Market Value: 259090.00
Total Assessed Value: 259090.00
161 All data is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not 11 Ited to the
Davie County, implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and ail claims or causes of action due to
NC or arising out of the use or inability to use the GIS data provided by this website.
Davie County Health Department
-
4�;6f Environmental Healdl Section
.r P.O.Box 848
- j� 210 Hospital Street #o..
Q Colu-ier# :09-40-06
U Mocksville,NC 27028
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Phone:(336)-753-6780 Fac:(336)-753-1680
ON-SITE WASTEWATER CERTIFICATION
.(Check One) Replacement Remodeling Reconnection
Name: t / Phone Number{ 1L l (Home)
Mailing Address: �iIVS �t� ��D`"�0 366 (Work)
lit l-e._
Detailed Directions To Site: 60 ��� . 1(G(. ft-� -
Property Address:_ :(�
Please Fill In The Following Information About The EXIST yG Facility:
Name System Installed Under: Type Of Facility:_
Date System Installed.(Month/Date/Year) Number Of Bedrooms:Number Of People
Is The Facility Currently Vacant oesNo If Yes,For How Long? _
Any Known Problems? oesNo If Yes,Explain:
Please Fill In The Foll ing Information About The NEWFacility:
Type Of Facility: j &�-4 0 Number Of Bedrooms: Number of People
Pool Size: G a e Size: Other:,
Requested By: Date Requested:
(Signatur
For ronmental Health Office Use Only
ED
Disapproved
Comments: M%Ac_, — Y-Q wlCLiYn 5' ::f=yt::{=y61L Oct Y 6 6 F 'Se ph L 0P&CL, Inrl d,Nir,
E e,17CAi r cl'�• .`
Environmental Health Specialist Date: £
*The signing of this for►n by the Environmental lth 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#: