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292 Boxwood Church RdDavie Ccunty, NC r- _� Tax Parcel Report Wednesdav. October 12. 2016 r' � � � }. ,.' � ;;F;�I(�� � l.fv 1 f ..,,, ` � "�.� l 1 � � 'I WARNING: THIS IS NOT A SURV�Y ; . . ParcelInformation Parcel Number: N60000004801 Township: Jerusalem NCPIN Number: 5754391451 Municipality: Account Number: 77124500 Census Tract: 37059-807 Listed Owner 1: WAUGH MELISSA F Voting Precinct: JERUSALEM Mailing Address 1: 292 BOXWOOD CHURCH 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: 1.04 AC BOXWOOD CHURCH RD Fire Response District: JERUSALEM Assessed Acreage: 0.86 Elementary School Zone: COOLEEMEE Deed Date: 11/1983 Middle School Zone: SOUTH DAVIE Deed Book I Page: 001210057 Soil Types: PcB2,PcC2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 43130.00 Outbuilding & Extra 90.00 Freatures Value: Land Value: 16270.00 Total Market Value: 59490.00 Total Assessed Value: 59490.00 �---- ----___— _ _ _. ______ _ __ _ _ . ------ --------- °��'°'F Davie County, �'o,;N�j NC All data Is provlded as Is without warranty or guarantee of any kfnd either expressed or Implied including but not limited to the Implied wa�renties of inerchantability or fitness for a particular use. All users of Davio County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all clafms or causes of actfon due to or arisfng aut of the usa or inability to use the GIS data provided by thls webslte, PV j �I�ePCounty Health Department � 1836 � ��`' �-onmental Health Section .-_ � , r�U� O � \,��:1� �: `'� �a P.O. Box 848 �'�`S„ y f,::�, 210 Hospit��l Street U �'S. . - - Courier # : 09-40-06 �� �� � � Mocksville, NC 27028 Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Fas: (336) - 753-1G80 Name: � +� � �/'V � �[ %7 Phone Number �3�' �!��OUG' (Home) Mailing Address: (�� '� � (Work) —�vC�y'�cS (%i,� - / lf C ��V �� Email Address: Detail d Direction�j To Site: ���OC.�f' l��'/� /L(1 • o,� Lc �cr�. .S �d ✓1'1. I'i 1J ? r iC !? v . L6 •� i /J --�r��, n � -�' �.� �.l. l�/� . Property Address: ��o? ��,r(,{� �, �. �1(�e�SU���F� Please Fill In The Following Information About The EXISTING Facility: � �• Name System Installed Under: Type Of Facility: �,- "` (/lJ ��� � Date System Installed (Month/Date/Year): %� Z� 9 Number Of Bedrooms: /� Number Of People: ✓ Is The Facility Cunently Vacant? es No If Yes, For How Long? ��l�U�i'f �,/1%(,�� ��� �/% . � Any Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The 1V�W Facility: Type Of Facility: � .� �(�(, Number Of Bedrooms: f Number of People � Pool Size: Gar ge Size: Other: � � �(Requested By: �ate Requested: � � �� � (S ignature) ...-. � Approve Disapproved omments: I 01? n G�"�l' Environmental Health Specialist For Environmental Health Offce Use Only s� Date: *The signing of this form by the Environmental Health Siaff 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 Paid By Money Order # S� Amount:$ ved By:_ Account #: �", � �� Invoice # 7i � .,� _ � � . t ��.b �^'" _ , ,, � P8 I,�' � : - ',`� .C�� ~ ''�'S,, O U � �C 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: /�I'� l' G/t/Q �{ /l7 Phone Number_ ��� �y`�'��U�' (Home) Mailing Address: a 6jC i (Work) 1�(� h` js (,�/ �C ! u���V G- � Email Address: Detail d Direction To Site: D �� f�v)C (,�Q� 1... �� �(i� (� /L� LC - (•f(a/� S � �. . � . n . .r � �0✓� , �1C� �� � , no • /<.'/� . Property Address: �, �� � (��'�C.)t d . �I �1. i �1(��f )S �����' Please Fill In The Following Information About The EXISTING Facility: (, � � � ��-� � Name System Installed Under: Type Of Facility: �- Date System Installed (Month/Date/Year): f�(> � Number Of Bedrooms: .� Number"Of People: � Is The Facili Currentl Vacant? es No If Yes, For How Lon � � I � tY Y � g•� (� �t/ L1 Lli i'% G.�v�7 ,.� P_ Y GE�� • .� Any Known Problems? Yes No If Yes, Explain: .. . . .... w ^ � . . . . // , .... . , ..L� . . . . � . . Please Fill In The Following-Information About.The W Facility: .,.. Type Of Facility: �ln� l.rV i'��� �(�1I Number Of Bedrooms: F� Number of People J� Pool Size: Garage Size: Other: (�(Requested By: //�E 1 ; , , >� ir �.._ir,/rL � ' ' ��ate Requested: /f1;r- �� '' �� � ���� � �" (Signature) . , j �� .. , , � For Environmental Health Office Use Only Approved Disapproved ' ._.—�`' ) % �^- - � � _ f � omments:� � l �'��'l� i('ii /�"GSi` `-, r 11 �e�' ` `--,r��:- <1.�.'� . , ,C. r"/(j'� ! .! � i _ . t ?"��/ '�` �./f' Environmental Health Specialist ;i _r r/�{ f�1 _Date: � T,% �� f i� i,/ r *The signing of this form by the Environmental Health Staff is in,no way,intended, nor should be taken as a guarantee (extended ar limited) that the on-site wastewater system will function properly for any given period of time. Payment: Paid By:_ � Money Order # / SSG Amount:$� eived By:��� Account #: � 7 � cg - Invoice #: l