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192 Mocks Church RdDavie County, NC T Tax Parcel Report 1 f X2A Friday. September 30. 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WARNIA T: TH15 lS 1VUT A NUKVLY Parcel Information F80000003701 Township: Shady Grove 5870872805 Municipality: 82519286 Census Tract: TKACH ALBERT GENE Voting Precinct: PO BOX 94 Planning Jurisdiction: ADVANCE Zoning Class: Land Value: Total Assessed Value: NC Zoning Overlay: 27006-0000 Voluntary Ag. District: 1.61 AC MOCKS CHURCH RD Fire Response District: 1.55 Elementary School Zone 9/2007 Middle School Zone: 007290476 Soil Types: Flood Zone: Watershed Overlay: 142040.00 Outbuilding & Extra Freatures Value: 27550.00 Total Market Value: 181560.00 37059-803 EAST SHADY GROVE Davie County DAVIE COUNTY R -A No ADVANCE SHADY GROVE WILLIAM ELLIS GnB2 DAVIE COUNTY 11970.00 181560.00 Davie 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 a particular use. All users of Davie County's GIS website shall hold harmless the 161 NC County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and ail claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this website. AUTHORIZATION NO. I 0 8 %t„ DAVIE COUNTY HEALTH DEPARTMENT _ {� Environmental Health Section PROPERTY INFORMATIONP&mit1 tee's Llf 5z -1L j -FiL Q Cid P.O. Box 848 Name: Mocksville, NC 27028 Subdivision Name: Directions to property: 1 t �' v 1 ! t -O !'J Phone # 336-751-8760 Section: Lot: AUTHORIZATION FOR H{ WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION - ' 12 C 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 Fom-dAuthorization Number should be presented to the Davie County Building Inspections Officq when applying for Building Permits. (In_comphanc 1 '� 11 SiG.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ' L O IS VALID FOR A PERIOD OF FIVE YEARS. �NVIRO M ALTH Sk0 LIT DA E ISSUED US ,DAVIE COUNTY HEALTH DEPARTMENT ` IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION r P6rmittee's , Name: � . s�, _;.:. T' r 14 C1- .i-1 Directions to property: 1 ; IMPROVEMENT t i N.,,) ::� /•", �. ,, f.� PERMIT Subdivision Name: Section: Lot: Tax Office PIN:# Road Name:i'IF. 2 Zip:" i **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) � l ***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 r INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE :-{l7lJ59; # 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 -- r DESIGN WASTEWATER FLOW (GPD) 7F-iD NEW SITE REPAIR SITE f SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH *3(--" ROCK DEPTH 12-- LINEAR FT.2yy ' OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUFU4T FILTERS USE I (S) IF 6" BID O�I FI IISHED GRADE* Z fi7 � G V n C c�s 1 "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 INSTALLkTION. TELEPHONE # IS (7(OtVi O.x x 1 (336)751-0764 OPERATION PERMIT ' SYSTEM INSTALLED BY: --• 0& /CC AS S t� �Vv CLAV SD 1 (2 F7VTOt, 0 __4A. t\LV,,)0 AUTHORIZATION NO. ��-N1 OPERATION PERMIT BY: DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SY ESCRIBED ABOVE EEN INSTALLED IJCOtMPLIANCE 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) AVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS' PROPERTY INFORMATION Krmittee's _ Name: �� a ! i' `' "' 1 " Subdivision Name: p Directions to property: , � r 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"11X^4 # BEDROOMS --S—# BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLYL'N), DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE/ .J •LINEARr6 Gif_l , SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ic' ROCK DEPTH FT. REQUIRED SITE MODIFICATIONS/CONDITIONS: �z k. r '' ' E ► �' `" i " + S "" 1 **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION t I4)511STEM BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INiTALLITION. TELEPHONE # IS (7�i0.�7�� OPERATION PERMIT �� _ SYSTEM INSTALLED BY: cc�----��)4 �) ITA 1_t e f i AS S1�Mr\) (F_Y_C;LPT AUTHORIZATION NO. OPERATION PERMIT BY: J .�/ DATE: V. **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SY TEM'DESCRIBED ABOVE EEN INSTALLED dCOMPLIANCE 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) IMPROVEMENT PERMIT LAYOUT �KSPP O0 IVE.? EFFMENT FILTERK IF 611 EE L014 FINIGIRM GRADE:#— 21 Vic: z �CJ 1 **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION t I4)511STEM BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INiTALLITION. TELEPHONE # IS (7�i0.�7�� OPERATION PERMIT �� _ SYSTEM INSTALLED BY: cc�----��)4 �) ITA 1_t e f i AS S1�Mr\) (F_Y_C;LPT AUTHORIZATION NO. OPERATION PERMIT BY: J .�/ DATE: V. **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SY TEM'DESCRIBED ABOVE EEN INSTALLED dCOMPLIANCE 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 ENVIRONMENTAL HEALTH SECTION (� ,. APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) NAME ! ILSELL 1 V-AU1 PHONE NUMBER ADDRESS M S �iJ t ��Cz SUBDIVISION NAME LOT # DIRECTIONS TO SITE DATE SYSTEM INSTALLED 'r I o NAME SYSTEM INSTALLED UNDER )-)V10A)A TYPE FACILITY 4005 NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED TYPE WATER SUPPLY CAD>JrJI'l? SPECIFY PROBLEM OCCURRING t5d1YIA.Cc 136 A.-1' 0-0 DATE REQUESTED 5 NFORMATION TAKEN BY This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT]✓Iy' Rev. 1193