1860 Hwy 801SDavie Co��nty, NC
Tax Parcel Report
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Wednesdav, October 12, 2016
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WARNING: TIIIS IS NOT A SURV�Y
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Parcel Information
Parcel Number: G800000023 Township: Shady Grove
NCPIN Number: 5880125194 Municipality:
Account Number: 62802500 Census Tract: 37059-803
Listed Owner 1: S& G INVESTMENTS INC Voting Precinct: EAST SHADY GROVE
Mailing Address 1: PO BOX 150 Planning Jurisdiction: Davie County
City: KURE BEACH Zoning Class: DAVIE COUNTY R-A,R-20,H-B
State: NC Zoning Overlay:
Zip Code: 28449-0000 Voluntary Ag. District: No
Legal Description: 4.449 AC HWY 801 Fire Response District: ADVANCE
Assessed Acreage: 3.89 Elementary School Zone: SHADY GROVE
Deed Date: 1/1900 Middle School Zone: WILLIAM ELLIS
Deed Book / Page: 001280630 Soil Types: WeC,WeB,PcB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 114240.00 Outbuilding & Extra 3670.00
Freatures Value:
Land Value: 253400.00 Total Market Value: 371310.00
Total Assessed Value: 371310.00
91.�'/�, 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� fmplied warranties of inerchantability or fitness for a paRicular use. All usen of Davle County's GIS website shall hold harmless the
N� County of Davfo, North Carolina, its agents, consultants, contractors or employees from any and all clatms or causes of actlon due to
�'p ��x.�'L or arlsing out of tho use or fnabllity to uso the GIS data provtded by this webske.
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.AUTYO�IZATION NO. �� � � �� DAVIE COUNTY HEALTH DEPARTMENT �d 7 ^ � �'Or/
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Environmental Health Section PROPERTY INFORMATION
- _ Permittee's~� �/ , y ,r��,�^ P.O. Box 848
Nar�3e: s''�?�"/,i%i>"�F' �S / C.� 1" ��",I�,,, Mocksville, NC 27028 Subdivision Name:
���_,,�j�i�"/�►�j� ; ' ' ,� Phone # 336-751-8760
Direct�on to property: �� .% �� a„�-� ; r..::;rij
`,/�! ` AUTHORIZATION FOR
/ �Y ,�;+il�'�"�'� /_%�/�` �� �/l�:r ✓`"C� WASTEWATER
� -7�— -T—� SYSTEM CONSTRUCTION
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Section: Lot:
Tax Office PIN:# - -
Road Name: Zip:
**NOTE** This Authonzation for Wastewater System Construction MUST BE ISSUED by the Davie County Envuonmental Health Section prior
to issuance of any Building Perniits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(ln compliance with Articie 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
;;,.% +t` � � �� ,, �,r �,�, �' � ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r"'l,�� �;'� ��/ i,+��� �?�'-�� .S :����� IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPEC`IALIST DATE ISSUED
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,� ,�. a� -, . i � � :��.� DAVIE COUNTY HEALTH DEPARTMENT ' �f �� =�� � � `'
� �MPROYEMENT AND OPERATION PERMITS PROPERTY INFORMATION
-�:..Permittee's- , ; _ T - �, .
'Na�e:- `;'=;''r �.�;. �'' :i� /t � �`:�� f SubdivisionName: ,
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,:.D�rectio �o property: ✓, .�r` ..--- ., ,. , _. ,:,� + , ;r �. " ' f
,,ij l,� y �,', �., ,IlIIPROVEMENT ' ��
�J�`,�'j � �7 ,; � r i�,; �: 'yr .." , �'� .., PERMIT � ' Ta�c Office PIN:# - - _
7` .� � � � `�'f �, Road Name:
Zip:
**NOTE** This Improvement Permit DOES NOT authorize the construction or installadon of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the .
conshvction/installation of a system or the issuance of a building pemut. .
(In compliance with Article 11 of G.S. Chapter 130A,. Wastewater Systems, Section .1900 Sewage TreaUnent and Disposal Systems)
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ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
***NOTICE*** TIII.S PERNIIT LS SUBJECT TO REVOCATION IF SITE
PLANS OR Tf� INTENDED USE CHANGE. YOUR WASTEWATER -
SYSTEM CONTRACTOR MUST SEE THLS PERNIIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
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COMMERCIAL SPECIFICATION: FACILITY TYPE PEO LE �� # PEOPLElSHIFT � # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY ��, ? DESIGN WASTEWATER FLOW (GPD) � NEW SITE REPAIR SITE __ _�
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SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH—rv ROCK DEPTH � LINEAR FT. ��
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENTPERMITLAYOUT .��n���U�D EFFLUwEaT FILTER� '�RI�R�S) IF b� � B.�-.LQ:1 1=I1;:: �{.�:.} .G:;t�D�i�
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**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 (7TSdji>34�8'%K� �
( 336 ) 7� 1—f37G�1
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SYSTEM INSTALLED BY:
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AUTHORIZATION NO /��� OPERATION PERMIT BY: �"Y DATE: S/` `� I
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAP'TER 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 OS/96 (Revised)
r��' DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
� APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME C O !�� ��� �v��P� NUMBER
ADDRESS /�� T rr� �� �i.�� �-� U:������� SUBDIVISION NAME
�I)� Y. ���• LOT #
DIRECTIONS TO SITE •
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
This ia to certi}y that the information provided is eorrect to the best of my knowledge, and that I underatand I am responsible }or all charges incurred irom this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93