269 Boxwood Church Rd ,Davie County,NC Tax Parcel Report ' l��C �- Monday, September 26, 2016
\ i'r
2316
i 11
44
—�� 256 \• ��'t
---r--�"� � 1 26 9
��
�. .` 107 �'r"
WARNING: THIS IS NOT A SURVEY
l Parcel Information
Parcel Number: N600000042 Township: Jerusalem
NCPIN Number: 5754390888 Municipality:
Account Number: 36774000 Census Tract: 37059-807
Listed Owner 1: HONEYCUTT JOEL EDGAR Voting Precinct: JERUSALEM
Mailing Address 1: 269 BOXWOOD CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27028-6667 Voluntary Ag.District: No
Legal Description: 1 LOT BOXWOOD CHURCH RD Fire Response District: JERUSALEM
Assessed Acreage: 0.63 Elementary School Zone: COOLEEMEE
Deed Date: 12/1991 Middle School Zone: SOUTH DAVIE
Deed Book/Page: OWILLO000 Soil Types: Pc62
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 75410.00 Outbuilding&Extra 3410.00
Freatures Value:
Land Value: 13840.00 Total Market Value: 92660.00
Total Assessed Value: 92660.00
161
AlldataIsprovided 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
N� County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
AUT9;*; IZATION_No: 162 OADAVIE COUNTY HEALTH DEPARTMENT
` ! Environmental Health Section PROPERTY INFORMATION
Permittee's _...11• 1/// P.O.Box 848
+J
Name: d P //Oil l6,1 A Mocksville,NC 27028 Subdivision Name:
Phone# 336-751-8760
Directions-to property: Section:' Lot:
AUTHORIZATION FOR
WASTEWATER
c+�r1 SYSTEM CONSTRUCTION Taxffice PIN: OD _ -6a&?1Zo
o��I ;
Road NameJr�ti,"/,11 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)
n
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
�?�''`` r `�� `� • DAME COUNTY HEALTH DE T ,� e
t62O
tlr� IMPROVEMENT AND OPERATIOP�Ia - PROPERTY INFORMATION
' k Permittee' i
t
Name: L�C' , '..` = /% Subdivision Name:
birections`to property: f, cf r .�: - 9/`,.+' 4 " £ p Section: Lot:
µ IMPROVEMENT
PERMIT Ta�xPffilce PIN: �10v -1 E P1 0& Z '
Road Name: t,......, r f. . ,/ Zip` z
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation of aseptic tank system or any wastewater system.An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the ,
constructfon/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)
✓s' j ***NOTICE***TILS PERMIT IS SUBJECT TO REVOCATION IF SITE
;�! / ' �✓ PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE— A;j #BEDROOMS "3 #BATHS _-2_#OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY ` u DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE IrAL. PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTH LINEAR FT.,,VO0
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT PpROV® U�JVT FILTER* *RISER(S) IF 6" FINISHED ISHED GRADE*
N �
-1V
IA
1�
**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(MmIrM a'x
(336)751-8760
OPERATION PERMIT
{{3'OV SYSTEM INSTALLED BY:
1
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS 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)
,
` �.�,'^ vtls.-i.y:,.y}.,, �S J.;w„ ..a.a'Lf •e s'-A."'v::�'.+(J""^':'vJ. ,,'.?--e o `. .c .7 6'. i , .- ...-... . .� ria•:,.�.
