236 Knoll Crest Rd Davie County,NC . Tax Parcel Report Tuesday, October 4, 2016
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WARNING: TffiS I5 NOT A SURVEY
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Pazcel Information
Parcel Number: K500000052 Tovmship: Jerusalem
NCPIN Number: 5747908908 Municipality:
Account Number. 20372000 Census Tract: 37059-807
Llsted Owner 1: DAVIS CHARLES M JR Voting Precinct: JERUSALEM
Mailing Address 1: 236 KNOLLCREST ROAD Pianning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 2702&5337 Voluntary Ag.District: No
Legai Description: 10.42 AC OFF DEADMON RD Fire Response District: JERUSALEM
Assessed Acreage: 10.50 Elementary School Zone: CORNATZER
Deed Date: 10/1973 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 000910734 Sofl Types: PaD,WeC,WeB,Ce62,ChA
Piat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 27150.00 �utbuilding�Extra 1280.00
Freatures Value:
Land Value: 60570.00 Total Market Value: 89000.00
Total Assessed Value: 89000.00
9�.�v t�, All data Is provlded u is without warranty or guarantee of any kind elther expreued or ImpOed Including but not IimRed to the
Davie County� implled warraMles of inerchaMablllty w ffiness for a particular usa AII users ot DaWe Courrtys GIS websRe ahatl hold harmiesa the
CouMy ot Davle,NoAfi Carollna,lfs agmts,eonwltants,coMiactors w employecs from�ny and�daims or causes a(actlon due to
�o Ux�'ti NC or arising out of the use or Iaabii(ty to use the GIS dah proWded by thts webs(ta
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AUTHORI7�ATION NO: Q 8 6 6 �. ` DAVIE COUNTY HEALTH D,EPARTMENT
" �����r� � Environmental Health Section PROPERTY INFORMATION
Permittee's �. fj i ' P.O.Box 848 . .
Name: l�l��' �.J/7a/'r ( Mocksville,NC 27028 SubdivisionName:
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„ - Phone#:704-634-8760
Directions to property:_,.,,�iir"�/���i= /Y Section: Lot:
�7 } AUTHORIZATION FOR `
C�1 � ��.�./��=� '�r,�,<;. �,,':�r; WASTEWATER Tax Office PIN:# _ _
�- SYSTEM CONSTRUCTION
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Road Name• O l�"e�aip:�Q��
**NOTE**This Authorization far Wastewater System Construction MUST BE ISSLTED by the Davie County Environmental Health Section prior
to issuance of any Building Pemuts.This Form/Authorization Number should be presenterl to the Davie County Building Inspections
Office when applying for Building Pernuts.
. (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Secdon.1900 Sewage Treatment and Disposat Systems) ' '
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�f . t f ��! � / ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
,�`�'�` �f.��/� ��� F ;; � /`�'� � IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SP.CIALIST. 'DATE ISSUED
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"�� '- x t��DAVIE COUNTY HEALTH'DEPARTMENT
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�""� ��y�J�,�r j IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perrt�iftee's . �' .��;., �.��; • :
Name: ��t.!< �` .'..����', �` SubdivisionName:
Directions to property: ,�, � ,'� ��%'� .� : Section: Lot:
,f ',: IMPROVEMENT
',( � :'� ' « PERNIIT Tax Office PIN:# -
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P� �7o.r3�
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' **NOTE**This Improvement Pernrit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system.An
ALTTHORIZATTON FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage.Treatment and Disposal Systems)
>j .;+°�,,�' ;.� ; ;.f'`. ;r �� ,�-- �„_� **•NOTICE*r*THLS PERNIIT LS SUBJECT TO REVOCATION IF SiTE
, /�`.;:'`e..r•� �' a._ .✓' .:r;�'� ��`.� J .,� %;�.�:�,,,� PLANS OR Tf�INTENDED USE CHANGE.YOUR WASTEWATER.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TI�S PERNIIT BEFORE
INSTALLING Tf�SYSTEM.
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RESIDENTIAL SPECIFICATTON:BUILDING TYPE�[� #BEDROOMS � #BAT'HS�#OCCUPANTS��GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATTON: FACILTfY TYPE #PEOPLE #PEOPLF/SHIFf #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) � �%"l� NEW SITE REPAII2 SITE «/'�
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH /� LINEAR Ff�-���lJ
OTHER
REQUIRED SITE MODIFICATIONS/CONDTTIONS: -
IMPROVEMENT PERMIT LAYOUT
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"*CONTACT A REPRESENTATIVE OF Tf�DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BET'WEEN 8:30-9:30 A.M.OR 1:00=1:30 P.M.ON THE DAY OF INSTALLATTON.TELEPHONE#IS(704)6348760.
OPERATION PERMTT `�
SYSTEM INSTALLED BY: L�/�"
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AUT'fIORIZATION NO: � OPERATION PERMIT BY: / /�'� DATE: ����7 I
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**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WIT'H 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 TE�SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96(Revised)
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, ��.�.. � ` o ;, •�-�`DAVIE COUNTY HEALTH DEPARTMENT
���r)r�r, -� : " IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's ,�,',� ,�, y (',�.:., '
Name: •'
' �'���' % Subdivision Name:
Directions to property:��� '�� � Section: Lot:
" , IMPROVEMENT
`� pE�T Tax Office PIN:#
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. Road ame: �j�l B �� �f"c:- ip:�;��,�
**NOTE**This Improvement Pemut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system.An
AUTHOR�ZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/'installation of a system or the issuance of a building pemrit.
(In compliance with Article 11 of G.S.Chapter 130�,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
��_ - . ***N01TCE***THLS PERNIIT IS SUBJECT TO REVOCATION IF SITE
.' � �;� � . ,' PLANS OR Tf�INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE
INSTALLING Tf�SYSTEI�L
�
RESIDENTIAL SPECIFICATION:BUILDING TYPE �>' ` #BEDROOMS�#BATHS �J #OCCUPANTS`"�GARBAGE DISPOSAL:Yes or No
�
. COMMERCIAL SPECIFICATION: FACILTTY T'YPE #PEOPLE #PEOPLFlSHIFT #SEATS INDUSTRIAL WASTE:Yes or No '
'•�LOT SIZE TYPE WATER SUPPLY ` �DESIGN WASTEWATER FLOW(GPD) � `:/%� NEW SITE REPAII2 SITE_�
fl�.
�SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH� LINEAR Ff�.-�"�� �
OTHER
' .' REQUIRED SITE MODIFICATIONS/CONDITIONS:
'=""+ IMPROVEMFNT PERMIT LAYOUT
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,;;
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� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 830-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLAITON.TELEPHONE#IS(704)634-8760. �
OPERATION PERMIT �
SYSTEM INSTALLED BY:
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AUTHORIZATION NO.���OPERATION PERMIT BY: ��� DATE: S ���T �
**TF�ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WIT'H ARTICLE 11 OF G.S.CHAPTER 130A,SECI'ION.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 OS/96(Revised) '
, /�����/�� DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
�- APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME s��-�e''� ��is',�S PHONE NUMBER
ADDRESS �l� �f���� (%'Pf/ SUBDIVISION NAME
��i1��CS 1„��/ LOT#
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY •
Thia is to certity that the intormation provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred trom this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1/93 .