134 Bear Creek Church Rd Davie County, NC Tax Parcel Report 0 d Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: E200000043 Township: Clarksville
NCPIN Number: 5811583256 Municipality:
Account Number: 62416000 Census Tract: 37059-801
Listed Owner 1: ROLLINS HAROLD LOYD JR Voting Precinct: CLARKSVILLE
Mailing Address 1: 1201 WAGNER ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 1.000 AC BEAR CREEK CH Fire Response District: WILLIAM R. DAVIE
Assessed Acreage: 0.91 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 11/2006 Middle School Zone: NORTH DAVIE
Deed Book/Page: 006880621 Soil Types: MnB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 45740.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 18180.00 Total Market Value: 63920.00
Total Assessed Value: 63920.00
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County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
r'pU Kq'� NC or arising out of the use or inability to use the GIS data provided by this webslte.
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A4JTH0R'ZATION NO: 8 D bhDAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTYINF.
C Permittee's-�--�-� �, P.O.Box 848
.Name: lot Mocksville;NC 27028 Subdivision Name:
Direc`tions'to property: t{,tl� X10 . t� Phone# 336-731-8760
" Section: Lot:
TON FOR"AUTHORIZA
WASTEWATER
Tax Office PIN:# _
' SYSTEM CONSTRUCTION , f
vz l4 Road Name: Pixie `-i LZip�7-2 R
**NOTE**This Authorization for Wastewater System Construction MUST BE
' y ISSUED by the Davie County Environmental Health Section prior
A. to issuance of any Building'Permits.This Form/Authorization Number should be presented to.the Davie County Building Inspections
1'
'Office when applying for Building Permits:
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section'.1900 Sewage Treatment and Disposal Systems)
***NOTICE**.*THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
7o 6 1 IS VALID FOR A PERIOD OF FIVE YEARS. .
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0 M 7R -tt THS'ECIALSO lSSU D
It 60h DAVIE COUNTY HEALTH DEkktMANT ';.
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION -
h .Perniitt0ets�-,.;.�..-•.---. � �
.Name `01 1 x � — Subdivision Name:
�.,eDire6tions`to property: ` t- �� `1 t ,I+- .i'� Section: — Lot:
" EUPROVEMENT .
tr.a PERMIT Tax Office PIN:# - -
Road e. l...r., i_ -,i',.t.� ' '�II ''
r., NOTE_ Ibis 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 1 I 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
ENVIRONMENT HEALTH SPECIALIST. DA ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
..... INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPEH u.J #BEDROOMS 7 #BATHS,7_#OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITYTYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY0-b0;J f 1"
DESIGN WASTEWATER FLOW(GPD) "f ' NEW SITE REPAIR SITE'
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH 2 LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: l A)n T RLL O j C6kd rOO2, Fr Co 'JEtJ (JAS Fr rS'�
IMPROVEMENT PERMIT LAYOUT*APPROVED EFFLUENT FILTER* *RISER(S) IF 6112 BEL06 . FINISHED GRADE*
_ `
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X-T . Get*.�T� -S
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"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH D TMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY INSTALLATION.TELEPHONE#IS�4tf0814iB'f8W.
(336)751-8760
OPERATION PERMIT SYSTEM INSTALLED BY: c�H QLMA�
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AUTHORIZATION NO. !k OPERATION PERMIT BY: DATE: d
""THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS M DESCRIB AB AS BEEN INSTALLED IN COMPLIANCE
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)
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6 011 DAVIE COUNTY HEALTH DEI�Ar0,A1f'NT
g IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
C. . Perniitte�'s .
t � .Nafne: M r ► j Subdivision Name:
Dire6tipns to property: �' (.1+', '�` Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# - -
Road Name s Zip:IS
'
**NOTE**This Improvement Permit DOES NOT authorize the constriction 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 DAT4 ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
H...
