171 Edgewood CircleDavie County. NC Tax Parcel Report aD LO A Thursday, September 29, 2016
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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 a particular use. All users of Davie County's GIS website 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
NC or arising out of the use or Inability to use the GIS data provided by this website.
ParcelIi orniation
Parcel Number:
M5070A0024
Township:
Jerusalem
NCPIN Number:
5745386500
Municipality:
Account Number:
82519814
Census Tract:
37059-807
Listed Owner 1:
LIPNICKI TOMASZ
Voting Precinct:
COOLEEMEE
Mailing Address 1:
171 EDGEWOOD CIRCLE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE
COUNTY R-20
State:
NC
Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOTS 10-14 EDGEWOOD SECTION 1
Fire Response District:
JERUSALEM
Assessed Acreage:
0.71
Elementary School Zone:
COOLEEMEE
Deed Date:
11/2002
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
004510060
Soil Types:
GnI32
Plat Book:
0004
Flood Zone:
Plat Page:
030
Watershed Overlay:
DAVIE COUNTY
Building Value:
97350.00
Outbuilding & Extra
Freatures Value:
110.00
Land Value:
21000.00
Total Market Value:
118460.00
Total Assessed Value:
118460.00
N
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 a particular use. All users of Davie County's GIS website 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
NC or arising out of the use or Inability to use the GIS data provided by this website.
Permittee's / ( t DAVIE COUNTY HEALTH DEPARTMENT
�J Name:%>� I- �C�-� t Environmental Health Section PROPERTY INFORMATION
! P.O. Box 84$
Directions to property: l �. fir Mocksville, NC 27028 Subdivision Name: .+� %t•:(-' �-'�
nphone #: 336-751-8760 �1
Lw.lt7;:3 Section: Lot: I U - 1
�^ AUTHORIZATION FOR
WASTEWATER:
SYSTEM CONSTRUCTION Tax Office PIN:# - -
AUTHORIZATION NO: 4 A Road Name: y'Z3p "?�a r
**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,Arti :le _11 of G.S hapter 130A, Wastewater Systems, Section .1900 Sewage. Treatment and Disposal Systems)
* ;*NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
, f IS VALID FOR A PERIOD OF FIVE YEARS.
ENVI�TgL-, EAL-- H-SPECIALISTL�DATE ISS ED
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 SUPPLYC—� rDESIGN WASTEWATER FLOW (GPD) � NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ` GAL. PUMP TANK GAL. ,TRENCH WIDTH ROCK DEPTH /G LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: I l L) i
"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: (o TIC/1 ALN_
�illigA . COCA. j Tl D !NN
AUTHORIZATION NO. ' OPERATION PERMIT BY: DATE:
_
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH YSTEM DESCRIBED ABOE 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 02M (Revised) d
i
' DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) �k
NAME , —/�—S D N CJ� l PHONE NUMBER �� — 7 0 Z
`b
ADDRESS 1 :2 ""Cc6SUBDIVISION NAME �Ijp� "-4,
✓ c Ll�e- IJ C LOT #
DIRECTIONS TO SITE o e- e A^-e-
cz)
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPP C SPECIFY PROBLEM OCCURRING !�
rte! b 'Q..-
q M
DATE REQUESTED [ 5 INFORMATION TAKEN BY �
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
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