123 Bethlehem Rd Davie County, NC Tax Parcel Report Friday, September 23, 201 f
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WARNING: THIS IS NOT A SURVEY
ParcelInformation
Parcel Number: D700000116 Township: Farmington
NCPIN Number: 5861492429 Municipality:
Account Number: 8300342 Census Tract: 37059-802
Listed Owner 1: ALLEN BARBARA P Voting Precinct: SMITH GROVE
Mailing Address 1: 156 ROLAND ROAD Planning Jurisdiction: Davie County
City:- MOCKSVILLE - Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: .27028-0000 Voluntary Ag.District: No
Legal Description: LOTS 105-108 SMITH - Fire Response District: SMITH GROVE
Assessed Acreage: 0.48 Elementary School Zone: PINEBROOK
Deed Date: 5/2011 Middle School Zone: NORTH DAVIE
Deed Book/Page: 008590193 Soil Types: GnB2
Plat Book: 0003 Flood Zone:
Plat Page: 075 Watershed Overlay: DAVIE COUNTY
Building Value: 33280.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 32400.00 Total Market Value: 65680.00
Total Assessed Value: 65680.00
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
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NC or arising out of the use or inability to use the GIS data provided by this website.
+ 0. DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION Pe3
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) �-.� (�
1
NAME PHONE NUMBER
ADDRESS 1,03 3&4.Ie. t 1 S+teat SUBDIVISION NAME
adu. 27uo(a LOT#
DIRECTIONS TO SITE I�$" T• L-0 F4- ReJ td,-Q ReQ — 1 R+- 44A1e_hC_ S'-.
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS a NUMBER PEOPLE SERVED
TYPE WATER SUPPLY Cejt..Tti SPECIFY PROBLEM OCCURRING
DATE REQUESTED_ INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1193
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AUTHORIZATION NO: rJ DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's:.r P.O.Box 848
Name: f'G Mocksville,NC 27028 Subdivision Name:
-Phone# 336-751-8760
Directions to property: r� r%!!• �/ Section: Lot:
.� AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# _ -
SYSTEM CONSTRUCTION
Road Name:ItAlt kj—Sl. Zips L7u0G
**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 cpliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section:1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
EN IRONME TAI HEALTH SPECIALIST DATE ISSU D
tis `�,,::c � � -y •�-. - ' �-�• Utz.p,:i}a 'w: F. s,• af. ti t -i'.,,. i :p. _ - :_. ` . r�...y:,.� fF ,�r,•a, y --, ti yv ,,
5-"UF DAVIE.COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROP
TYINFORMATION
— .Permittee's..---
Subdivision Name.
Directions to property; Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: ?QW e h` 0• Zip: 2 7 uy
**NOTE**This 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/mstallation 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
O AL HEALTH SPECIALIST DATE ISSUED _ SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS / #OCCUPANTS / GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFr #SEATS INDUSTRIAL WASTE:Yes or No.,
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR Fr.Z.2e)..
OTHER
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REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUENT FILTER* *RISER(S) IF 6" BELOW FINISHED 6RRDE*
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**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 THE DAY OF INSTALLATION.TELEPHONE#IS(7%U 63418 WH X
(336)751-8760
OPERATION PERMIT
YSTEM INSTALLED BY:
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AOLI) o e�Te-�PA,
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AUTHORIZATION NO. � PERATION PERMIT BY: 1
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS SCRI BOVE HAS 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)