217 Cedar Grove Church Rd Davie'County,NC Tax Parcel Report 1 �p Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: J700000106 Township: Fulton
NCPIN Number: 5777175000 Municipality:
Account Number: 19012000 Census Tract: 37059-804
Listed Owner 1: CREWS HAROLD EUGENE Voting Precinct: FULTON
Mailing Address 1: 217 CEDAR GROVE CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 1.77 AC CEDAR GROVE CHR Fire Response District: FORK
Assessed Acreage: 1.09 Elementary School Zone: CORNATZER
Deed Date: 10/1972 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 000880474 Soil Types: PaD,Pc132
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 175940.00 Outbuilding&Extra 9250.00
Freatures Value:
Land Value: 20050.00 Total Market Value: 205240.00
Total Assessed Value: 205240.00
I.v 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 Countys 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
�O Noy NC or arising out of the use or Inability to use the GIS data provided by this website.
_ DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
AP/P (CATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME
/'r//�re C-
�� �. PHONE NUMBER
ADDRESS C,� ` ��dve ��G, SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
,V
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: ,` 8.9.0,4DAVIE COUNTY HEALTH DEPARTMENT
'En vironmental Health Section PROPERTY INFORMATION
:Permittee's / P.O. Box 848 d
Name: /� l�'�-�' ti Mocksville,NG 27028 Subdivision Name:
Phone# 336-751-8760
Directions to property: /_�C ' ��h/ J�3t/P' Section: Lot:
"� AUTHORIZATION FOR�"'
�' ;/,�/_s✓: / {� WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION "
Road Name: Zip:
**NOTE**This Authorization for Wastewater System Cons-truction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of,any Building Permits.This Form/Authon'zation Number should be presented to the Davie County Building Inspections
Office when applying for Building PetmitS.
(In compliancewith Article I 1 of G.S.Chapter 130A,'Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
t' ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
r ENVIRONMENTA HEALTH SPECIALIST ' DATE ISSUED.
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1`8 9 Oft DAVIE COUNTY HEALTH DVP •RTMENT
IMPROVEMENT AND OPERATION ERMITS PROPERTY INFORMATION
;.Name: Jf% - �''!�'' 't Subdivision Named ' �2 5- O
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"Directions to property:� f `' .-' �; I/r' Section: Lot:
ff IMPROVEMENT
PERMIT. Tax Office PIN:#
Road Name: Zip:
**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/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)
r ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER, ' .
ENVIRONMENT�HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE .
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS S #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION:.FACILITY.TYPE #PEOPLE #PEOPLE/SHIFT #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.6 !ROCK DEPTH_ LINEAR FT. �
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT 0J)PROVED EFFLUENT FILTER* *RISER(S) IF 619 BELEM FINISHED GRADE*
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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(764J 151#MMUI x "
(336)751-8760
OPERATION PERMIT
SYSTEM INSTALLED BY:-A"j �'
;7D
Ate
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: J l�
**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)