328 Deadmon Rd Davie County,NC Tax Parcel Report 6 tab, 3 Monday, September 26, 2016
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Parcel Information _.... . .. _ ... . ,._ .- ..., . .. y .
Parcel Number: K500000092 Township: Jerusalem
NCPIN Number: 5747327258 Municipality:
Account Number: 8304061 Census Tract: 37059-807
Listed Owner 1: ROBERTSON BROOKS M Voting Precinct: JERUSALEM
Mailing Address 1: 328 DEADMON ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 1.2 AC WALT WILSON RD Fire Response District: JERUSALEM
Assessed Acreage: 0.98 Elementary School Zone: CORNATZER
Deed Date: 8/2014 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 009670241 Soil Types: CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 62810.00 Outbuilding&Extra 1960.00
Freatures Value:
Land Value: 16010.00 Total Market Value: 80780.00
Total Assessed Value: 80780.00
l 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
u' F Davie County, implied warranties of merchantability or fitness for a particular use.All users of Davie counwe GIS website shall hold harmless the
County of Davis,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this webske.
Permittee q,„,_ n D VIE COUNTY HEALTH DEPARTMENT
Names %' ?��` -` 4'` ( Environmental Health Section PROPERTY INFORMATION
Jr
P.O. Box 848
Directions to property: .x/ ` ”%`f' r,f '` 1Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
Section: Lot.
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:# - -
3
AUTHORIZATION NO: 002593 A Road Name:, ' R Jk-an J?^4 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)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
l/,` T'' •f'%'ffr �/p y ?.S IS VALID FOR A PERIOD OF FIVE YEARS.
-'ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
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 SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH - (ROCK DEPTH LINEAR Fr_—21r
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT
YSTEM INSTALLED BY:
1`
AUTHORIZATION /�OPERATION PERMIT BY: / DATE:
..jC0_&,W4
**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.
DMD 02M(Revised) C-"P .-tv- 3V 7 2):4L,/-z--' ��i
;
• "�',PD}�ei'rec't "�1�. " ' ' '� `6` DAVIE COUNTY HEALTH DE--P.-A. R teeEnvironmental Health Sect$A 3N�PRO .E...R
TY INFORMA ITION
P.O. Box 848
ionsto " �.
".._ ...
prop rty: Mocksville;NC 27028 Subdivision Name:
Phone#: 336-751-8760
Section: Lot:
--- AUTHORIZATION FOR
�< WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION
-a-.*a9
AUTHORIZATION NO: 002593 A Road Name: .d w.on P-1 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)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
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 SIZE TYPE WATER SUPPLY /L)// DESIGN WASTEWATER FLOW(GPD)� NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ZE LINEAR FT-�
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
' IMPROVEMENT PERMIT LAYOUT
r
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT
STEM INSTALLED BY:
1y -
0
AUTHORIZATION NO � OPERATION PERMIT BY: / DATE: 4 y
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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 SYSTEMWILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD
OF TIME... j
l
l/
DCHD 02102(Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION C 'S
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) _
NAMEPHONE NUMBER
ADDRESS ��G-�-/'�''�'� SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE (e v -s 4-0
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY LL'e-tl SPECIFY PROBLEM OCCURRING
DATE REQUESTED l INFORMATION TAKEN BY l�
This is to artiy that the information provided is correct to the best of my kno edge,and that I u rstand I tm responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGEN .
Rev.1193