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1326 Liberty Church RdDavie lCounty, NC It r Tax Parcel Report 194 - Monday. October 3, 2016 t,y1\348 4 =^1331 ��t wa0 iI 32.- 1:30 _ h( _! 3� i '1303104 .,- ✓ _;....__._ _. .......... i 12 9913 0 0 i 1277-,-,\l 2 9 f•'� -- - _-- ��,,..�� 12 6 6 .".,.1212 r X1230' WARNING: THIS IS NOT A SURVEY 686 1448 �� Parcel Information Voluntary Ag. District: Parcel Number: D200000035 Township: Clarksville 721' �r Municipality: ! 741138 8 1382 30429000 76 lf` 37059-801 Listed Owner 1: GREEN WANDA B t,y1\348 4 =^1331 ��t wa0 iI 32.- 1:30 _ h( _! 3� i '1303104 .,- ✓ _;....__._ _. .......... i 12 9913 0 0 i 1277-,-,\l 2 9 f•'� -- - _-- ��,,..�� 12 6 6 .".,.1212 r X1230' State: WARNING: THIS IS NOT A SURVEY Zoning Overlay: Zip Code: Parcel Information Voluntary Ag. District: Parcel Number: D200000035 Township: Clarksville NCPIN Number: 5812267199 Municipality: Elementary School Zone: Account Number: 30429000 Census Tract: 37059-801 Listed Owner 1: GREEN WANDA B Voting Precinct: CLARKSVILLE Mailing Address 1: 400 WEST PARK DRIVE Planning Jurisdiction: Davie County City: ROCKWELL Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 28138-0000 Voluntary Ag. District: No Legal Description: 36.0 AC LIBERTY CHURCH Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 35.77 Elementary School Zone: WILLIAM R DAVIE Deed Date: 1/1997 Middle School Zone: NORTH DAVIE Deed Book / Page: 1997EO020 Soil Types: AaA,MnC2,MnB2,GrB,MdB Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 25460.00 Outbuilding 8r Extra Freatures Value: 0.00 Land Value: 218880.00 Total Market Value: 244340.00 Total Assessed Value: 244340.00 IN 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 fora 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 N`'/'. or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) PHONE NUMBER ADDRESS G SUBDIVISION NAME LOT # DIRECTIONS TO SITE (�/� DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY AaQf NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY e SPECIFY PROBLEM OCCURRING DATE REQUESTED /b-/%-�� INFORMATION TAKEN BY This is to certify that the information provided is correct to the best of my knowledge, and that I undo tend I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1/93 AUTHORIZATION NO: 18 O 4/A DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's P.O. Box 848 Name: //i/�-nc& �I"Q�'1 Directio s to property: w D/ Mocksville, NC 27028 Subdivision Name: Phone # 336-751-8760 Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION - — Road Name: 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 Article 11 of G.S. Chapter 130A, Wastewater Systems, Section.] 900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �4 7T— 0Z IS VALID FOR A PERIOD OF FIVE YEARS. LTH SPECIALIST DATE ISSUED z 18 © DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS K Perinittee's Name: Directio s to prop rty: r —- ' IMPROVEMENT PERMIT PROPERTY INFORMATION Subdivision -NaifiF Section: Lot: Tax Office PIN:# - - Road Name: Zip: **MOTE** 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 pen t. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) -- ***NOTICE*** TILS PERMIT IS SUBJECT TO REVOCATION IF SITE o / -Qa PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER NVIR NMENLM,H ALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE, INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE GYI # BEDROOMS,3 # BATHS �( # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE 1 # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY / DESIGN WASTEWATER FLOW (GPD) NEW SITE PAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE �GAL PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.it � REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUENT FILTER* *RISER(S) IF 6" BELOW FINISHED GRADE* �t �o5r �C rrodt /--7 C�>/-1111/c "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 (;W44344;60. XXXXXXXXX OPERATION PERMIT AUTHORIZATION NO/ 4&5��° ( OPERATION PERMIT BY: SYSTEM INSTALLED BY: / 4� /C-4i°t / /74 & DATE:/a 0 —0 b "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TFII: SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH 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 THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) �. Road Name: 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 Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. MENTAL-HEALTH SPECIALIST DATE ISSUED AUTHORIZATION NO: 18 0 4 DAVIE COUNTY HEALTH DEPARTMENT r = ''Petfiittee's Environmental Health Section PROPERTY INFORMATION . � ) � �f P.O. Box 848 . Name: — Mocksville, NC 27028 Subdivision Name: Phone # 336-751-8760 Directions•to property:` <i . ,, / Section: Lot: r f % AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION _ �. Road Name: 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 Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. MENTAL-HEALTH SPECIALIST DATE ISSUED U ly�/ t' DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION • PermitFee's ' /. , Name: a ; Subdivision Name: Directions to property: ,!' i', Section: Lot: IMPROVEMENT PERMIT Tax Office PIN:# Road Name: 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TEO PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE Q'/Sc- # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY ' I// DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE PUME�PTA K GAL. TRENCH WIDTH � ROCK DEPTH � LINEAR FT. 5-' OTHERfi `T r i/ r?�►' j�f- i 61 REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUFJIT FILTER* tRIEER(5) IF 611 BELO:) FI HSHED GRADE* 65' S sr l "CONTACT A REPRESENTATIVE OF THE DAV,IE 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 (�0. XXXXXHHXX J.SbIZ11-010 OPERATION PERMIT I II/D SYSTEM INSTALLED BY: ' 0, AUTHORIZATION NO!' Z"� 14 OPERATION PERMIT BY: 1/1�� 4 - _ DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TfM—SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH 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 THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05,96 (Revised) DAVIE COUNTY HEALTH DEPARTMENT 4'. � IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Peritiittee's: f -� Name: a - Direetons to property: ' Subdivision Name: Section: Lot: IMPROVEMENT PERMIT Tax Office PIN:# - - Road Name: 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE ` PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE&!!•'; -f # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS - _ - - INDUSTRIAL WASTE: Yes or No .q LOT SIZE TYPE WATER SUPPLY r ::: "/ / DESIGN WASTEWATER FLOW (GPD) NEW SITE ( REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE OG' GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR Fr., R! �A/11 �' OTHE REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUENT 1=I1_sL'R* -R SER( ) IF f;" KELM) FINISI;ED GRnDE* —<T "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 (70.4) 6344760. li?t3CK�:kSM7tN OPERATION PERMIT SYSTEM INSTALLED BY : s ,.:. AUTHORIZATION NO! `— !' ' /`� OPERATION PERMIT BY: ` - ' / DATE. "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH 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 THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised)