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1644 Hwy 801SDavie County, NC , Tax Parcel Report 93-7oA Tuesday, September 27, 2016 0797 :.k: \ v 1624 \1641 X2646 30,E 3549 �s7 - 557t'` r �1 ".� . ,. - t655 s° •' ' 6561 .- 3.551 `\ r 41644 ' 7 7366, ,I �\ y a \ 1675 ��- 1666 , N -- ----- ------- -- --------------- -------- ------- 141 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, NC 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. WARNING: THIS IS NOT A SURVEY • Parcel Number: F800000098 Township: Shady Grove NCPIN Number: 5880043551 Municipality: Account Number: 940000 Census Tract: 37059-803 Listed Owner 1: ALLEN JOHN G Voting Precinct: EAST SHADY GROVE Mailing Address 1: 2517 INDEPENDENCE LN Planning Jurisdiction: Davie County City: SAINT CLOUD Zoning Class: DAVIE COUNTY R -A State: FL Zoning Overlay: Zip Code: 34772-8809 Voluntary Ag. District: No Legal Description: 1 LOT HWY 801 Fire Response District: ADVANCE Assessed Acreage: 0.60 Elementary School Zone: SHADY GROVE Deed Date: 9/1963 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 000710129 Soil Types: WeC,WeB Plat Book: Flood Zone: x Plat Page: Watershed Overlay: - Building Value: 101730.00 Outbuilding & Extra 940.00 Freatures Value: Land Value: 18060.00 Total Market Value: 120730.00 Total Assessed Value: 120730.00 141 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, NC 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. t, •'rr .at - a - - s. ,. .a- a Permittees.•--� ,i,/,�. DAVIE COUNTY HEALTH DEPARTMENT ` lTame: ��-•. )� j ✓ �` (/ Environmental Health Section PROPERTY INFORMATION 1 P.O. Box 848 Directions to property: '�` Mocksville, NC 27028 Subdivision Name: Phone #: 336-751-8760 a; !i jlf ' C;' r fJ > �c*" S ✓ f r 7f l Section: Lot: AUTHORIZATION FOR r .r WASTEWATER `�._.0 7 ";,_..,�j•,/"�/i...r�. r :; Tax Office PIN:# ~- SYSTEM CONSTRUCTION AUTHORIZATION NO: 0 � 0 A Road Name: Zip: **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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. , ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE f # BEDROOMS # BATHS # OCCUPANTS 1 GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS . INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD), NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH `� ROCK DEPTH � LINEAR ] •I. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: **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. L AUTHORIZATION N WOPERATION PERMIT BY: DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I I 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. . ' DCkID01/02(Revised) t : • .1 r i '1^ - "i I.v ^I Y. `6L :-_„> >. ., n a -. ,- i- .. . a .. c �.�.- , -` �r DAVIE COUNTY HEALTH DEPARTNIEN. 1, Narpei;A Environmental Health Section PROPERTY INFORMATION . TT r P.O. Box 848 c r =Dutctiong fo-property:'% ?'' f ; N&ksville, NC 27028 Subdivision Name: , . s -- ��r•. �,' Phone #: 336-751-8760 i r Section: Lot: AUTHORIZATION FOR WASTEWATER • Tax Office PIN:# - SYSTEM CONSTRUCTION :. 27070 1. AUTHORIZATION.NO: -, A Road Name: Zip: **NOTE** This Authorization for Wastewater System Constriction 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 I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED 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 SUPPLY DESIGN WASTEWATER FLOW (GPD),- F NEW SITE REPAIR SITE -� s SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP,TANK GAL. TRENCH WIDTHS ROCK DEPTH �% �'� LINEAR FT.� r ., OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: 1 IMPROVEMENT PERMIT LAYOUT 4 `f ' 4 "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: 4C 1 pv ' AUTHORIZATION NC��� 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 02/02 (Revised) ^ . ter. k" i DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERVT (REP I ) NAME---),-)n� PHONE NUMBER ADDRESS SUBDIVISION NAME LOT # DIRECTIONS TO SITE DATE SYSTEM INSTALLED �`�' s NAME SYSTEM INSTALLED UNDER TYPE FACILITY NUMBER BEDROOMS - NUMBER PEOPLE SERVED �-- TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING DATE REQUESTED L 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 11 (l)