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P0568 Childrens Home RdDavie County, NC Tax Parcel Report Tuesday, October 11, 2016 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: C30000000301 Township: Clarksville NCPIN Number: 5813710233 Municipality: Account Number: 47836500 Census Tract: 37059-801 Listed Owner 1: MATHIS NORRIS DALE Voting Precinct: CLARKSVILLE Mailing Address 1: 1733 CENTER RD Planning Jurisdiction: Davie County City: BOONVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27011-0000 Voluntary Ag. District: No Legal Description: 57.08 AC OFF CHILDRENS HM Fire Response District: COURTNEY,WILLIAM R. DAVIE Assessed Acreage: 57.08 Elementary School Zone: WILLIAM R DAVIE Deed Date: 5/1996 Middle School Zone: NORTH DAVIE Deed Book I Page: 001870191 Soil Types: MnC2,MnB2,MdD,RvA,ChA,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: Land Value: Total Assessed Value: °���°'�' Davie County, `'oux�c" NC Outbuilding & Extra 0.00 Freatures Value: 30.00 148910.00 Total Market Value: 148940.00 148940.00 All data Is provlded as Is without warranty or guarantee of any klnd either expressed or Implled Including but not limlted to the implicd warrantics of inerchanta6ility or fitness For a particular use. All users of Davle County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, eontroctors or employees from any and all claims or causes of action due ta or arising out of the use or inability to use the GIS data provided by thls webslte. ._ : ; _ , ��i:',l 1 ,:`,,, t.:.4�'- n ... :.Y._ {S .' Y��.< ' . w.'".Y` _' ��+� .. _ . Y .� � .. j '��' � . .:1._ . z�.a � i .� '� �/ � -- { �.....l.py�� . . -_ ���V ' �. ! 'i�. -.• - ." . �.� �:�. ' -,'. t 1 �► `�� ' > : au�rxoxizkTioN rio: O 5 6$ DAVIE COUNTY HEALTH DEPARTMENT '�� ' a a'� l.'�'y`�'��' �` . , Environmental Health Section PROPERTY INFORMATION Permi.te�' �t � '(�{'� ��1, � � P.O. Box 848 � Name: ������� � �' E Mocksville, NC 27028 Subdivision Name: ` � � � „ � � Phone #: 704-634-8760 Directions to property: �p t'` Section: '_ Lot: AUTHORIZATION FOR �... � 1 'fv � �) i..� i E � ��` � "' ��, L: , �. � � � � i; ;- c �,�, WASTEWATER SYSTEM CONSTRUCTION �` r. �`�, '��"` R �` N � � 4�, � � � J � � `�'t�'''. . <ht�„ C„j�j•�'.� SJ'r3,�}, , . . Ir Tax Office PIN:#,.% �� :- 1�- d�� �' 1 � l � Road Name�. r, S \ � 1 ' P;' - � �a t,',,.'.�ip: } � Q � �, **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance�of any Building Pernuts. This Form/Authorization Number should be presented to the Davie Counry Building Inspections • Office when applying for Building Pernuts. � (In compliance with Article ll of G.S: �hapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) >�.. �, �� � L {`it ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �� �' \� ��'n , \�..h-7'�7��`�...��- - � �� i 1!'• � ��r� � . . . �___,�t.-�;a,..R.... ->.:� IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONM�NTAL HEALTH�SPECIALIST .` , DATE ISSUED �`^, �iUDSD . . , ';';.. . _ ;�,.� .s_,�� _ ��:-,�,ti -..�. . � � ..,:,_y,._.� r�,�l ,.._., .,�.._„t��. � �.� .. , -� �- . ..,. y ,..;�., ,\. . ..i . �- � : '� : - ' , � `- �� �_��=--� -� �%� �' • 4'�° ~ DAV� COUNTY HEALTH DEPARTMENT '� ' �'�� F� � � " ` ``" �" " IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION y„'', " ` .Petrfii`tt e � � � � � a ��'�ti ;_' , �, � �; . , Name.n ., � ;�i. f ����,. 1 � �� i. ., _ , , --� - -^� ' �� � Subdivision Name: • . " . _, -. ,. �: { "buections.to property: ''�` � �� t � � � ''° � '�S�` Section: Lot: t� ' � o IMPROVEMENT 1��� � �� � s � � : t ` �x :i " f� s � �r�c, ��. "�� � � � � s � , � PERNIIT Tax Office PIN:# � 7 t . _� # . �a�i,�., 11:� " � ',... � :'`1. sr^.. '. � �`�.. ' � �� , . �.. � `' Road Name. Zip: **NOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An ALTTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Deparhnent prior to the �, construction/'u►stallation of a system or the issuance of a building pernut. (In comp�i�ance 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 ":; •., -,: � ',., �,, '` 4;;., �._ �-`- t PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE �1t,��,� INSTALLING THE SYSTEM. ! RESIDENTIAL SPECIFICAITON: BUILDING TYPE ����c izb # BEDROOMS ,� # BATHS �. # OCCUPANTS �, GARBAGE DISPOSAL: Yes o�!,�To� ,� , COMMERCIAL SPECIFTCATTON: FACILITY 1'YPE # PEOPLE # PEOPLF/SHIFf # SEATS INDUSTRIAL WAST'E: Yes or No �y-+'�`SA ... � � LOT SIZE�� � TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) �� NEW SITE V�� � REPAIR SITE /�, v -, 1 u SYSTEM SPECIFICATIONS: TANK SIZE� �� � GAL. PUMP'TANK GAL. TRENCH WIDTH �-� ROCK DEPTH '� LINEAR FI'. u J t 01'HER � ".,� '' REQUIRED SITE MODIFICATIONS/CONDTfIONS: IMPROVEMENT PERMIT LAYOUT F '�• '�4 �_ � � �l^- _ , -.. -" --- ._.. 