RESIDENTIAL SPECIFICATION:BUILDING TYPE(- (U+- #BEDROOMS #BATHS Z_#OCCUPANTS GARBAGE DISPOSAL:Yes or No
i
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY L�nFl 1 DESIGN WAS FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH'-�' ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: 1 �LC C :�Toy�, E`r'C/� t J1w 14)
IMPRovEMENTPERMITLAYoUT-*APtP-ROVED EFFLUENT FILTE.R* *RISER(S) IF 611 130L0i4;FINISHED GRADE*
` C- ti- hc,V
n1L ; C
t-? y .
r.
V3 �L
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH D� TMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY QF INSTALLATION.TELEPHONE#IS(%6?R41W.
(336)751-11760
OPERATION PERMIT SYSTEM INSTALLED BY:Na
w rT.
, sr
TtT
c A
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED AB AS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE i I 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 HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. i
Permit Number
Name " fr �_. ;` i . f ti Date / 2092
Location 1 ,1' /• j
Subdivision Name Lot No. _ Sec. or Block No.
Lot Size House Mobile Home - Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES .❑ NO Specifications for System:
Auto Dish Washer*. YES ❑ NO 0--'-
Auto Wash Machine YES ❑_.'-NO {]
Type Water Supply '' ' f.� r', •. -> : :., -- ; ':," ti k .
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by ? ' �,i'-� �-{ i
*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.
11 it4� {
Final Installation Diagram: System Installed by `�'
I
. I
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i
(, �,� 3 �
.i o f
Certificate of Completion ~ �'� �r `/ ,r Date —_
*The signing of this certificate shall indicate that the system described above has ben 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.
02/20/2001 DAVIE COUNTY WATER DEPARTMENT PAGE 1
10:24:22 ADJUSTMENT ubacthst
A/R CATEGORY: 60
ACCOUNT # CUSTOMER NAME PARCEL INTEREST DUE ENDING BALANCE TOTAL DUE
LOCATION
DATE BILL# SERVICE# TYPE CURR READ # USAGE AMOUNT
------------------------------------------------------------------------------------------------------------------------------------
01811776 208798 JONES RICHARD TODD .00 .00 .00
134 BEAR CREEK CH RD
02/09/2001 69784 it -001 Pmt Pr 71.17
01/16/2001 69784 11 -001 Charge 1515700 19400 -�)ls 71.17
12/18/2000 62049 LF -001 Pmt Pr 5.00
12/18/2000 62049 11 -001 Pmt Pr �2p� 73.98
11/16/2000 62049 11 -001 Charge 1496300 20300 JD 73.98
11/16/2000 62049 LF -001 Adj 5.00 DG'
10/06/2000 54335 11 -001 Pmt Pr e1, 84.2709/15/2000 54335 11 -001 Charge 1476000 23600 �1 J /84.2710/06/2000 46685 11 -001 Pmt Pr 5.0008/11/2000 46685 LF -001 Pmt Pr 5.0008/11/2000 46685 11 -001 Pmt Pr 77.40
07/15/2000 46685 LF -001 Adj �],cT9 2 5.00
Vv
07/15/2000 46685 it -001 Charge 1452400 23000 82.40
06/07/2000 39052 11 -001 Pmt Pr — 73.35
05/15/2000 39052 11 -001 Charge 1429400 20100 '3310 73.35
04/05/2000 31501 11 -001 Pmt Pr 63.99
03/15/2000 31501 11 -001 Charge 1409300 171 63.99 �X
02/08/2000 23961 11 -001 Pmt Pr M02fZ 75.15
01/18/2000 23961 11 -001 Charge 1392200 21200 JJ/ 75.15
** END OF REPORT **
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CAW TO
COMPLAINT FORM
DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
Date Received 7,/1,5/0, (�J
Name of Complainant �— Received By (�
v
Address -Telephone—
Complaint
Telephone Complaint Acr 1T QQ r=2p=t� 19,A_
Person Responsible for Cmplaint V
Address Telephone.( L47 'X7 to
Directions to Complaint AJ `�• `) � ® � CQ.Z���
Date Investigated Investigated By
Complaint Justified Complaint Not Justified AA-- + �
Action Taken ✓�S�,'�"L>`� �tfT� 7 ) d �eN^ Pyr ,J
v s
1 % a
Date Environmental Health Staff Signa re
(DCHD 1/85)