1110 Salisbury RdDavie County, NC
Tax Parcel Reuort :a M1 Thursday. October 6. 2016
WAR1V11V(T: THIS 1S 1VUT A SURVEY
Parcel Information
Parcel Number:
J5160B0008
Township:
Mocksville
NCPIN Number:
5737973139
Municipality:
MOCKSVILLE
Account Number:
40790000
Census Tract:
37059-805
Listed Owner 1:
JONES CLEMENT DAVIS
Voting Precinct:
SOUTH MOCKSVILLE
Mailing Address 1:
964 CORNATZER ROAD
Planning Jurisdiction:
MOCKSVILLE
City: MOCKSVILLE
Zoning Class:
MOCKSVILLE GI,HC
State:
NC
Zoning Overlay:
Zip Code:
27028-7133
Voluntary Ag. District:
No
Legal Description:
LOTS 95-98 + 241 EATON
Fire Response District:
MOCKSVILLE
Assessed Acreage:
1.37
Elementary School Zone:
MOCKSVILLE
Deed Date:
3/1979
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001070747
Soil Types:
GnB2
Plat Book:
0001
Flood Zone:
Plat Page:
091
Watershed Overlay:
MOCKSVILLE
Building Value:
37920.00
Outbuilding & Extra
Freatures Value:
1030.00
Land Value:
120230.00
Total Market Value:
159180.00
Total Assessed Value:
159180.00
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.
q/1 3Davie County Health Department
�8 t� Environmental Health Section
P.O. Box 848 a I
P�
210 Hospital Street Rece� Z_�`l3®�
p U Courier # : 09-40-06
Mocksville, NC 27028 S
Phone: (336) - 753 - 6780 Fax: (336) - 751 - 8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Name: U Phone Number �✓/0/6Home)
Mailing Address: 9y�� d (Work)
�Ulr�nkSyj e Email
Detailed Directions To Site: �� / o/ j�eT Ad
d S
v-
/, 383
Property Address: /// S u ry
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: "l Type Of Facility:
/PlrvolK 1
Date System Installed (Month/Date/Year): Number Of People:_
Is The Facility Currently Vacant? Yes00
If Yes, For How Long?
Any.Known Problems? YesIf Yes, Explain:
6)0
Please Fill In The Following Information About The N W Facility:
Type Of Facility: Ruvlve5s1 �-N v Number of People
Requested By Date Requested:
( ignature)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form 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 properly for any given period of time.
Paym nt: Cash Check Money Order # Amount:$ Date: /R [i-(3
Paid By: G' ' YON e 5 Received By: �• l�NierL-
Account #:2 �Z Invoice #: Z ��5
oo�
00
y
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name Q Date zL� 'lam
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size _ House Mobile Home _ Business __ Speculation
No. Bedrooms No. Baths _ Z No. in Family _
Garbage Disposal YES ❑ NO Specifications for System:
Auto Dish Washer YES ❑ NO
Auto Wash Machine YES ❑ NO
'n'
Type Water Supply
*This permit Void if sewage stem described below is not installed within 36 months from date of issue.
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
-2
w,e
;7/' lav �r
C��-1��
a
Certificate of Com Pletion Date
*The signing of this certificate shall indicate that the system desc i ed a ove 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 COUFTY HEALTH DEPART IEi?T
ETTVIROM EENTAL HEALTH SECTION
SOIL/SITE EVALUATIOU
VAIT 4 �/La/' DATE
ADDRESS
LOT SIZE
TOPOGRAPHY e
SOIL TEhTURE:
SOIL STRUCTU e U� S
DEPTH*.
RESTRICTIVE HOr IZOVS o --
PERCOLATION FATE:
1.
2.
3.
LOCATIO11
Presoak
Tlark & time
Drop Time
Rate/11i%. Inch
%CLASSIFICATIOP?'Suitable Provisionally Suitable Unsuitable
C012-MTTS e
SANITARIAIT
SITE DIAGMi