624 Baileys Chapel Rd (2) Davie County,NC Tax Parcel Report Wednesday, February 8, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: H80000005201 Township: Shady Grove
NCPIN Number: 5779526939 Municipality:
Account Number: 8302317 Census Tract: 37059-804
Listed Owner 1: STUMP FRANKLIN A JR Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 624 BAILEYS CHAPEL RD Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27006-7143 Voluntary Ag.District: No
Legal Description: 10 AC BAILEYS CHAPEL RD Fire Response District: ADVANCE
Assessed Acreage: 9.86 Elementary School Zone: SHADY GROVE
Deed Date: 6/2013 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 009290368 Soil Types: PaD,PcB2,PcC2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 178170.00 Outbuilding&Extra 2450.00
Freatures Value:
Land Value: 133950.00 Total Market Value: 314570.00
Total Assessed Value: 314570.00
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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
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Davie County Health Department
8 ftp Environmental Health Section .
P.O. Box 848 �1
210 Hospital Street WWI
Courier# :09-40-06 1
Mocksville, NC 27028
Phone:(336)-753-6780 Fax:(336)-751-8786
ON-SITE WASTEWATER CERT ION FOR DWELLING
(Check One) Replacement emodeling '' Reconnection
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Name: (L yu-' �n���Yrr7 Phone Number l 4(— T O3�a (Home)
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Detailed Directions To Site:�S Ics14 7D kj��VT � ug �1 , LM E AI l'ti�S
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Property Address:
Please Fill In The Following Information About The EXISTING Facility: "-,%u-1
Name System Installed Under: Type Of Facility:
Date System Installed(Month/Date/Year):C.)Q(L1 .a�4 ? Number Of Bedrooms:__ Number Of People: o_
Is The Facility Currently Vacant? Yes No If Yes,For How Long?
Any Known Problems? Yes (!!� If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: D Number Of Bedrooms: Number of People
Requeste Date Requested:
( ature)
For Environmental Health Office Use Only
Approved Disapproved
Comments: LA 16
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Environmental Health Specialist Date:
*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 functio perly for any given period of time.
Payment: Cash Check Money Order # Amount:$ OPQ Date:
Paid By: Received By: \.
Account#: Invoice#:
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