488 Main Church Rd Davie County, NC Tax Parcel Report ���"o� Friday, September 30, 2016
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WARNING: THIS IS NOT A SURVEY
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Parcel Information
Parcel Number: G40000002601 Township: Mocksville
NCPIN Number: 5830708536 Municipality:
Account Number: 8303401 Census Tract: 37059-806
Listed Owner 7: ROLLINGS GLENN Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: 488 MAIN CHURCH RD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 2.910 AC MAIN CHURCH RD Fire Response District: MOCKSVILLE
Assessed Acreage: 3.17 Elementary School Zone: MOCKSVILLE
Deed Date: 4/2014 Middle School Zone: SOUTH DAVIE
Deed Book I Page: 009560095 Soil Types: Mr62,GnB2,EnC
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 187270.00 Outbuilding&Extra 3620.00
Freatures Value:
Land Value: 30730.00 Total Market Value: 221620.00
Total Assessed Value: 221620.00
�v� All daW Is provided as Is without warranty or guanntee of any k�nd either expressed or Implied Including but not Iimited to the
9 ie a F Davie County� Implied warrantles of inerchantability o�Fltness tor a particula�use.All users of Davie County's GIS website shall hold harmless the
County of Davle,North Carollna,Its agents,eonsultants,contractors or employees from any and all claims or eausea of action due to
no��N,�; NC or arlsing out of the use or Inabllity to use the GIS daU provided by this website.
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� :-�+, DAVIE COUNTY HEALTH DEPARTMENT � d 9��
J'' ` IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
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' *NOTE: �Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
� Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number ;
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Name � ti,��.�.•.;� '�. ,�.�- <��> L, ;�., �. �� Date � - :--� _ �i, "� No `*.�L;., A
Location �� '� '� �,;� ,�\:`. < \r ., .\ K '! //1� ' �
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Subdivision Name � Lot No. Sec. or Block No.
Lot Size � `� `� '�� - L House � Mobile Home _ Business Speculation
No. Bedrooms ''k• No. Baths --� No. in Family �`� _
Garbage Disposal YES p NO p� Specifications for System:
Auto Dish Washer YES p' NO ❑ � h .,^ ; �, - . �. ;._. " _... ��= , •,;
Auto Wash Machine YES p� NO �❑ _ t ,;
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Type Water Supply _
*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` ��-�
"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.
Final Installation Diagram: ' • System Installed by }����'n �s �-� �-��"� �=-�•>.� �/,
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Certificate of Completion � � ������ � - Date � � �1 " I U
"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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APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT �
' Davie County Health Department �� APR 2 �
Environmental Health Section ��C�.�V
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
� I C i' �,{ i�� C U h,Q n ��C/ Home Phone �D J���-��P �
1. Permit Requested By J��(��� �Q�"�-�'�— Business Phone
2. Address ��n�' ks✓'
3. Property Owner if Different than Above
Address
4. Permit To: a) Install�Alter Repair
b) Privy�Conventional Other Type
Ground Absorption
c) Sub-Division Sec. Lot No.
5. System used to serve what type facility: House�Mobile Home Business
Industry Other
b) Number of people �
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensi ns � 5
Bed Rooms�Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water-using fixtures:
commodes urinals garbage disposal
lavatory showers_ washing machine �
dishwasher � sinks � _
8. a) Type water supply: Public Private�Community
b) Has the water supply system been approved? Yes No
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9. a) Property Dimensions � —� Q r/�.P/�
b) Land area designated to building site � �'-����
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewa e system is intended to serve?
What type? G�i � � Q CC C� ('.(��'�/1�-f: ��('�(� S I��'12� n O � �� �
This is to certify that the information is correct to the best of my knowledge.
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Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property: �� +l
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DAVIE COUNTY HEALTH DEPARTMENT
` Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date � -�-� ' ��
Address � A�'� Lot Size � ��-a
FACTORS AR 1 AR 2 AR A 3 ARE 4 �'�
1) Topography/Landscape Position S S S -
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2) Soil Texture (12-36 in.) Sandy, '� S
Loamy, Clayey, (note 2:1 Clay) PS � r5} P �
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3) Soil Structure (12-36 in.) S �...� S �--�
Clayey Soils � �" P5) �PS �P.�
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4) Soil Depth (inches) , - S
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5) Soil Drainage: Internal , S ��
PS � PS ( r�j
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External �
PS PS PS
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6) Restrictive Horizons r,_._____, �^ __1
7) Available Space . S S : ..,.
PS PS PS PS
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8) Other (Speciry) S S S S
PS PS PS PS
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9) Site Classification S � S ��
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments: •! � � � ' -�
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Described by Title ��o-��'�- - Date J�.J-o�
SITE DIAGRAM
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