114 Mocks Church Rd'r-
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Davie County Health Department
Environmental Health Section
Phone: (336) - 753 - 6780
P.O. Box 848
210 Hospital Street
Courier # : 09-40-06
Mocksville, NC 27028
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Fax: (336) - 753-1680
Name:V,4V e_1 N 6 u l w w Phone Number 3 3 6 - 'L/67-766/ (Home)
Mailing Address: 2156) If.L11'ry- IeD - `S,1}WI7'C (Work)
Detailed Directions To Site: CORM -T Or B6+%ACYA Me &i -JP MOCKs e4iu l2Cii 12D
Property Address: 114 MOCKS' C4(4 fCeW- AT-
Please
T-
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under:
Ct yeirr`n!6
Type Of Facility: A/0 ISE
Date System Installed (Month/Date/Year):I A7 Number Of Bedrooms: -3 Number Of People: t'7�
Is The Facility Currently Vacant? Yes
Any Known Problems? Yes NO
V
0
If Yes, For How Long?
If Yes, Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: ZL I K 36 !�-7 nom' Number Of Bedrooms: Number of People
Pool Size: Garage Size: Other:
Requested By: Date Requested: c? Off" ?4 �3
(Signature)
For Environmental Health Office Use Only
Disapproved
Environmental Health Specialist 1L Date: V 0/Z_
*The signing of this form by the Environmental Health Slaff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order # Amount:$ Date:
Paid By: Received By:
Account #: �� Invoice #: !?(J4
i
294.15
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18 (150) (1•
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All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied
`W_+�r warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of G U N-,,
Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of
ti the use or inability to use the GIS data provided by this website. Prl nted.AUg 29, 2013
110
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Appraisal Card Page 1 of 1
JAVae cUUNrr, NU
V/.�/1u1.7 V:4u:ua AM
Retum/Appeal Notes:
HYMAMIAEL R HYMAN STAFFORD M
N CH
DEPTH / I
EPT SIZE
114 MOCKS CHURCH RD
UNIQ ID 9550
JAND NOTES
RF AC LC TO OT
38855430
ID NO: 5870771937
LAND
UNITS
CARD NO. 1 of I
COUNTY TAX (100),
FIRE TAX (100)
Reval Year: 2013 Tax Year: 2014
1.000 AC MOCKS CHURCH RD
ikppralsed by 19 on 10/14/2008 07002 MOCKS CHURCH
TW -07
CONSTRUCTION DETAIL
0 2.5000
DEPRECIATION CORRELATION OF VALUE
MARKET VALUE
Foundation - 3
10.29000
9,900.00
Eff.
BASE
3.00
Continuous Footing
5.0
USJMOJ
Area
UA RATE
RCN
Sub Floor System - 4
29,700
1.00
OTAL MARKET VALUE - CARD
116,030
Plywood
8.00
011 01
11,375
11161 81.20
11835 7
Exterior Walls - 08
TYPE: Single
Family Residential
Masonite on Sheathing
31.00
STORIES: 1 - 1.0 Story
Exterior Walls - 21
Face Brick
0.0
PRIOR
Roofing Structure - 03
Sable
8.0
84,010
Roofing Cover - 03
4s halt or Composition Shingle
3.0
ND VALUE
29,700
Interior Wall Construction - 5
D all/Sheetrock
20.0
42'
DEFERRED VALUE
Interior Floor Cover - 13
Parquet
10.0
116,76
26
Interior Floor Cover - 14
Carpet
o.0
CODE I DATE I NOTE I NUMBER AMOUNT
10' WDD 10'
26'
Heating Fuel - 04
Electric
1.0
SALES DATA
10' 10'
Heating Type - 10
Heat Pump
4.0
RECORD DATE DEE
10' 10
41r Conditioning Type - 03
Central
4.00
WDD
Bedrooms/Bathrooms/Half-Bathrooms
3/2/0
12.000
4300
10' 24
Bedrooms
BAS - 3 FUS - 0 LL - 0
11'FSP
11
10'
Bathrooms
BAS -2 FUS -0LL-0
26'
Office
12uallty 1 3 1 AVG 1 1.0991
OTAL ADJUSTMENT FACTOR 1.
OTAL QUALITY INDEX
SUBAREA
VALUE
L-'__. -" / - i wo or more - ---I
Click on image t
UNIT
UNIT PRICE I COND JBILD
570 10.0 _
IIGHEST AND
LEST USE
V/.�/1u1.7 V:4u:ua AM
Retum/Appeal Notes:
FS -000-00-013
DEPTH / I
EPT SIZE
LND
MOD
UNIQ ID 9550
JAND NOTES
RF AC LC TO OT
RESB-6-11-4650
ID NO: 5870771937
LAND
UNITS
CARD NO. 1 of I
TOTAL
ADJST
ADJUSTED
UNIT PRICE
1.000 AC
SRC= Inspection
0120
TW -07
C- EX- AT- LAST ACTION 20110712
0 2.5000
DEPRECIATION CORRELATION OF VALUE
1.2000
Standard
10.29000
9,900.00
1.00
REDENCE TO MARKET
3.00
% GOOD
71.0 :)EPR. BUILDING VALUE - CARD
84,030
Single Family Residential DEPR. OB/XF VALUE - CARD
2,300
MARKET LAND VALUE - CARD
29,700
1.00
OTAL MARKET VALUE - CARD
116,030
TOTAL APPRAISED VALUE - CARD
116,030
TOTAL APPRAISED VALUE - PARCEL 116,030
TOTAL PRESENT USE VALUE -
PARCEL
0
TOTAL VALUE DEFERRED - PARCEL
0
TOTAL TAXABLE VALUE - PARCEL
116,030
PRIOR
BUILDING VALUE
84,010
BXF VALUE
3,050
ND VALUE
29,700
RESENT USE VALUE
0
42'
DEFERRED VALUE
0
TOTALVALUE
116,76
BAS
24' PERMIT
CODE I DATE I NOTE I NUMBER AMOUNT
ROUT: WTRSHD:
SALES DATA
26:)FF.
INDICATE
RECORD DATE DEE
SALES
30014PAGE MOjYR ITYPE /
PRICE
0166 103 11 1992 WD Q I
8150
05600527 7 2004 WD E I
4300
004E 149 2004 WL E I
HEATED AREA 1,248
o enlarge
NOTES
11 -ADDITION
RACK 17
.52 AC TO HYMAN STAFFORD
ORIG %
ANN DEP I I % I OB/XF DEPR
UNIT PRICE I COND JBILD
570 10.0 _
IIGHEST AND
LEST USE
USE
CODE
I LOCAL
ZONING
I FROM
TAGE
DEPTH / I
EPT SIZE
LND
MOD
I COND
FACT
JAND NOTES
RF AC LC TO OT
ROA
TYPE
LAND UNIT
PRICE
LAND
UNITS
LINT
TYP
TOTAL
ADJST
ADJUSTED
UNIT PRICE
LAND LAND
VALUE NOTES
.URAL AC
0120
350
0 2.5000
4
1.2000
+10 +10 +00 +00 +00
PW
9,900.00
1.00
AC
3.00
29 700.0
2970
'OTAL MARKET LAND DATA
1.00
29,70
'OTAL PRESENT USE DATA
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http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=F800000013 9/5/2013