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1716 Fork Bixby RdDavie County, NC Tax Parcel Report O 43� Wednesday, September 28, 2016 141 Davie County, NC WARNING: THIS IS NOT A SURVEY ,... — Parcet7nformatiori_ � � _�. Parcel Number: G700000102 Township: Shady Grove NCPIN Number: 5779086586 Municipality: Account Number: 8302929 Census Tract: 37059-804 Listed Owner 1: ZIMBARDO ANTHONY Voting Precinct: WEST SHADY GROVE Mailing Address 1: 1716 FORK BIXBY RD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: 1.27 AC MARKLAND RD Fire Response District: ADVANCE Assessed Acreage: 0.89 Elementary School Zone: SHADY GROVE Deed Date: 12/2013 Middle School Zone: WILLIAM ELLIS Deed Book f Page: 009450336 Soil Types: GnB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: - Building Value: 67730.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 27300.00 Total Market Value: 95030.00 Total Assessed Value: 95030.00 141 Davie County, NC l 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 harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **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 CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAS / \I dlif-01V PROPERTY ADDRESS �U) Y- fir. f %., Rr+� % n n t.� DATE LOCATION ,��i fes,/� aI, SUBDIVISION NAME LOT NUMBER SEC./BLOC( NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE }1lXls r I« BEDROOMS c A BATHS t OCCUPANTS ` GARBAGE DISPOSAL: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY 14© DESIGN WASTEWATER FLOW (GRD) NEW SITE REPAIR SITE e- ' SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH �� • ROCK DEPTH , LINEAR FT. � / OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BYE/�� C **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. OPERATION PERMIT SYSTEM INSTALLED BY _R:LQ��4 =v�A) AUTHORIZATION NO. �1 S� OPERATION PERMIT BY IN DATE -1 -A5 - 1 " **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 SATISFACTOPILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 DAVIE COUNTY HEALTH DEPARTMENT �! -`} .,•.: IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT 0 **N0TE** This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewate. system. AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME '. �f/,/°, "� l(4 %` PROPERTY ADDRESS t't.it` J. h„ '',i %nr,l DATE -/i'"•!' LOCATION SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS c7,V # BATHS :) # OCCUPANTS f-) GARBAGE DISPOSAL: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY 'j�; DESIGN WASTEWATER FLOW (GPD) - 'rte'? NEW SITE REPAIR SITES-'" SYSTEM SPECIFICATIONS: TANK SIIE GAL. PUMP TANK GAL. TRENCH WIDTH 1f ROCK DEPTH LINEAR OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BY **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. OPERATION PERMIT SYSTEM INSTALLED BY S Fv E ry R AUTHORIZATION N0. OPERATION PERMIT BY ��',�• i 11 DATE -1 'DLG C�" **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 :1908 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS', BUT SHILL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 '+1 DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) �� � - NAME /�� Ja .� A PHH�ONE NUMBER ADDRESS 1%�� SUBDIVISION NAME LOT # DIRECTIONS TO SITE�'�'�� . 4-1�lelr DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY B NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY e/ SPECIFY PROBLEM OCCURRING DATE REQUESTED 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 Rev. 1/93 A Davie County Health Department ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) ***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.*** AUTHORIZATION NLI BER NAME �J�/, i ���1�f0! DATE - �� `�� N1c 0 / NAME ON IMPROVEMENT PERMIT (If different than above) SITE LnmTInN Zr/ COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM }*{NOTICE*" THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE DCHD 10/95 s