1038 Ijames Church Rd (2) Davie County,NC_ , Ta�c Parcel Report ����' Thursday, September 29, 2016
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WARNING: THIS IS NOT A SURVEY
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Parcel Number: G200000056 Township: Calahaln
NCPIN Number: 5719490377 Municipality:
Account Number: 38906000 Census Tract: 37059-801
Listed Owner 1: IJAMES CROSSROADS BAPTIST CHR Voting Precinct: NORTH CALAHALN
Mailing Address 1: 728 SHEFFIELD ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: . NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Descriptlon: 5.07 AC SHEFFIELD RD Fire Response District: CENTER
Assessed Acreage: 4.31 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 3/1979 Middle School 2one: NORTH DAVIE
Deed Book/Page: 001070344 Soil Types: MnC2
Plat Book: Flood Zone:
Piat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 625030.00 Outbuilding 8�Extra gg20.00
Freatures Value:
Land Value: 47650.00 Total Market Value: 681600.00
Total Assessed Value: 681600.00
�v� All daW Is provided as Is without wartanty or guanntee ot any kind either exp�essed or Implled Including but not Ilmited to the
9°ia�' Davie County, Impiled warranUes of inerchantability or fitness for a particular usa.All users of Davle Countys GIS website ahall hold hartnless the
County of Davie,North Caro�ina,ka agents,consultants,contracton or empioyees from any and all claims or causes of actlon due to
�'pUx.�'ti NC or arlsing out of the use or Inability to use the GIS data provided by thls website.
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=�- ,:- • , DAVIE COUNTY HEALTH DEPARTMENT
• " • ` IMPROVEMENTS PERMIT 'AND CERTIFICATE OF COMPLETION
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"NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c �'
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Pet't171t NU111be1'
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Name ��:.-�,,,�j 1:�. �l =� ....f �'�;,T:r�%- r'.�,, ;.l Date a� - _�-�t'i`" n�� .�'���i�
', ` `Locat on `:2l`,r�� � ./ ;�•/ %7�,,� .,, �f% �rF ..�-�'' — i,
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Subdivision Name Lot No. Sec. or Biock Na
Lot Size / r`r�-.�<-- �' House Mobile Home — Business Speculation
No. Bedrooms -_ No. Baths No. in Family _ ��"`''�' �'''��f"`� '
Garbage Disposal YES � NO p� `�f���^ �
i �� r-„ ,�; Specifications for System: i t»u �<rr. t��',,� '`
Auto Dish Washer YES ❑ NO p�-� 2 � ,��� . ..Q _ ;�z� ,�! - �„��„ 1�o k` � ��z ' I
Auto Wash Machine YES ❑ NO p" " -�
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Type Water Supply __— '
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
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Improvements permit by — �_ • 11 �'�"���^'
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*Contact a representative of the Davie County Health Department for finai inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: � System Installed by ���' s�"^^�°� � �''�� ��•4,•
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Certificate of Completion � i������ Date �'� y 2� �� _
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"The signing of this certificate shall indicate that the system described above has been instailed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function .
satisfactorily for any given period of time.
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_ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section ,���R� ���p
P. O. Box 665 � �� �-Y'� �
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
� "'Home Phone
Permit Re�uested By e , u,c �,v '�usiness Phone ���.S z�v
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2. Address �• �� v G a o c. ' � w.��
�3. Property Own r if Different than Above � ��S oss o `
Address � �Q �Q ��� � �e e
4. Permit To: a) Install �Alter Repair
b) Privy Conventionai_��Other Type •
Ground Absorption
c) Sub-Division ^��a Sec.��T Lot No. N �
5. System used to serve what rype facility: House Mobile Home Business
� Industry Other-C�,a�z�.l.
� b) Number of Mp�le S a��
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions �r�
Bed Roomsl�..�/1—Bath Rooms �- Den w/Closet N�/A_
b) If Business, Industry or Other, State: Number of persons served sA...� r�� � 5�}
What type business, etc. �� ����
Estimate amount of waste daily (24 hours) ���
4•'7. Number and type of water-using fixtures:
commodes ``� urinals � garbage disposal
lavatory Z showers washing machine
dishwasher sinks
�' 8. a) Type water supply: Public ✓ Private Communiry j
b) Has the water supply system been approved? Yes No �
�^9. a) Property Dimensions � �e-�"�-
b) Land area designated to building site
�c) Sewage Disposal Contractor
✓10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? , ��
What type?
This is to certify that the information is correct to the best qf my knowledge. �
/- / 9- �'�, t1� ������
� Date ��' Owner Signature
' � OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
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