3114 Hwy 158 (2) Davie County,NC Tax Parcel Report Tuesday, December 20, 2016
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WARNING: THIS IS NOT A SURVEY
„ ,. -, . _ Parcel Irforriiahon
Parcel Number: _F600000001 Township: Farmington
NCPIN Number: 5850263661 Municipality:
Account Number:, 8306167 Census Tract: 37059-803
Listed Owner 1:` v. SMITH STEVEN DENNIS Voting Precinct: SMITH GROVE
Mailing Address 1: 3140 US HIGHWAY 158 Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
Stater NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028 Voluntary Ag.District: No
- Legal Description: 1.85 AC HWY 158 Fire Response District: SMITH GROVE
Assessed Acreage: - 1.13 Elementary School Zone: PINEBROOK
Deed Date: 3/2016 Middle School Zone: NORTH DAVIE
Deed Book/Page: 010140515 Soil Types: EnB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
9 tl� 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 Davie County's GIS website shall hold harmless the
/-r County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
�O UNC NC or arising out of the use or Inability to use the GIS data provided by this website.
HEp►LTH DEPARTMENT RELEASE *CDFor office Use Only
P File Number ;22$279- 1
Davie County Health DWX ED
{ 210 Hospital Street County ID Number:
P.O. Box 848 vete: HDR/WWC
Evaluated For.
Mocksville NC 27028
Phone:336-753-6780 Fax:336-753-1680 PERMIT VAUD 0 7 / a 0 / a 0 1 6
UNTIL:
Applicant: Steve Smith Property Owner. Steve Smith
Address: 3114 US Hwy 158 Address: 3114 US Hwy 158
City: Mocksville City: Mocksville
State2ip: NC 27028 State2ip: NC 27028
Phone#: (336) 998-3513 Phone#: (336)998-3513
Property Location& Site Information
rAddress3114 US Hwy 158 Subdivision: Phase: Lot
Road# Mocksville NC 27028SINGLE FAMILY. Township:
Structure: Directions
#of Bedrooms: 4 #of People: Hwy 158 East on the right
*Water Supply: PUBLIC
Basement: Yes D No Type of Business:
Total sq.Footage: No.Of Employees:
'Proposed Improvement:
Pool and Storage Building
'Release Conditions
This release in no way expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site will continue to function for any period of time.
Applicant/Legal Reps.Signature Required? OYes ONo
Applicant/Legal Reps.Signature* *Date:
*Issued By: 2140-Nations,Robert *Date of Issue: 0 7 a 0 a 0 1 6
Authorized State Agen .
**Site Plan/Drawing attached.**
O Hand Drawing Olmport Drawing
HEALTH DEPARTMENT RELEASE I '
aoM��F4 Davie County Health Department CDP File Number: 2282T9 - 1
210 Hospital Street
P.O.Box 848
County File Number:
Mocksville NC 27028 - Date: 0 7 / 2 0 / 2 0 1 6
0Inch
Scale: , QBIock
Drawing Type: Health Department Release QN/A
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Page 2Aof
Davie County Health Department
9 1836 Environmental Healdl Section ,. .
P.O. Box 848
C 210 Hospit d Street
0 , 3�(�!f Courier# : 09-40-06
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oto: Mocksville, NC 27028
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Phone:(336)-753-6780 Fax:(336)-753-1680
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Name:',<4_U SM. % � 'r Phone Number336-92? 3.5-/3 (Homel
Mailing Address:3 11 tt.—1C U e tt o l/ 5s_ (Work)
M 0CQsu 1 w 211702�
Detailed Directions-To_Site:_�l.�J�►/ 15"Y" �il' !!f/RST" bR � e- v wI91i1 f /�
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_ Property Address: C
_ , i I uS i� M0� sv,
-7D ZSI
Please Fill In The Following Information About ThSTING Facility
Name System Installed Under: -fFtlflje_e�s�a4l Type Of Facility: /1QALj`
y
Date System Installed(Month/Date/Year): 179-0 Number Of Bedrooms: Number Of People: 2 '
Is The Facility Currently Vacant? Yes CI If Yes,For How Long?
Any Known Problems? Yes If Yes,Explain:
Please Fill In The Fo-UoLwing InformVa on About The NEWFacility:
Type Of Facility: dD `- O!Q -e,he Number Of Bedrooms: Number of People
Pool Size: C rage S' Other.
Requested By: Date Requested:
(Signature)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this fonn by the Environmental Health 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.
Payme<Cash Check Money Order # Amount:$ IMO.()d Date: - �-
Paid By: #VM60W Ne,(L' Received By: (6L,
Account#: a�2�6o`t?R Invoice#: �
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