1532 Deadmon Rd 0
I?avie County,NC Tax Parcel Report `fb Monday, September 26, 2016
T 1532
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TOM CROTTS LN
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: L600000032 Township: Jerusalem
NCPIN Number: 5756674704 Municipality:
Account Number: 82525600 Census Tract: 37059-807
Listed Owner 1: ALLEN REBECCA LEE ANGELL ETAL Voting Precinct: JERUSALEM
Mailing Address 1: 799 CHERRY HILL RD 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: 0.400 AC DEADMON RD Fire Response District: JERUSALEM
Assessed Acreage: 0.35 Elementary School Zone: CORNATZER
Deed Date: 11/2004 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 2004EO313 Soil Types: PcB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 43290.00 Outbuilding&Extra 6320.00
Freatures Value:
Land Value: 8640.00 Total Market Value: 58250.00
Total Assessed Value: 58250.00
I,v i 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 s particular use.All users of Davie County's GIS webstte 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
co UNC; NC or arising out of the use or Inability to use the GIS data provided by this weba@e.
Pennittee'sDAVIE COUNTY HEALTH DEPARTMENT
Name: 1.f tet;"je Environmental Health Section PROPERTY INFORMATION
'P.O. Box 848; .
Directions to property: -� Ik—r;� . �.!It�''rr.�'JAC t�M�cksville,NC 27028. Subdivision Name:.
Phone#:336-751-8760
Section: Lot:
T T / AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
24,06
AUTHORIZATION NO: A Road Name: Zip:
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie Countv Environmental Health Section prior
to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article I 1 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
a ; ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE /7- #BEDROOMS_ #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) �L� NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.
OTHER
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REQUIRED SITE MODIFICATIONS/CONDITIONS:
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IMPROVEMENT PERMIT LAYOUT
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is
"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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
2)
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1 SArG-V q.�
AUTHORIZATION NO. '" OPERATI PERMIT BY: D /
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**THE ISSUANCE OF THIS OPERATION PERM ALL INDICATE THAT THE SYSTEM DESCRIBED AB VE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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.
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) _DAVIE COUNTY HEALTH DEPART'M�NT
Name s i�J s �•"ii l '�` l!r Environmental Health SeVtio PROPERTY INFORMATION
•, �„ P.O.Box 848
Directions toproperty: /: ? I' r'r':� ;- � �'Ivl�cksville,NC 27028 Subdivision Name: t
Phone#:336-751=8760.E
T .�r i 1�_ Y:. ✓f 1 ,�`� Section: Lot:
f AUTHORIZATION FOR
WASTEWATER
Tax Office PIN:#
SYSTEM CONSTRUCTION
AUTHORIZATION NO: C- iO A Road Name: Zip:
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
ti +
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED'
RESIDENTIAL SPECIFICATION:BUILDING TYPE /74 #BEDROOMS #BATHS I #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TY PE• #PEOPLE #PEOPLE/SHIFT #SEATS' �j' INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY r)" DESIGN WASTEWATER FLOW(GPD) OKd NEW SITE ' REPAIR SITE -
r
SYSTEM SPECIFICATIONS: TANK SSE _ GAL. PUMP TANK GAL TRENCH WIDTH ROCK DEPTH LINEAR FT. j
OTHER �-
REQUIRED SITE MODIFICATIONS/CONDITIONS: I
IMPROVEMENT PERMIT LAYOUT
17 t
**CONTACT A�EPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FbR 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 (336)751-8760.
OPERATION PERMIT C. ,• n
SYSTEM INSTALLED BY: 1IAAN
AUTHORIZATION NO. OPERATI PERMIT BY: ' l D TE:
**THE ISSUANCE OF THIS OPERATION PERM HALL INDICATE THAT THE SYSTEM DESCRIBED A OVE HAS$EEN INSTALLED IN Co ANCE
WITH ARTICLE I 1 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.
DMD 02/02(Revised)
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) G
NAME /1.G %� PHONE NUMBER o �
ADDRESS If73 V+-o� 4� • SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE �� �' `�'�-' ►' `� �� `'��
C__ _\v
C
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER W I.<� /1
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY C, SPECIFY PROBLEM OCCURRING
DATE REQUESTED a INFORMATION TAKEN BY ✓�`— -Y
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