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612 Gladstone RdDavie County, NC t Tax Parcel Report tj,j Thursday, September 29, 2016 WARNING: THIS IS NOT A SURVEY All 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 Parcel Information County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to Parcel Number: L400000023 Township: Jerusalem NCPIN Number: 5736625481 Municipality: Account Number: 16630000 Census Tract: 37059-807 Listed Owner 1: COMMUNITY BAPTIST CHURCH Voting Precinct: COOLEEMEE Mailing Address 1: % LARRY DANIELS Planning Jurisdiction: Davie County City: COOLEEMEE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27014-0000 Voluntary Ag. District: No Legal Description: 2.3 AC GLADSTONE RD Fire Response District: JERUSALEM Assessed Acreage: 2.30 Elementary School Zone: COOLEEMEE Deed Date: 6/1984 Middle School Zone: SOUTH DAVIE Deed Book / Page: 001230565 Soil Types: EnB,MsC,CeB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 351360.00 Outbuilding 8r Extra Freatures Value: 0.00 Land Value: 27340.00 Total Market Value: 378700.00 Total Assessed Value: 378700.00 Davie County, All 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 �CUN�� NC or arising out of the use or Inability to use the GIS data provided by this website. Phone: (336) 753 - 6780 Davie County Health Department Environmental Health Section. ,.. P.O. Box 848 210 Hospital Street Courier #: 09-40-06 ; Mocksville, NC 27028 . . ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Fax: (336) - 753-1680 Name: Z 1 Phone Number �D`7' J 0G ���� (Home) Mailing Address: ` /off rr {- (Work) �XlLI�S!/i Ile-, A• - Email Address: Detailed Directions To Site: Property Address:' 61,2 (�� S hQ L W 'L Please Fill In The Following Information About The EXISTING Facility: Name System Installed. Under: �o•� ,h, /z-phS� (fG d— Type Of Facility: Date System Installed (Month/Date/Year): 19 ?.3 Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes Q If Yes, For How Long? Any Known Problems? Yes QNo If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Gr{ � k coo M -1 �` 5 1 ` sic uCtk Type Of Facility: �i �1 (�i 5 Number Of Bedrooms: Numifer of People Pool Size: Garage Size: Other: Requested By: (.lir Date Requested: -0Qr? ' .20l For Environmental Health Office Use Only Appro a Disapproved Comments: p�✓I a � ti �t *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function pro e�yfor a y iven period of time. Payment: Cash Check Money Order # Amount:$ / V `*' Date: Paid By: 4 1 A IFReceived By: a' Y LU 1 4 '' : 1. . Account #: lrni Invoice #: DAVIE COUNTY HEALTH DEPARTMENT j SEPTIC TANK PERMIT Date v Jwner/Occupant 017t u h A /;'s f� u r'_4 To: Address Address Building Contractor eKf Address Cal. Manufacturer's Name a,'� ��% Car Address ¢/ No. of lines � Width in. Total length �� p ft. No. sq. ft. ya© r Type of filter material n Total tons used Z_a — / Y Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400 Two-bedroom house 800 600 Three-bedroom house 900 900 No one shall install a septic tank in Davie County without a permit from the Health Offic ,or his agent. Date of Final Approval Signed: Sanitarian I hereby certify that the above septic tank has been installed according to specification Signed: 1de"In", �G Septic Tank Contractor Note: Make sketch of disposal system on back of sheet and mail to Davie County Health Center, Box 57, Mocksville, North Carolina 27028. y .: .' ;---- ; . 1 1 � �( 4 . - �—` i i �_ ,. ,. s DAVIE COUNTY-HEALTH DEPARTMENT SEPTIC TANK PER,1IT Date Nmer/Occupant ?0*)?1Ma,R�Ovo To: �` A� , Address Czars p1-r � Address Building Contractors 67P Address Gal. Manufacturer' s Name` S', j , Ca, Address jj�¢-/ i No. of lines / Width in. Total lengthft. No, sq. ft. yao Type of filter material Total tons used /e2—/� Minimum REquirements: House Trailer Tank cap. 800 Sq,. ft. line 400 Two-bedroom house 800 600 Three-bedroom house 900 9,00 No one shall install a septic tank in Davie County without a permit from the Health Offi,C or his agent. Date of Final Approval Signed: Sanitarian I hereby certify that the above septic tank has been installed according to specificatior Signed: ! Septic Tank Contractor "dote: Make 'sketch of disposal system on'back of sheet and mail to Davie County Health Center, Box 57, Mocksville, North Carolina 27028. r 11 f tl