210 Magnolia Farm LnDavie County, NC
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Tax Parcel Report I b � l � Friday, September 30, 2016
WARNING: THIS IS NOT A SURVEY
Parcel Information -
Parcel Number:
M60000000502
Township:
Jerusalem
NCPIN Number:
5755081367
Municipality:
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Account Number:
82532552
Census Tract:
37059-807
Listed Owner 1:
RATLEDGE CARRIE TENERY
Voting Precinct:
JERUSALEM
Mailing Address 1:
210 MAGNOLIA FARM LANE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
2.967AC OFF PLEASANT ACRE
Fire Response District:
JERUSALEM
Assessed Acreage:
2.96
Elementary School Zone:
COOLEEMEE
Deed Date:
12/2010
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
008470009
Soil Types:
PcB2,PcC2,RnD
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 181540.00 Outbuilding & Extra 0.00
Freatures Value:
Land Value: 21790.00 Total Market Value: 203330.00
Total Assessed Value: 203330.00
Davie Count
County,
All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for articular use. All users of Davie County's
p y p GIS website shall hold harmless the
County of Davis, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
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or arising out of the use or Inability to use the GIS data provided by this website.
AUTHORIZATION NO. '1879/4 DAVIE COUNTY HEALTH DEPARTMENT:
Environmental Health Section PROPERTY INFORMATION
Petmittee's r P.O. Box 848
Name:'��-�-� �°'a�-�=ti' Mocksville, NC 27028 Subdivision Name:
Phone # 336-751-8760
Directions to property: f..t"I > Ci Section: Lot:
AUTHORIZATION FOR
WASTEWATER.,;.- Tax Office PIN:# - -
/ SYSTEM CONSTRUCTION
-.� f` lll(:, ► i �pf�l%w Vii . f IV,I- C-) �i��J RoadlVame:����ll�i/;t
**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 withArpele. I ],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.
ENVI96NM N L— t1 LTH`SPEIST DA E I SUED
DAVIE COUNTY HEALTH DEPARTIVIVNT r i
v IMPROVEMENT AND OPERATIONPERMITS PROPERTY INFORMATION bY�
Permtttrre'--S .- _ ,
� .` ;'1;% L. I °�{ ` 1� ...} � � M1 ,F• Subdivision Name:
Name: l i.`;
P
Directions to property: I` ? ' Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name is r,
**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)
j ***NOTICE*** THIS PERMIT IS SUBJECT TQ REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL -HEALTH SPECIALIST DAIFE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
1 j INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 00 # BEDROOMS ;7 # BATHS # OCCUPANTS-' GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE `6L, TYPE WATER SUPPLY ( - ! DESIGN WASTEWATER FLOW (GPD)—)( -Q NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH '- ROCK DEPTH 17 LINEAR FT. i G:
REQUIRED SITE MODIFICATIONS/CONDITIONS: f AG e' MO N L-cl OLM 1- (A p 7--jj-UCL Nij�DJ AL,
IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUaIT FILTER* ':RMEP(S) IF 6'
BELOO F
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"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTI Q � S ISTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS(� jfjf
OPERATION PERMIT
AUTHORIZATION NO. OPERATION PERMIT
SYSTEM INSTALLED BY: tV W fT 1A Yom` 1
y;
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT/T I�' SYS LSCRJBE VE HASH
WITH ARTICLE 1 I OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATME AND DISPOSAff SYSTEMS", BUT
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
LTE: d
CALLED IN COMPLIANCE
IN NO WAY BE TAKEN AS A
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND `CERTIFICATE OF COMPLETION
NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewaqe Systems A
Name
Location
Permit Number
N° 7 6'6 4
Subdivision Name
Lot No. Sec. or Block No.
Lot Size —�17—XL_
House
Mobile Home —_ Business —_ Industry
No. Bedrooms —P—�—No. Baths —�—
No. in Family _Z_ Public Assembly Other
Garbage Disposal
Auto Dish Washer
YES ❑ NO
YES NO
[.-
Specifications for System:
Auto Wash Ma
4
YES NO
/��� /
thine
[1j
❑
Type Water Supply —
___—
1 Q 5
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
p.f r
Improvements permit by ,zz,,�, —
'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
f
System Installed by 1'
Certificate of Completion �%U Date e�
'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.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
'
PO ' Box 848/210 Hospital Street
MAY
' Mocksville, NC 27028
�'GPITAL HEALTH Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT ❑ REMODELING ❑ r�RECONNECTION ❑
Name: 8m ( Phone Numbe : �J 0 (Home)
Mailing Address: c r n A 1 }- 2'f R Ad (Work)
Detailed 1
Directions To Site:
l 1C4J4 h`I C 1
AA o/ 6 n\. l A F��'r4M Q 2 � 1 , _? b A
Property Address: L-h'a` ,,j_
Please Fill In The Following Information About The Existing Dwelling -
Name System Installed Under: CAie , e-/ �/1 eRS� Type Of Dwelling: /b
Date System Installed(Month/Day/Year): J Number Of Bedrooms: �` Number Of People:_
Is The Dwelling Currently Vacant? Yes ❑ No [L. f Yes, For How Long?,
Any Known Problems? Yes ❑ No P—If Yes, Explain:
Please Fill In The Following Information About The New Dwelling:
/� 3
Type Of
Requested By:.
Of Bedrooms: Number Of People:
Date Requested:
For Environmental Health Office Use Only
� 41_11p'
Approved ❑isa nprooved
Comments: K l r 15�
`7J ACc�r►o1�T ti�2ean— �5 tom%--�Gv�
Environmental Health
sLe
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'Me
'Me signing of this form by the Epvironmental Health Staff is in no way intended, nor should be taken as a
auarantee(extended or limite"at the on-site wastewater system will function properly for any given period of time.
Payment: Cash ❑ Checkl7 Money Order ❑ # `F A Amount: $ 0 U Date:_ 0
Paid By: Received By: }'lv 4�c-
Account #: Invoice #:
Name:
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 ❑ r�RECONNEjC�TION ❑
Phone Numbe :
1 3 3 L� J . (Home)
Mailing Address: ') G o r n A 1.}
2 f
,
Detailed Directions To Site: �� n
Property Address: 1-k c' ,e
Please Fill In The Following Information About The Existing Dwelling:
(Work)
Name System Installed Under:tai �`• /� i e- -% e,, e t2 Type Of Dwelling: -
Date System Installed(Month/Day/Year): C% V. Number Of Bedrooms: Gam'' Number Of People:_
Is The Dwelling Currently Vacant? Yes ❑ No EL, � es, For How Long?
Any Known Problems? Yes ❑ No P- -'"If Yes, Explain:
Please Fill In The Following Information About The New Dwelling:
Sine /e
Type Of Dwelling: o t -i I -f Number Of Bedrooms: -3 Number Of People:
Requested By: Date Requested:,
(Signature)
For Environmental Health -Office Use Only
Approved ❑ isa � pr9ved
Comments::r��
-TD F5 a_uap
f
Environmental Health Specialist Date /
f
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be as a
guarantee(extended or limitec)� at the on-site wastewater system will function properly for any given period of time.
Payment: Cash ❑ Check'f7 Money Order ❑ # a- t k� Amount: $ ' 0Date: i� 0
Paid By: Received BY:
.
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Account #:_TInvoice #:
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