1894 Hwy 801SDavie County, NC Tax Parcel Report 0 -13 H Tuesday, September 27, 2016
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141
Davie County, NCimplied
WARNING: THIS IS NOT A SURVEY
Parcel Number:
G800000021
Township:
Shady Grove
NCPIN Number:
5880112761
Municipality:
Account Number:
2989500
Census Tract:
37059-804
Listed Owner 1:
BAILEY AMY TALBERT
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
4122 WELCOME ARCADIA ROAD
Planning Jurisdiction:
Davie County
City:
LEXINGTON
Zoning Class:
DAVIE COUNTY 1-1,R-20
State:
NC
Zoning Overlay:
Zip Code:
27295-0000
Voluntary Ag. District:
No
Legal Description:
3.369 AC CORNATZER RD
Fire Response District:
ADVANCE
Assessed Acreage:
3.33
Elementary School Zone:
SHADY GROVE
Deed Date:
9/2002
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
2003E0245
Soil Types:
WeC,WeB,PcB2
Plat Book:
Flood Zone:
X
Plat Page:
Watershed Overlay:
-
Building Value:
96600.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
26520.00
Total Market Value:
123120.00
Total Assessed Value:
123120.00
141
Davie County, NCimplied
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
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 all claims or
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
l?erinitte s, j DAVIE COUNTY HEALTH DEPARTMENT N
Name: ' ' 1 1 ` Environmental Health Section PROPERTY INFORMATION
e file P.O. Box 848 -
Directions to property: I ��. "� Mocksville, NC 27028 Subdivision Name:
Y - Phone #: 336-751-8760
Section: Lot:
AUTHORIZATION FOR
, � WASTEWATER Tax Office PIN:#
rp SYSTEM CONSTRUCTION i - -
AUTHORIZATION 01 e" j , :,� t � ,
NO: A Road Name: ice' Zip:
**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 with A.M-le I 1 of G.SS,hapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r' r' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONKIik ALH ALTIfSPE6A1J§T DAT ISSU D
RESIDENTIAL SPECIFICATION: BUILDING TYPE { 10t& R BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE i� l9�# PE&1'LE 1— # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE `/ �PE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ,� NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS`. TANK SIZE GAL. PUMP TANK GAIL. TRENCH WIDTH '"� ROCK DEPTH t LINEAR FT. 1
1J .
.'OTHER 'tlJ30 XeS , tJSTALL L -AS 1
REQUIRED SITE MODIFICATIONS/CO Io 'S:° At 1. .D^� �f7+ )�Op2 �: { �%�� � �' SANE
IMPROVEMENT PERMIT LAYOUT
��AI
T,&Q, 4
- 'icy ll��kB�J
**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.
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED APVE HAS EEN INSTALLED IN COMPLIANCE
li/rrU ADTT!"iC II f%V n C!`LT A DrMD 1Qn A' CT:!`TVIM IUM 11QRWAf7R TRF ATIIARMT A Mn TITQDnQ A T QTRAAC!VhT TT CU A T T. TAT mn R7 A V DC T A 11VXT A CA
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DAVIE COUNTY HEALTH DEPARTMENT 11
Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
F:Duecftons to.property: '' `"� -a: ' Mocksville, NC 27028 Subdivision Name:
•; + ] x`,� c �a �, s + , �� Phone: #: 336-751-8760
l; Section: Lot:
AUTHORIZATION FOR
WASTEWATER . 'Tax Office PIN:#
SYSTEM CONSTRUCTION - -
2 �" ,..,
AUTHORIZATION NO. A Road Name i ;, +` K- $ _ ` Zip
r **NATE** This Authorization for Wastewater System Construction MUST BEJSSUED by the Davie County Environmental Health Section prior
to issuance of any Building Penrii[s.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for. Building Permits.
(In compliance with Article I 1 of G.S. 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
!1 IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DAT ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No.,.,",, �.
"4 ftwix f.IR L
COMMERCIAL SPECIFIC)kTIgN rpAC�ILITY TYPE 1,-01t- t- <#fE6PLE +-! # PEOPLF/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
SLOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)"' NEW SITE REPAIR SITE _ t'
SYSTEM SPECIFICATIONS: TANK SIZE 1,J _- 0 GAL. - _ r 1 I*
-.. PUMP TANK GAL. TRENCH WIDTH '�-%' ROCK DEPTH � �=- LINEAR FT.
l,aOTHER 4 I '^ n� } 0XLS 1����L� �.1�� �+�+�' InI/,�•
RE UIRI DSITE- 06,iFICA IONS/CfiNIjITIONS.
IMPROVEMENT PERMIT LAYOLFP
L &Y
A CiIN
d
l>
**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
SYSTEM INSTALLED BY:
J� (WSF,
;4
• 4-
AUTHORIZATION NO. '% Q OPERATION PERMIT BY:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SY M DESCRIBED
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL
GUARANTEE THAT.THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF
DCHD 02/02 (Revised)
�rA
741
DATE: Z
tE HAS EEN INSTALLED IN COMPLIANCE
,M ! , UT SHALL IN NO WAY BE TAKEN AS A
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DAVIE COUNTY HEALTH DEPARTMENT
- Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville, NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑
Name: A$CA ► -t Phone Number: 7 �D y- -Z (Home) I
Mailing Address: Z W C. t 0M . d , `76 O 0 7 O 6 (Work)
LP x. X15'Ayry VC, 2 72 9S- 7W 24,0.2
Detailed Directions To Site: TG k -f N Wy qO 1 -5. -iv (-4�C,L - 1 f Y r- C_ct") is
s ► r„rn�;c,�cl SGi,c` �{� rG�\�oa� CrvSS��
Secyn p gU a Cf SCMe 5A e o( 801 C CCI J7. t2
Pro Address: 1 C1 _t \ i J d `- .5 G
Property iV
Please Fill In The Following Information About The Existing Dwelling•.
Name System Installed Under: C cr r )-es u t ') �Ct' �J f �(T Type Of Dwelling:_r e 5 d t •t ii q
Date System Installed(Month/Day/Year): 1 q b Q Number Of Bedrooms: 3 - Number Of People:
Is The Dwelling Currently Vacant? Yes i/ No ❑ If Yes, For How Long? (0 L'i { t -s
Any Known Problems? Yes ❑ No D� If Yes, Explain:
Please Fill In The Following Information About The New Dwelling. GctCI;n 5 I add on joo 4A
Type Of Dwelling: \d C 6 r e Number Of Bedrooms: 3 Number Of People:
.C.�to 5ckoot ori 3-�o�w�
Requested By: Date Requested: '. .
(Signatur
For Environmental Health Office Use Only
APprovedpl--Disapproved '0 n
Comments pe"'`-�/ �/l,d'�,.� �. -6 73
j1
Environmental Health Specialist Date_7 J�
" The sighing '65i s form by the Environmental Health'Staff is in no way intended, nor should be taken as a
guarantee(extended or limited) 2git the on-site wastewater system will function properly for any given peri
Payment: Cash ❑ Check oney Order ❑ # 3((,o Amount.' w.o T Date:
Paid By: �,( Received By: _
Account #: '� al Invoice
od of time.
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