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199 Covington Drive Lot 53n Davie County, NC Tax Parcel R Pnnrt Wednesday, November 30, 2016 Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9 AuVia��' 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 NCor arising out of the use or inability to use the GIS data provided by this website. WARNING: THIS 1S NOT A SURVEY _ Parcel Information Parcel Number: H806OA0053 Township: Shady Grove NCPIN Number: 5789237918 Municipality: Account Number: 82526094 Census Tract: 37059-804 Listed Owner 1: ACORN PAUL Voting Precinct: EAST SHADY GROVE Mailing Address 1: 45 TALLMAN STREET Planning Jurisdiction: Davie County City: JACKSONVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 28540-0000 Voluntary Ag. District: No Legal Description: LOT 53 COVINGTON CREEK PHASE ONE Fire Response District: ADVANCE Assessed Acreage: 0.70 Elementary School Zone: SHADY GROVE Deed Date: 3/2006 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 006550263 Soil Types: PcB2,PcC2 Plat Book: 0007 Flood Zone: Plat Page: 057 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9 AuVia��' 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 NCor arising out of the use or inability to use the GIS data provided by this website. DCHD 05/96 (Revised) d7G. t i Kit. Y�.� c;;y .'r: '."+'. r.k�:• :+ .y. t..- .ate--zw�--r...er •.e1 , I IoE4AT16N NO: 1 8 8 5 ,.DAVIE COUNTY HEALTH DEPARTMENT ` Environmental Health Section PROPERTY INFORMATION Pe it P.O. Box 848 :Name '` � • Mocksville NC 27028 - Subdivision Name: t '%Joe . Phone # 336-751-8760 Directions to property: fJ/ :%G' r �U/Section: Lot: AUTHORIZATION FOR Y WASTEWATER: Tax Office PIN:#.`%- SYSTEM CONSTRUCTION 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 Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section.1900 Sewage Treatment and Disposal Systems) IL ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.: ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI' Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE RE UIRED INFORMATION IS PROVIDED. 1. Name to be Billed 1yA rv%E S Contact Person I �r e- Mailing Address }�' //�)� is [l >! ;)-3d � Home Phone /� City/State/Zip witi c -C WC. ,-2 760IU Business Phone Wk -4177.L �8/3-aY/e C/ -WALT 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ite Evaluation [ ] Improvement Permit & ATC [ ] Both 4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ] Other ._.I(>+ uL�Iy�.S�o•�1 5. If Residence: # People # Bedrooms # Bathrooms [ I Dishwasher [ ] Garbage Disposal [ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: County/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes (tT90---- If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: A)a &� &6 ac . 0,rc.e WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # S- 789 - d -q - �� rLt a � 1 Sn 1A L 0! d -J4 w Le Property Address: Road lame 901 &Wr 8,4 1 m 't — [SLS 4 __ lide of E City/zip Alk• 27oo b Q L'.�520 r7Am ��e 1) Iw 4ers' �— If in Subdivision provide information, as follows: Name: [ ��t / n '0 1re e•k ?r��Sz�t ' l Section: ! Lot #: #" S3� This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter ar subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified o changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorize ve of the Davie County Health Department to enter upon above described property located in Davie County and owne .,.Y I all testing procedures as necessary to determine the site suitability. DATE i \J AN - Revised DCHD (06-96) 11115 ,ll:E.l 11 111 tir U FU J'01Z D1MIVINcj !J011k ;Q 11 PIAN: I" = ao' 1co•A ys, Lo T- 53 �gv*7((34SLI-f&Nr Go(,Y I tLl) Cu& l APPLICATION FOR SIZE EVAIMMON/IMPROVEMENT PERMIT do ATC Davie County Health Department t� a ' Env/ronmenfalIfeaft Seclfon D is P.O. Box 848/210 Hospital Street Mockoville, NC 27028 JAN - 81999 (336)751-8760 ***ZWCRTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THEQOIl2EIN,VIE-COU,�,ITY INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Dame to be Billed lor V Alarne 61"f ' /(>� Contact Person �/ sem. ✓��1 Mailing Address A /C /�'/ Home Phone City/State/ZIP; 11 (, 106/ Business Phone 2. Dame on Permit/ATC if Different than Above Nailing Address City/State/Zip 3. Application For: U Site Evaluation B'Improvement Permit/ATC 0 Both 4. system to service: ®'House ❑ Mobile Home ❑ Business 0 Industry 0 Other a. If Residence: # People # Bedrooms # Bathrooms 91Dishwasher 0 Garbage Disposal prxashing Machine 0 Basement/Plumbing 6. If Business/Industry/other: Specify type # Commodes # showers # Urinals # People kriasement/Do Plumbing # sinks # dater Coolers IF FOODSERVICE: 11 Seats Estimated slater Usage (gallons per day) 7. Type of water supply: b County/City 0 well 0 Community a. Do you anticipate additions or expansions of the facility this system Is intended to serve? 0 Yes If yes, what type' ***IMPIDRTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Zoo "X -30o - WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # Property Address: Road Name eJ ✓ K. Ae • gay T,1 eo64 i21,mn City/Zip If in a Subdivision provide information, as follows: Name: e-00,12 4✓2 4,"EC d 4 - Section: _� Block: Lot: Date Property Flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed I, also, understand that 1 ant responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Da_yie County Pleaith De artment to enter upon above described property located in Davie County and owned by le rr�4tyrn r /06--r� arc. to conduct all testing procedures as necessary to determine the site suitabigty. ,,, i DATE 7 / _ _ SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Account No. Revised DCHD (07/98) Invoice No. o 2