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773 Bear Creek Church RdDavie County, NC . � Tax Parcel Report Wednesday, October 12, 2016 WA1Z1V1N(T: 1tllS 1S NUT A SURVEY Parcel Information Parcel Number: D20000001503 Tovmship: Clarksville NCPIN Number: 5802707872 Municipality: Account Number: 8300427 Census Tract: 37059-801 Listed Owner 1: FORD JONATHAN ANDREW Voting Precinct: CLARKSVILLE Mailing Address 1: 773 BEAR CREEK CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Buiiding Value: Land Value: Total Assessed Value: NC Zoning Overlay: 27028-0000 Voluntary Ag. District: LOT 1 CHILDRESS PLACE Fire Response District: 9" ~'�' Davie County, `'��N��' NC 1.02 Elementary School Zone: 6/2011 Middle School Zone: 008620209 Soil Types: 0008 Flood Zone: 120 Watershed Overlay: 93290.00 Outbuilding 8� Extra Freatures Value: 18300.00 Total Market Value: 131140.00 No WILLIAM R. DAVIE WILLIAM R DAVtE NORTH DAVIE MnB2 DAVIE COUNTY 19550.00 131140.00 , ,�, .: _.`-+'"� � :�'`. \ Phone: (336) - 753 - 6780 � Davie County Health Department Environmental Health Section P.O. Box 848 210 Hospital Street Courier # : 09-40-06 _.�, Mocksville, NC 27028 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Fax: (336) - 753-1680 Name: �� Y� q'�� n �n (` a Phone Number 33� -�� � I-���5 � (Home) MailingAddress: ��.� �F�,� �r{, �c (�;,�,h d��� (Work) Mn( %�sv� II� N( �� �(�� � Email Address: . � Detailed D'uections To Site• D/o i��P r�( �i �i� � �� Property Address: � � �.t,r � ,�t �[ �„ ,f, h �z � Please Fill In The Following Information About The EXISTING Facility: iil7 � />��'/ / ,� Name System Installed Under: �, i� n r,��-��., �� r � Type Of Facili�..�� �� y Date System Installed (Month/Date/Year): N� (�� iQ �i j�'��� ! I Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? �Yes No If Yes, For How Long? f Jh� ii Any Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: /t�(' -� �, � r t,i ��c�� n,u � ��'�(0 Number Of Bedrooms: Pool Size: Garage Size: Other: Number of People. Requested By:,�.-Sj,.?-�,��f� .>^.�,/" Date Requested: �� %- �� (Signature) � pprove Disapproved Comments: For Environmental Health Office Use Only � � Gr? �>/� �� ��- � 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. Payment: Cash Check Money Order # Amount:$ Paid By: � Received By:_ Account #: Invoice #: Date: GoMAPS - Davie County NC Public Access ***WARNING: THIS IS NOT A SURVEY!*** This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the information contained on this map. The County and mapping company assume no legal responsibility for the information contained on this map. � Y�IAiERSHED_SiRUCi�� W�1'fER_BQDIES , � ��l1NTY_��UNDA�E�Y AC�C�E�ES� � � � �E�IV�S SiREET� .,_y1.:��J� RAILRQAD_C�N7ERLIN .�_, . � P,�FtC��S C ITY_LIf�91TS � BER�stUDA RUN � �OOLEE��;EE � DAVIE COUNTY � h40C1{SVILLE nccountics DAV I E � <all ather values> Tuesday, May 1 2012