8ADAVIE COUNTY HEALTH DEI�ARTME4TT
IMPROVEMENT AND OPERATIONPE' "I� PROPERTY INFORMATION
Permittee's.. »
Name: *��# ;` ,fi°'�: �F' Subdivision Name:
Directions»to property: Section: Lot:
s IMPROVEMENT
'
PERMIT Tax Office PINjFfitl0
,r,1 .:^
Road Name �- . Zip:
**NOTE**This Improvement Permit DOES NOT authorize the construction oiinstallation 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 DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
r INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS -9 #OCCUPANTS_�GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY r DESIGN WASTEWATER FLOW(GPD) /r!' C NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE&&AL. PUMP TANK GAL. TRENCH WIDTH :-v ROCK DEPTH LINEAR FT.r✓fQ0
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: M
IMPROVEMENT PERMIT LAYOUT *APPROVED E + UENT FILTER* *RISER(S) .IF 611 BELOW FINISHED GRADE* �
N
1 ”
**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(�b�)'��d��M x
(33677SI-8760
OPERATION PERMIT -Jae
�� SYSTEM INSTALLED BY: i
{
4
AUTHORIZATION NO. `� OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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)
.j
' - r
• r
. . .. . . _ . _ ... ��: 1,
AfT 6 a klell;o ms
4�
Dpi
�,Jaoa� -
—4-
. . . . -_
.;flo v S 0 i—c DAVIE COUNTY HEALTH DEPARTMENT
O V'% s Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville,NC 27028
l e Phone: (336)751-8760
J ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
((Check One) REPLACEMENT❑ REMODELING ❑ RECONNECTION)(
Name: -j U �-- 17y Phone Number:`3 JC 2 9' z7 I (Home)
Mailing Address: �� oDX ,. ., c N, A 7 6?3 FSG (Work)
nloc k-SuII l ie N.(. 9-701,8 �J
Detailed Directions To Site: P p y b o l So� ,} R� "1 o vox t1oc� c N Y gal
rte, Ic o 'j . P4j1j1 !9 ))UusV 1';3Ln ).►i
(dao I=
Property Address: -L69 [3* t-,oJ C l 9,,o,
Please Fill In The Following Information Ajbout The Existing Dwelling.
Name System Installed Under: co r,� W`1 l)c.fv"-s Type Of Dwelling: r Q A M
Date System Installed(Month/Day/Year): X57 Number of Bedrooms: Number of People:_
Is The Dwelling Currently Vacant? Yes❑ N0>0 If Yes,For How L g?
Any Known Problems?Yes❑ No)� If Yes,Explain:
Please Fill In The Following Information About The New�Dwelling:
Type Of Dwelling: M 4--J V r/j G?v10-h-V l)0Number Of Bedrooms: J Number Of People:
Requested By: 7q Date Requested:
(Signa e)
For Environmental Health Office Use Only '
I Appro Disapproved /
Comments: S P 'f1�/ a / a C e-
his
Environmental Health Specialist
�4dd/ 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: $ Date:
Paid By: Received By: (�/�C/
Account #: F�o Invoice #: -I q
•: x .�'y�-''.T�'+'SxlK'�� i�j,s:,i;iriyu�{a¢�pp?�1�..".-"o'vv. ". /;`�..^.• s-.-v- ... _. _._ - ._
DAVIE COUNTY HEALTH DEPARTMENT
Ao
S �: s Environmental Health Section j
PO Box 848/210 Hospital Street
~� Mocksville,NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
1 (Check One) REPLACEMENT❑ REMODELING ❑ RECONNECTIONS
Name: �U e LN Phone Number:`3 3G Z Fjki � + (Home)
Mailing Address. ,,2 hcf I. e u k Cb . 7 c 23 $9 S 6 (Work)
mo(,1LSlii Ile N.�. �_7oZt3
Detailed Directions To"Site: 14 wy 6 o l S,A� to 60 1� INyocle CP , k a\
'1z rr lc 0"i ) e r-) Pm L-e j,rj
no o r
Property Address: Z G q C
Please Fi11.In The Following InformationA�out The Existing Dwelling.
/f' w1 LLS
A,
Name System Installed Under: "'`2'a W`) S Type Of Dwelling. �' a A;M
Date System Installed(Month/Day/Year): 157 ( Number Of Bedrooms: Number Of People:_
Is The Dwelling Currently Vacant? Yes❑ 'No� ; If Yes,For How L g? ~`
Any Known Problems?Yes❑ No If Y ,\]Explain:
Ur
Please F'11 l'}�'Th� Fo� owing Information About The New Dwelling: `
Type Of wellur °Number Of Bedrooms: Number Of People: '
k •cc
t Request'ci� :' 71 Date Requested: . �- 1 1
k: ` (Signa e) G
t•i''� 1 r y. '
For Environmental Health Office Use Only
Approved_ Disapproved4 >
Comments:.._ . f'%�17G,�f �✓ /' /l / y's/ D o F
Environmental Health Specialist ' ate
"The signing of this form by the Environmentallie—alth Staff is ' no way intended,nor should'be taken as a
guarantee(extended or limited)that the on-siVwastewa_ter syst m will function properly for.any given period of time.
Payment: Cash❑ Check❑ MoneyOrderIV # E'er J-i Amount: $ Date:
z.
Paid By: / Received$y:
',, Account # z 0 f oice #: