618 Ijames Church RdDavie County, NC
Tax Parcel Report 0110 Thursday, September 29, 2016
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I yr All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
9 toe Davie County, 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
�pUNq� NC or Msing out of the use or Inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
G300000006
Township:
Clarksville
NCPIN Number:
5810819290
Municipality:
Account Number:
82522853
Census Tract:
37059-801
Listed Owner 1:
ELLIS VAUDA G & ROBERT L
Voting Precinct:
NORTH CALAHALN
Mailing Address 1:
618 IJAMES CHURCH ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-4826
Voluntary Ag. District:
No
Legal Description:
2.20 AC IJAMES CHURCH RD
Fire Response District:
CENTER
Assessed Acreage:
1.91
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
6/2004
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
005550322
Soil Types:
Ce132
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
128640.00
Outbuilding & Extra
Freatures Value:
22570.00
Land Value:
26050.00
Total Market Value:
177260.00
Total Assessed Value:
177260.00
I yr All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
9 toe Davie County, 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
�pUNq� NC or Msing out of the use or Inability to use the GIS data provided by this website.
�• 751-�yyL
Davie County Health Department
1836 t Environmental Health Section
P.O. Box 848'
ECEIVE �.
D;c
10 Hos ital Street � t
��� 5 �� �� ourier # : 09-40-06 q �rj'
cksville, NC 27028
Phone: (336) - 751- 8760—f'� 4 Fax: (336) - 751- 8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELL
(Check One) Replacement ❑ Remodeling )9 Reconnection ❑
Name: M q Pi( ca/" Phone Number ��3 - Y9Z~ Z/ (L (Home)
Mailing Address: ,FJ'A_"'e s G tAdt- %L I4 31.7 -66,70
u -r<
Detailed Directions To Site: Zsacr Its /o S��.ries �1Gt2� �/ . �✓�
Property Address: �e_ 1p�Gin��.f L hl�c �c� ��`l� H C 70 2-i j'
20
Please Fill In The Following Information About The EXISTING Facility: 3 6U 00dU b C Z `�iJ
Name System Installed Under:_&"i f VQ•l(GiC(�! / i Type Of Facility:
Date System Installed (Month/Date/Year): 176 -
Number Of Bedrooms: _Number Of People:_
Is The Facility Currently Vacant? Yes ❑ No �S, If Yes, For How Long?,
Any Known Problems? Yes ❑ Nq$' If Yes, Explain;
Please FBI In The Following Information About The NEW Facility:
Type Of Facility: is 30� 0 Number Of Bedrooms: Number of People
RequestedB : Date Re uesei d: ✓l/L
Y 4 T
ignature)
For Environmental Health Office Use Only
Approved D Disapproved ElCorx�ments:
Environmental Health Specialist
Date: /0/2?./a0ia
*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 ❑ She*,Z Money Order ❑ #
Paid By: —�J . i �/� I e7- Received By: L12 LaAll U- ,
Account#:Invoice #:
O -DP 91/119
Davie County, NC - GoMaps Advanced
ivie County, NC - GoMaps Advanced
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Lafitude:35156 28,93" Longitude: -80137 24.52'
http://maps.roktech.net/davic�_gomaps/index.html 10/15/2012
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f DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
r a
IMPROVEMENT PERMIT
**NOTE** This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater
systema AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article 11 of B.S. Chapter 13OA, Wastewater Systems, Section .1900 SewageTreatment and Disposal Systems)
NAME� `� PROPERTY ADDRESSg C77c-`me C%Y-e� cL.� /DATE S - n-%
r
LOCATION Ca til �►�. o sr,
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICAT;ON:-BUILDING TYPE Hf.)q% # BEDROOMS # BATHS # OCCUPANTS .L GARBAGE DISPOSAL: Ye No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: 4k(No
LOT SITE arm- 'HYPE NATER SUPPLY'DESIGN WASTEWATER FLOW (GPD)l kV 4 FEW SITE REPAIR SITE
y
SYSTEM SPECIFICATIONS: TANK SIIE:�04� GAL. 'PUMP TAM( GAL. TRENCH WIDTH �_ ROCK DEPTH ja LINEAR FT.
OTHER :, 1 " �,1, �, ��'< 1 • t r
a
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT ISVBJECT TO REVOCATION IF SIV PLANS.OR'THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
'•5, p U S �
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IMPROVEMENT PERMIT BY,�
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FIRANSPECTION OF THIS SYSTEM BETWEEN
8:38-9:38 A.M. OR.1:OO-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8768.
OPERATION PERMIT SYSTEM INSTALLED BY
'=Al i
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AUTHORIZATION NO. G `t70
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 13OA, 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 10/95
DAVIE COMITY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT i
IMPROVEMENT :PERMIT
**MOTEf* This improvement permit DOES NOT authorize the construction or, installation of a septic tank system or any wastewater
system. .'AMI AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
HANE ►' s .,,� , S PROPERTY , aouREsSg `-' Qm e 1 C�-t�r e� d , DATE
LOCATION
` • 1 �,
LOCATION n'[ ( Ur..;: �%.. Q TV%/74
SUBDIVISION NAME, LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE 0 # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Ye No
COMMERCIALSPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE r`r_ HYPE WATER SUPPLY 1J� �3DESI8N WASTEWATER FLOW (GPD)l � MEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE%�aU GAL. F PUMP TANK GAL. TRENCH WIDTH 7 _ ROCK DEPTH LINEAR FT. h
OTHER , ' �C �?�, k
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS'BUBJECT TO REVOCATION IF SI�TE"PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
F
Jr
t
- ` IMPROVEMENT PERMIT By, .,,., "y -n .�•�
l
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL/IMbECTION OF THIS SYSTEM BETWEEN
8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION. ."TELEPHONE -#'-IS (704)-634-8760. ;
OPERATION PERMIT' SYSTEM INSTALLED BY J a
t\ ,. L�./a_ 9/ _
**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 -SE4E TREATMENT AND DISPOSAL SYSTEMS., BUT
SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PEMOD OF TIME.
DCHD 10/95
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLIC TION FOR IMPROVEMENT PERMIT (REPAIR)
i�
NAME / /"S PHONE NUMBER
ADDRESS SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE �ZXIl� ,��4'S / ��/�'�r •C ✓/,Zf� [ rr+��c
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDERa Nps
TYPE FACILITY 1 NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY IIS s" SPECIFY PROBLEM OCCURRING
DATE R
NFORMATION TAKEN BY.
This is to certify that the information provided is correct to the best of my knowledge, and that
SIGNATURE OF OWNER OR AUTHORIZED AGENT
J
Rev. 1193
am
incurred from this application.
Davie County Health Department
. 1 ENVIRONMENTAL HEALTH SECTION
P.D. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A,Wastewater Systems)
***This Authorization For Wastewater System Construction oust be issued by the Davie County Environmental Healtht�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.+*+ tf
Q AUTHORIZATION NUMBER
NAME Vs DATE Q ` ' t �,, N12 0470.
NAME ON IMPROVEMENT PERMIT (If different than above) \ r
SITE LOCATION c
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
**WICE*H THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE.(5) YEARS.
ENVIROMIEMAL HEALTH SPECIALIST DATE
DCHD,10/95- L