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1411 Eatons Church RdDavie Cc�unty, NC Tax Parrel Rennrt Wednesdav. October 12, 2016 WAK1V11VU: lril� l� 1VU1 A JUKVLY Parcel Information Parcel Number: D30000005506 Township: NCPIN Number: 5822426795 Municipality: Clarksville Account Number: 82530181 Census Tract: 37059-801 Listed Owner 1: OVERTON WILLIE ODELL Voting Precinct: CLARKSVILLE Mailing Address 1: PO BOX 511 Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028-0511 Voluntary Ag. District: Legal Description: 1.214 AC EATON CHURCH RD Fire Response District: Assessed Acreage: 1.18 Elementary School Zone: Deed Date: 10/2008 Middle School Zone: Deed Book / Page: 007730236 Soil Types: Plat Book: 0007 Flood Zone: Plat Page: 154 Watershed Overlay: Building Value: Land Value: Total Assessed Value: 95730.00 Outbuilding & Extra Freatures Value: 20880.00 Total Market Value: 129780.00 WILLIAM R. DAVIE WILLIAM R DAVIE NORTH DAVIE Mn62 DAVIE COUNTY 13170.00 129780.00 No �,\'� All data Is provided as Is without warranty or guarantee of any kfnd either expressed or Implied including but not limited to the 9�"' �' Davie County� Implied warranties of inerchantability or fitness for a paRicular use. AII users of Davie County's GIS website shall hold hatmless the County of Davia, North Carolina, its agents, consultants, contrectors or employees from any and all clafms or causes of actlon due to np� N,�" NC or arising out of the use or Inability to uso tho GIS data provfded by this wc6site, Plione: (336) - 753 - 6780 �1� �llll � Environlnent� JUN 1 1 �o. 21� Hc � � Department alth Section t��eet 27028 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) Replacement Remodeling Reconnection ��' � ��� ��� � I'ax: (336) — 753-1680 Name: ��� � I �� � • O I%' �+-O N Phone Number ,� _>� -- /��— ��(Home) Mailing Address:�'� , C� j��( [ (Work) �in o�-I � LI �' l% ��,11 �� �-70 �-8 Please Fill Tn The Following Information About The EXISTING Facility: Name System Installed Under: � i��� �• �� ��� � Type Of Facility: - � Date System Installed (Mortth/Date/'Year): Number Of Bedrooms:�Number Of People:_�_ Is The Facility Currently Vacant? Yes �N If Yes, For How Long? Any Known Problems? Yes No If Yes, Explain: Please Fill In The F Ilowing Information About The NEW Facility: Type Of Facility: Number Of Bedrooms:---;�Number of People_� Requested By: �:( !� .piv� �� >,l�����--- _ Date Requested: (Signature) For Environmental Health Office Use Only Approved Disapproved Comments: __ Environmental Health Specialist *The signing of this form by the Environmental Health S Date: in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment Cash Check Money Order # Amount:$ Gi� •�� Date:�fL� Paid By:���,( �����'�BU� Received By: � 2' �i, Account #: Sj �fi Invoice #: /�J � _