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2148 Hwy 801SDavie County, NC Tax Parcel Report 1 " Wednesday, September 28, 2016 CD 7793 00 7691 --' 0974 r N 'ic9 i 165 ; 2148 o w ---- - i ,, 2155 v. CD 268 co 7483 4 A N � Parcel Number. G813OA0010 NCPIN Number: 5789287793 Account Number: 42007000 Listed Owner 1: JUDD HELEN W Mailing Address 1: 2148 HIGHWAY 801 SOUTH City: ADVANCE State: NC Zip Code: 27006-0000 Legal Description: 1 LOT HWY 801 Assessed Acreage: 0.81 Deed Date: 1211992 Deed Book I Page: 001660389 Plat Book: WILLIAM ELLIS Plat Page: WeC,PcB2 Building Value: 82270.00 Outbuilding & Extra 12040.00 Freatures Value: Land Value: 23260.00 Total Market Value: 117570.00 Total Assessed Value: 117570.00 WARNING: THIS IS NOT A SURVEY Parcel Information Township: Shady Grove Municipality: Census Tract: 37059-804 Voting Precinct: EAST SHADY GROVE Planning Jurisdiction: Davie County Zoning Class: DAME COUNTY R-20 Zoning Overlay: Voluntary Ag. District: No Fire Response District: ADVANCE Elementary School Zone: SHADY GROVE Middle School Zone: WILLIAM ELLIS Soil Types: WeC,PcB2 Flood Zone: X Watershed Overlay: WS -IV P 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 °u a causes of action due to or arising out of the use or inability to use the GIS data provided by this website. a w►. Davie County Health Department 4 18 Environmental Health Section P.O. Box 848 210 Hospital Street O j 14 `5 Courier # : 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection INS Fax: (336) - 753-1680 x��lLCci. CRe �c;nn�yti' Name:WP Phone Number 3 l 1 - (Home) Mailing Address: ,7 / J llca4 6-6 1 " S (Work) Please Fill In The Following Information About The EXISTING Facility. 1qj,() , Name System Installed Under. ��.. `� �C�t ow t�cu �,� �o�s� 1913 Type Of Facility: �L"-z L �� �`n �`� Yos Date System Installed (Month/Date/Year): t Number Of Bedrooms: 3 Number Of People: Is T1he Facility Currently Vacant? 00 If Yes, For How Long? Any Known Problems? Yes 5,Yes, Explain: Please Fill In The Following Information About The NEW Facility: s� Type Of Facility: (G?? ty►'-Aa-1 (r ag e Number Of Bedrooms: %✓ 4 Number of People Pool Size: AGaza e3�iie:�S , Other: Requested By: Date Requested- (Signature) equested:( ignature) For Environmental Health Office Use Only /A prove Disapproved Comments: Environmental Health Sveciali *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 function properly for any given period of time. Payment: Cash Check C Check Money Order # Amount:$ Date: Paid By: I //" I ]S 3 -D y Received By: Account #: Invoice #: 11 1900 Key r4 ItIrt MET, zsuu.T47T95V&—biREcT 600 rAx 336.777.1805 �4