156 River Birch Ln (2) Qayie County,NC Tax Parcel Report Thursday, February 23, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Number: F80000013402 Township: Shady Grove
NCPIN Number: 5880375550 Municipality:
Account Number: 8300567 Census Tract: 37059-803
Listed Owner 1: POIRIER DENNIS O Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 13371 SW 40TH STREET Planning Jurisdiction: Davie County
City: DAVIE Zoning Class: DAVIE COUNTY R-A
State: FL Zoning Overlay:
Zip Code: 33330 Voluntary Ag.District: No
Legal Description: 10.714 AC LOT 1 R B FARMS Fire Response District: ADVANCE
Assessed Acreage: 10.66 Elementary School Zone: SHADY GROVE
Deed Date: 12/2011 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 008780820 Soil Types: PaD,PcB2,PcC2,RnD,ChA
Plat Book: 10 Flood Zone:
Plat Page: 210 Watershed Overlay: DAVIE COUNTY
Building Value: 752610.00 Outbuilding&Extra 5320.00
Freatures Value:
Land Value: 75250.00 Total Market Value: 833180.00
Total Assessed Value: 833180.00
O wKtF All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
Davie County Health Deparlanent
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4�1fi� uonnlelltal Health Section .._
C�+, P.O. Box 848
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210 Hospital Street ' '
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Courier# :09-40-06
Mocksville, NC 27028
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Phone:(336)-753-6780 Fzr(336)-753-1630
ON-SITE NVASTE`VATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Name: 'r� \'—\ r Phone Number 0 k5�10 (Home)
Mailing Address: j� ��`\-C 1.1 - (Work)
Detailed Directions To Site: y
Property Address: 1'5� AiyOJ2 ?
Please Fill In The Following InformationAboutThe EMST 1MG Facility: fes,
Name System Installed Under: L GI /� l0%(/Q./L Type Of Facility: F/U G4fe
Date Systein Installed Qylonth/Date/Year): Number Of Bedrooms: 3 Number Of People:.:-=-
Is The Facility Currently Vacant? Yes If Yes,For How Long?
Any Known Problems? Yes I� If Yes,Explain:
Please Fill In The Following InformationA/bout The 1VE TV Facility-
Type Of Facility: G'ree�. house S�iQ Number Of Bedrooms: — Number of People -6--
Pool Size: Garage Size: Other:.
Requested By: Date Requested: //z�-e 6 7
(Signature)
For Environmental Health Office Use Only
Approve Disapproved
ments: l4 GUl9 r Afll /2 � S �G Y- %�(G�' T
an toil
Environmental Health Specialist Date: 2G / 7
*The signing of this forin by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function prop e ly for any given period of time.
Payment: Cash Check Money Order # Amount:$ Date:
Paid By: Received By:
Account#: Invoice#:
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