237 Ijames Church Rd (2)Davie County, NC Tax Parcel Report I93) Thursday, September 29, 2016
WAlZ1 ING: TH15151VUT A SURVEY
Parcel :Information
Parcel Number:
G300000028
Township:
Mocksville
NCPIN Number:
5820410212
Municipality:
Account Number:
8300916
Census Tract:
37059-806
Listed Owner 1:
ROEDER GERALD HENRY JR
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
1869 US HWY 601 N
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
0.755 AC IJAMES CHURCH RD
Fire Response District:
CENTER
Assessed Acreage:
0.66
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
412012
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
008890308
Soil Types:
WeC,PcC2,CeB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding 8r Extra
Freatures Value:
0.00
Land Value:
22000.00
Total Market Value:
22000.00
Total Assessed Value:
22000.00
9 tis !�, 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
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
�O p�i� NC or arising out of the use or Inability to use the GIS data provided by this webshe.
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AUT�OUkI<~QTIO,N NO:.
1 `2 3 1 DAVIE COUNTY HEALTH DEPARTMENT 1 /_ �N ''I
+ Environmental Health Section PROPERTY INF TIO
Penmttee' - P.O. Box 848
Name: eJib�LLcs 1 �`� Mocksville, NC 27028 Subdivision Name:
Phone #:.704-634-8760
Directions to property: 11001 -10 Section: Lot:
t1AUTHORIZATION FOR
1, t MLS C ti Q J (tai K 1.10LL<L WASTEWATER Tax Office PIN:# _
SYSTEM CONSTRUCTION
Qr•1 t.i.�T l � �% Road Namel)%Nt4) ej 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.
(Incompliance with Article I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
f 1 ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�• '1 IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIR N HEALTH'SPEC ST DATE ISSUED
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 9:30 A.M. OR 100 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
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DCHD 05J96 (Revised)
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DAVIE COUNTY HEALTH DEPARTMENT
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IMPROVEMENT AND OPERATION PERMITS PROPERTY1 IFORIvi T v
Permittee's
" Name: ''" • 1 C LSubdivision Name:
Directions to property:"t' 1 1` \ Section: Lot:
IMPROVEMENT }'
PERMIT Tax Office PIN:#
Road Name?, s r 4 Zip:
**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 1,Yof G.S. Chapter 130A,• Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
t
***NOTICE*** THIS PERMIT IS SUBJECT TO REVQCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRbNMENTkriiEALTHiSPEC IST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT IJEFORE
INSTALLING TH``E SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE ��' # BEDROOMS # BATHS !__. # OCCUPANTS GARBAGEISPOSAL: Yes or No.,,
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS '.INDUSTRIAL WASTE: Yes or Noy
LOT SIZE 1�CC� TYPE WATER SUPPLY WELL DESIGN WASTEWATER FLOW (GPD) �`{ � 'NEW STTE REPAIR SITE
�cc..'(J
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH �� ROCK DEPTH LINEAR FTZ'�D
OTHER
`REQUIRED SITEMODIFICATIONS/CONDITIONS:
IMPROVEMENT PEI&i LAYOUT
"CONTACT A REPRESENTATIVE OF THE YAYIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
`BETWEEN 8:30 - 9:30 A.M. OR 1:00 L 1ii0 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS ('794) 634-8760.
i.
'ERATION PERM
A
SYSTEM
LLLED BY: j
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AUTHORIZATION N D. OPERATION PERMIT BY: DATE: V
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT IE SYSTE DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE,11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATIMENTIAND 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)
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r DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION°`- .�
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) i3G I
NAME PHONE NUMBER
ADDRESS c� r% �iQ -�c� — SUBDIVISION NAME
� (:!-k /1 I � � �� a � LOT # ?
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED r3U WLy • NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS c2 NUMBER PEOPLE SERVED 3
TYPE WATER SUPPLY "7� SPECIFY PROBLEM OCCURRINQV_G
"'i / ��n �,-s n . /1 /2 1A r Z'� . • n C/fi / a _ /i CJ_ _ .17E4
This is to certify that the information provided is correct to the best
SIGNATURE OF OWNER OR AUTHORIZED
Rev. 1193
Z:oo -z•3o
and that I unleistand I am responsible for all charges incurred from this application.
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