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1641 Hwy 801S)avip Cnunty NC Tax Parr_el Rpnnrt MAO AO Werinesdav Rpntpmhpr 9R 9011 a \ 1615 Al 8 395;3 J � 1.—.Q)— 323 r` 0797 1624 X1641 r! �, 2646 o 3551 J644 ____............ ___ 0 0000, ,0 1000, 557 rjO, /,,,19rb1§55 6561 228 Q Davle County, NC �a$ co 5961 Parcel Number: G800000031 Township: Shady Grove NCPIN Number: 5880044781 o 3551 J644 ____............ ___ 0 0000, ,0 1000, 557 rjO, /,,,19rb1§55 6561 228 Q 141 Davle County, NC WARNING: THIS IS NOT A SURVEY Parcel�nfonnatioa.-- Parcel Number: G800000031 Township: Shady Grove NCPIN Number: 5880044781 Municipality: Account Number: 8305116 Census Tract: 37059-803 Listed Owner 1: WELLS NATALIE E Voting Precinct: EAST SHADY GROVE Mailing Address 1: 1641 NC HWY 801 S Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: 1.397AC HWY 801 Fire Response District: ADVANCE Assessed Acreage: 1.20 Elementary School Zone: SHADY GROVE Deed Date: 6/2015 Middle School Zone: WILLIAM ELLIS Deed Book f Page: 009910677 Soil Types: WeB,PcB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: - Building Value: 147350.00 Outbuilding & Extra 6550.00 Freatures Value: Land Value: 32080.00 Total Market Value: 185980.00 Total Assessed Value: 185980.00 141 Davle 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. ;AUTHQRIZATION NO: Q 6 4 D DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Perinittee's) P.O. Box 848' Name: �r:�" CLJ ,�'�i' Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property: F, Section: Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# - - SYSTEM CONSTRUCTION Road Name: 0 Zip: 7 L t0 **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 Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) f ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �,�'�/�%! / l ; ' j� IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED J y DAVIE COUNTY HEALTH DEPARTMFr1T IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permlt%�s • Name �``s.J,.r.�r % 'l�� .'.�i`�� Directions to propeity: ' ,='.✓ !�j IMPROVEMENT PERMIT Subdivision Name: Section: Lot: Tax Office IST:# - - Road Nam0/.s . ZiP **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) F f, r+�r ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE A/ # BEDROOMS <F # BATHS ^� I/ # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No 14�. LOT SIZE / h TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE V SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH -.re' ROCK DEPTH %r LINEAR FT. REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT "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: 6;V iK/��,TyiN \ S� G� AUTHORIZATION NO. - b�=— OPERATION PERMIT BY: DATE: "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 SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) DAVIE COUNTY HEALTH DEPARTMENT PROPERTY INFORMATION IMPROVEMENT AND OPERATION PERMITS ! r Perrmtkers - Name: • ra,: l'?� f �, Subdivision Name: Directions to property: Section: Lot: IMPROVEMENT PERMIT Tax Of� Pr:# - - , of 5. ? rl0t)(a Road Name: - Zip: **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) f ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS —f' # BATHS ,-a9 # OCCUPANTS GARBAGE DISPOSAL: Yes or No J' COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No 1 LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE Y �� SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH re. ROCK DEPTH _%_Sp^ LINEAR FT. nTwpp REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT J f. �j r "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: n f f 1* S� Y t { r � l AUTHORIZATION NO. — 6 OPERATION PERMIT BY: /"� DATE: "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 SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) 1 . i; , f DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) NAME r 17 PHONE NUMBER ADDRESS 16A/ 14v it/ of P/ '57 SUBDIVISION NAME LOT # DIRECTIONS TO SITE DATE SYSTEM INSTALLED 7 NAME SYSTEM INSTALLED UNDER TYPE FACILITY 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. 1193