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Davie County, NC
Ail data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
Parcel Number:
0600000049
Township:
Jerusalem
NCPIN Number.
5754355941
Municipality:
Account Number:
82528934
Census Tract:
37059-807
Listed Owner 1:
LINDSAY JAMES L
Voting Precinct:
JERUSALEM
Mailing Address 1:
7610 PEGGY DRIVE
Planning Jurisdiction:
Davie County
City:
CLEMMONS
Zoning Class:
DAVIE COUNTY R-A,R-20
State:
NC
Zoning Overlay:
Zip Code:
27012-0000
Voluntary Ag. District:
No
Legal Description:
0.459 AC OFF BOXWOOD CHR
Fire Response District:
JERUSALEM
Assessed Acreage:
0.45
Elementary School Zone:
COOLEEMEE
Deed Date:
112003
Middle School Zone:
SOUTH DAVIE
Deed Book f Page:
2003E0315
Soil Types:
PcB2,PcC2
Plat Book:
Flood Zone:
X
Plat Page:
Watershed Overlay:
-
Building Value:
54390.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
8230.00
Total Market Value:
62620.00
Total Assessed Value:
62620.00
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Davie County, NC
Ail data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
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harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or
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causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
�S q
AUTi iORIZ�ITION NO [ , f Nl-
PcrUlittee
DAVIECOUNTYHEALTH DEPARTMNa's E v1ronmental Health Section ENT
.Name:. � ��
P -o- 13ox 848 PROPERTY INF
Directions r ocksville, NC 27028 ORMATION
A$hone #: 704-634- Subdivision Name:
8760
YS1EWAONFOR Section: "
TEM Lot:
CONSTIR
UCTIO Tax Office PIN:#
**NOTE** This Au -
thorization for Wastewater S -------
to
Z
issuance of an ystern Cons qoa" Mame:
Office when appj Building Permits. This Form/ action MUST. BE ISSUED b A-&
(in compliance with Article 11 of G S Building Pew Authorization Number should be the County Environine
Chapter 130A Presented to
Wastewater S the Davie County
Health Section prior
� f Systems, Section , ty Buildin
1900 Sewage Treatment g Inspections
ENVIRONMENTAL HEALTH SPE ***NOTICE*** and Disposal Systerns)
ST THIS A
DATE ISSUEDIORIZATION FOR
IS VALID FORA PERIOD �F IVE YEAR
ER CONSTRUCTION
RS.
DAVIE COUNTY HEALTH DEPARTMENT
' IM ROVE ENT AND OPERATION PERMITS PROPERTY. INFORMATION
Permittee's �
Name:/ t'Z*ye r . Subdivision Name: �.. �•
6 V(4
Directions aprope r r Section: Lot:
IMPROVEMENT
PERMIT r Tax Office PIN:# - -
l, = w/ Q ` Road Name:
s **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 CONST{JCTIONsmust be obtained from this Department prior to the
constructionhnstallation of a system or the issuance of a building pe iiut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 -Sewage Treatment and Disposal Systems)
y . ***NOTICE*** THISTERMIT IS SUBJECT TO REVOCATION IF SITE
/x "j%'fi �!"i'� PLANS OR -THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECiAEiST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING -THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS #BATHS _ #OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE74�17YPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR�TE
SYSTEM SPECIFICATIONS: TANK StzF/GAL. PUMP TANK GAL. TRENCH WIDTH 3�/ROCK DEPTH�,C LINEAR Fr�
OTHER (�/
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
. t
IS
U
**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 (704) 634-8760.
DCHD 05/96 (Revised)
' r
141 DAVIE COUNTY HEALTH DEPARTMENT
f2' * IM ROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's r-f=� p�
Name: Y° t &� Subdivision Name:• -
.. �� h't �. � ! f' �;
Directions Section: Lot:
--":~ IMPROVEMENT
,f� PERMIT Tax Office PIN:# -AJ
-
777J77.41, % � l oa ame: Nli ; t�1
* - **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
x AUTHORIZATION FOR WASTEWATER SYSTEM CONST.RUCTION,must be obtained from this Department prior to the
con structionfmstaHation of a system or the issuance of a building peFmit.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
/ ^k ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
r,�`"` ` 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 AITA # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No _
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE Yes or No ' ,
LOT SIZEYPAa'. TYPE WATER SUPPLY =— DESIGN WASTEWATER FLOW (GPD)*1 ? NEW SITE REPAIIt3SITE �
SYSTEM SPECIFICATIONS: TANK SIZF,�,-GAL. PUMP TANK GAL. TRENCH WIDTH /ROCK DEPTH� LINEAR FT s,!%y
k i
OTHER�/vl—_ 3"
r
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETW,131316.'30 - 9:30 A.M.,OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
ILI
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 0196 (Revised)
i
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETW,131316.'30 - 9:30 A.M.,OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
ILI
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 0196 (Revised)
NAME
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
iil�9tsl� PHONE NUMBER
...........
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
—o
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY___ SPECIFY PROBLEM OCCURRING
DATE REQUESTED A INFORMATION TAKEN BY 1-10-1 YA!/
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