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1894 Hwy 801SDavie County, NC Tax Parcel Report 0 -13 H Tuesday, September 27, 2016 r r� 62a', J ----- - –��- -:6377 248 t 1894 2761 00 rF- 1602 .,. 70 �~ 375 -___3-� 7�--__ --_�� _----�... S 230 �: — � 89..-~ �. 1510 � s205 '�- = 1 4 141 Davie County, NCimplied WARNING: THIS IS NOT A SURVEY Parcel Number: G800000021 Township: Shady Grove NCPIN Number: 5880112761 Municipality: Account Number: 2989500 Census Tract: 37059-804 Listed Owner 1: BAILEY AMY TALBERT Voting Precinct: EAST SHADY GROVE Mailing Address 1: 4122 WELCOME ARCADIA ROAD Planning Jurisdiction: Davie County City: LEXINGTON Zoning Class: DAVIE COUNTY 1-1,R-20 State: NC Zoning Overlay: Zip Code: 27295-0000 Voluntary Ag. District: No Legal Description: 3.369 AC CORNATZER RD Fire Response District: ADVANCE Assessed Acreage: 3.33 Elementary School Zone: SHADY GROVE Deed Date: 9/2002 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 2003E0245 Soil Types: WeC,WeB,PcB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: - Building Value: 96600.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 26520.00 Total Market Value: 123120.00 Total Assessed Value: 123120.00 141 Davie County, NCimplied All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the 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. l?erinitte s, j DAVIE COUNTY HEALTH DEPARTMENT N Name: ' ' 1 1 ` Environmental Health Section PROPERTY INFORMATION e file P.O. Box 848 - Directions to property: I ��. "� Mocksville, NC 27028 Subdivision Name: Y - Phone #: 336-751-8760 Section: Lot: AUTHORIZATION FOR , � WASTEWATER Tax Office PIN:# rp SYSTEM CONSTRUCTION i - - AUTHORIZATION 01 e" j , :,� t � , NO: A Road Name: ice' 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 A.M-le I 1 of G.SS,hapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) r' r' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONKIik ALH ALTIfSPE6A1J§T DAT ISSU D RESIDENTIAL SPECIFICATION: BUILDING TYPE { 10t& R BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE i� l9�# PE&1'LE 1— # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE `/ �PE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ,� NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS`. TANK SIZE GAL. PUMP TANK GAIL. TRENCH WIDTH '"� ROCK DEPTH t LINEAR FT. 1 1J . .'OTHER 'tlJ30 XeS , tJSTALL L -AS 1 REQUIRED SITE MODIFICATIONS/CO Io 'S:° At 1. .D^� �f7+ )�Op2 �: { �%�� � �' SANE IMPROVEMENT PERMIT LAYOUT ��AI T,&Q, 4 - 'icy ll��kB�J **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. **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED APVE HAS EEN INSTALLED IN COMPLIANCE li/rrU ADTT!"iC II f%V n C!`LT A DrMD 1Qn A' CT:!`TVIM IUM 11QRWAf7R TRF ATIIARMT A Mn TITQDnQ A T QTRAAC!VhT TT CU A T T. TAT mn R7 A V DC T A 11VXT A CA "'v W •t ,�/�f+� '+4 a - v 4� k i - C` „y n w y, ``"''7 '.3 .. . 1 1 - DAVIE COUNTY HEALTH DEPARTMENT 11 Environmental Health Section PROPERTY INFORMATION P.O. Box 848 F:Duecftons to.property: '' `"� -a: ' Mocksville, NC 27028 Subdivision Name: •; + ] x`,� c �a �, s + , �� Phone: #: 336-751-8760 l; Section: Lot: AUTHORIZATION FOR WASTEWATER . 'Tax Office PIN:# SYSTEM CONSTRUCTION - - 2 �" ,.., AUTHORIZATION NO. A Road Name i ;, +` K- $ _ ` Zip r **NATE** This Authorization for Wastewater System Construction MUST BEJSSUED by the Davie County Environmental Health Section prior to issuance of any Building Penrii[s.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. 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION !1 IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DAT ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No.,.,",, �. "4 ftwix f.IR L COMMERCIAL SPECIFIC)kTIgN rpAC�ILITY TYPE 1,-01t- t- <#fE6PLE +-! # PEOPLF/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No SLOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)"' NEW SITE REPAIR SITE _ t' SYSTEM SPECIFICATIONS: TANK SIZE 1,J _- 0 GAL. - _ r 1 I* -.. PUMP TANK GAL. TRENCH WIDTH '�-%' ROCK DEPTH � �=- LINEAR FT. l,aOTHER 4 I '^ n� } 0XLS 1����L� �.1�� �+�+�' InI/,�• RE UIRI DSITE- 06,iFICA IONS/CfiNIjITIONS. IMPROVEMENT PERMIT LAYOLFP L &Y A CiIN d l> **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: J� (WSF, ;4 • 4- AUTHORIZATION NO. '% Q OPERATION PERMIT BY: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SY M DESCRIBED WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL GUARANTEE THAT.THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF DCHD 02/02 (Revised) �rA 741 DATE: Z tE HAS EEN INSTALLED IN COMPLIANCE ,M ! , UT SHALL IN NO WAY BE TAKEN AS A ,, :+.::,, '•:w....+'6 frs R� �.y., .t.....::.L �z a,...� u�•�_:'^" ..i>' C•o: T,.:t='cn^•'.y,.s '.+ c, .cx m�..«a.r.q.<.. i.;._, �,..�_i;y„r•-r.u. —.. R3; r..---1 DAVIE COUNTY HEALTH DEPARTMENT - Environmental Health Section PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑ Name: A$CA ► -t Phone Number: 7 �D y- -Z (Home) I Mailing Address: Z W C. t 0M . d , `76 O 0 7 O 6 (Work) LP x. X15'Ayry VC, 2 72 9S- 7W 24,0.2 Detailed Directions To Site: TG k -f N Wy qO 1 -5. -iv (-4�C,L - 1 f Y r- C_ct") is s ► r„rn�;c,�cl SGi,c` �{� rG�\�oa� CrvSS�� Secyn p gU a Cf SCMe 5A e o( 801 C CCI J7. t2 Pro Address: 1 C1 _t \ i J d `- .5 G Property iV Please Fill In The Following Information About The Existing Dwelling•. Name System Installed Under: C cr r )-es u t ') �Ct' �J f �(T Type Of Dwelling:_r e 5 d t •t ii q Date System Installed(Month/Day/Year): 1 q b Q Number Of Bedrooms: 3 - Number Of People: Is The Dwelling Currently Vacant? Yes i/ No ❑ If Yes, For How Long? (0 L'i { t -s Any Known Problems? Yes ❑ No D� If Yes, Explain: Please Fill In The Following Information About The New Dwelling. GctCI;n 5 I add on joo 4A Type Of Dwelling: \d C 6 r e Number Of Bedrooms: 3 Number Of People: .C.�to 5ckoot ori 3-�o�w� Requested By: Date Requested: '. . (Signatur For Environmental Health Office Use Only APprovedpl--Disapproved '0 n Comments pe"'`-�/ �/l,d'�,.� �. -6 73 j1 Environmental Health Specialist Date_7 J� " The sighing '65i s form by the Environmental Health'Staff is in no way intended, nor should be taken as a guarantee(extended or limited) 2git the on-site wastewater system will function properly for any given peri Payment: Cash ❑ Check oney Order ❑ # 3((,o Amount.' w.o T Date: Paid By: �,( Received By: _ Account #: '� al Invoice od of time. I ` r