114 Camelot WayDavie County, NC
Tax Parcel Report Wednesday, October 12, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City: MOCKSVILLE
State:
WARNING: THIS IS NOT A SURV�Y
Parcel Information
N60000007304 Township: Jerusalem
5754397110 Municipality:
82524063 Census Tract: 37059-807
HAYES PHYLLIS S Voting Precinct: JERUSALEM
112 CAMELOT WAY Planning Jurisdiction: Davie County
Zoning Class: DAVIE COUNTY R-20
NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag. District:
Legal Description: 1.66 AC BOXWOOD CHURCH RD Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
1.66 Elementary School Zone
12/2004 Middle School Zone:
2005E0040 Soil Types:
Flood Zone:
Watershed Overlay:
0.00 Outbuilding & Extra
Freatures Value:
No
JERUSALEM
COOLEEMEE
SOUTH DAVIE
PcB2
DAVIE COUNTY
9000.00
Land Value: 23720.00 Total Market Value: 32720.00
Total Assessed Value: 32720.00
��,v i AII data is provided as is without warranty or guarantee of any kind either expressed or Implied including but not limited to tho �
9 �. e F Davie County� Implied warrenties of inerchantability or fitness for a particular use. AII users of Davie Countys GIS websita shall hold harmless the
N� County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of actlon due to
np�� �q'� or arising out of the use or inability to use tho GIS data provlded by thfs webslte.
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Ptione: (336) - 753 - 6780
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Davle County
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ENVIRONMENTAL HFJk�T�10 Ho
� DAVIE COUNIY
th Depart�nent
.ealth Section
8A,8
Street �
Mocicsville, NC 27028
P2r: (336) - 753-1680
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection (� 1�3.?� - 4�9 - f( 7� 3
Name: � Phone Number �v � �-��'Z � ' i' 7� � �(Home)
Mailing Addres . � a ��fa � � ��— 12,,��r✓ (Work)
r_ a T�� m w�sz �� vZ al `�'
Detailed Directions To Site: �p �� 5' 6'k,�, . �'�^ e�b ��i> I�,�,d �',, �( V�"-(.��j�
Please Fill In The Following Information About The EXISTING Facility: ( fL �� �6,�
`_ �-�' �
Name System Installed Under: Type Of Facility: __G ��� ���( ti$
Date System Installed (Month/Date/Year): e9 u�Number Of Bedrooms: � Number Of People:�_
Is The Facility Currently Vacant? Yes � If Yes, For How Long? 2-- �./z2.�t�,��, � C T.��
Any Known Problems? Yes No If Yes, Explain: �
�:nf'�' S i.f�f- 3i-7110
Please Fill In The Following Information About The NEW Facility:
Type Of Facility:� �C(,q � s� N 11 i1�. Number Of Bedrooms:�_Number of People�_
Requested By: � Date Requested:
(Signature)
For Environmental Health Office Use Only
Approved Disapproved
n n i i
Environmental Health Specialist
Date:_�2 $"/za/, t3
*The signing of this form by the Envirorunental Health Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payinent: a Check Money Order # Amount:$ /eJIJ•u/ Date: �-�,i- to«
Paid By:_ �� ti\L5 �4,,.� Received By: Q�
Account #: .$�S� Invoice #: �%S3
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