1 � � � �U � �� v V � ''`'- � ����`? �� � �.J r _ _ � � � � � �-- _._.. �� - , j^�•�----�"�""�--'�..-�'1 � � ., . 1 J.,-��, 1 � �,/,�� �l ' u �1/ � �1, / J� � � �0 � � ! �� �3 � � � d � **CONTACf A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEI� 8:30 - 9:30 A.M. OR 1:00 - 130 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. � I OPERATION PERMIT BY: i 6S� AUTHORIZATION NO. ,�2� OPERATION PERMIT BY: ��C/ 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. CHAP'TER 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 OS/96 (Revised) ., .� � . � ��/ ��,� ���' 1� ���' � ��, � i ��,�? � �� � �-� �;�� � r ��� �r APPLICA�(ON FOR SITE EVALUATION/IMPROV ENTS PERI , �� �✓e�,�� � �11r�� Davie County Health Department Environmental Health Section � �¢l-Y��1`''''� P. O. Box 665 . �%d � Mocksvil►e, NC 27028 1. Application/Permit I Mailing Address 2. Name on Permit if 3. Application for: 4. System to Serve: O Business O Mobile Home � ��i\ C P\1 Tank Installation Permit ❑ Place of Public Assembly O Industry � Other ❑ Unknown 5. If house, mobile home: Subdivision No. of People No. of Bedrooms _ No. of Bathrooms _ Dwelling Dimensions v 7i� 6. If business, industry, place of public assembly, other: Specify type No. of People Seroed No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers Section Lot # ❑ BasemenUPlumbing O Basement/No P�umbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal No. of Showers Water U�age Figures / 7. Type of water supply: 0 Public Cy'Private O Community 8. Property Dimensions �7 ��-�es �"�3�- � Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes No If yes, what type? 'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: � r� F G,f-1 � c-�rze,u S �_..L_2� � L¢ -F � a � ��,y . �or N � ��. � � j . �i"�" � Il� � t.l r4 ��� � �Q� � ,,� Ll-� r L � �-e�5 �a rx � � ' Tax Office PIN: #J���.3' 7%-� d 2.33 PIZOPE2�71, f,4bbItESS, as f o 11 ows : Ro ad NamD� �C�'! C. �,�P /J,S ��/yLY %GQ • City: /�ADC-�5 [I LG�Y . /l1� . SU$MZZ A PLAT WZTH THIS ttPPLZCATZON. Revisions effective October 1� 1995. �,47-�-. / S L� G �— G,� LL G e� �o�ST � ���� 1�3�-07�7 , �'1 � � LC_ This is to certify that the information provided is correct to the best of my knowledge incurred from thi pplicatioA. � _ � / C S � DATE �,�. � ��-��� - SIGNATURE I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. I OWN the property. Ci}�2. I DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized rePresentative of th Davie Count Health Departmer�/ to_ ent r yp n above described property located in Davie County and owned by G�j4 �' I� �� t�Y ��d � to conduct all testing procedures as necessary to determine said ite's suitability for a ground absorption sewage treatment and dispos I system. � � � �� � DATE " SIGNATU � /' (�Q ' U DCHD (1/93) ST r � w'' 'y''_ `'�, ' = _ _ � ` ----` �,, '� . � . .�,,.:., • , 6�7 ���lsw 2 O 8 I t- �' r � ,����.< • 550. 0�1 (.23ac')\ ¢�, w t �; i'r+ + ' � `" �` �,?�' � � � 1 "r lsb'�: �,�� '� a i"+�ta � � �!F" � . tn ' ��, �1 �y: 3 {'..��C �..�. i � , ,�• �+ m � t� � : rh ` � r ,, �; '��+.�,�, F .w M . . N � I �adr � h .,p . ,��� 1<. � 4� ^ a�F dit��e `S� � � � ^�r�M � i a.. '✓ °` S� •� �� '� �,, a v ° L� `' �".Fiic �� i ,S ,� t �z �2� . � t0 � _ V -,,4: 0. t,�d�%�`.'c .'� , . ' ,�^ �x� v �' . 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N.C. 27O2S PHONE: (704) 634-5985 Norris Dale Mathis P. 0. Box 672 Yadkinville, N.C. 27055 April 24, 1996 �e: Site �:valuation S7 Acres off Chil.drens Home Rd. Dear Mr. Mathis: As requested, a representative from this office visited the aforementioned site on Apri:1 23, 1996. Based upon the information provided on the application for a site evaluation and after an evaluation was completed, the site was found to be provisionally suitable for the installation of an on-sit� sewage disposal system. ' If you have any question�, ple�se feel free to contact this office. Enclosure(s) Sincerely, ,�o� �,z` � ����. Robert E. Hall, Jr., R.S. Environmental Health Section