881 Liberty Church Rd (2) .s� .-�-� - ' DAVIE COUNTY HEALTH DEPARTMENT
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IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name I i�� � � ;��, ,-.,�. Date �1- // " -? `7 . ���
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Location � � � � � � � � ��=` _
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home � Business Speculation
No. Bedrooms -- No. Baths � No. in Family 1
Garbage Disposal YES p NO p'
Specifications for System; ��-`" `i"fn�"`�`
Auto Dish Washer YES ❑ NO ��. �� .,; .Y r �U-� �,� ,� ��•"
Auto Wash Machine YES ❑ NO �p
Type Water Supply ��� �� ����- _—
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*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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Improvements permit by �� � ��� �'T^����
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' *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 day of completion. Telephone Number: 704-634-5985.
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Final Installation Diagram: System Installed by �-, %% ' `�%%°��� �� '�j
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Certificate of Completion �< � Date `� �� �
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"The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
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DAVIE COUNTY HEALTH DEPARTT�ENT 7 � � �
P. 0. BOX 57
IZOCKSVILLE, N. C. 27028
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAi'�E r�p� �a)Q, �,.�,`.r DATE ISSUED 9-/(-7�'
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ADDRESS p2-��� �,�•,C /07 �'� PERI�IIT N0. a��S
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Explanation of charge �. $' .i. �� ��
A�r40UNT DUE ,� SANITARIAN �
PLEASE REPdIT THE ABOVE At�10U?dT ON RECEIPT OF THIS STATENiENT.
�avie County,NC Tax Parcel Report Thursday, September 29, 201 E
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' - � �` WARNING: THIS IS NOT A SURVEY
��,��� „�,a,� :ParcelInformation �
Parcel Number: D200000050 Township: Clarksville
NCPIN Number: 5812414209 Municipality:
Account Number: 75616000 Census Tract: 37059-801
Listed Owner 1: WAGNER JOEL M Voting Precinct: CLARKSVILLE
Mailing Address 1: 881 LIBERTY CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 5.14 AC LIBERN CHURCH RD Fire Response District: WILLIAM R.DAVIE
Assessed Acreage: 3.97 . Elementary School Zone: WILLIAM R DAVIE
Deed Date: 11/1978 Middle School Zone: NORTH DAVIE
Deed Book/Page: 001060302 Soil Types: MnC2,MnB2,MdE
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 64290.00 Outbuilding 8 Extra 22130.00
Freatures Value:
Land Value: 36960.00 Total Market Value: 123380.00
Total Assessed Value: 123380.00
9��/�, All data is provided as Is without wartanty or guarantee of any kind either expressed or Implied Inctuding but not Ilmited to the
Davie County� Implled warcantles of inerchantability or fltness for a partieutar use.All users of Davte County's GIS website shall hotd harmless the
�7/�-� County o/Davfe,North Carolina,Its agents,eonsuttants,eontraetors or employees from any and all claima o►esuses of action due to
�oUry�C 1\l.. or a►Ising out of the use or Inability to use the GIS data provided by this website.