1164 Jericho Church RdDavie Countv. NC
Tax Parcel Report loll Monday, October 10, 2016
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OI�M iF
WARNING: THIS IS NOT A SURVEY
All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
Parcel Information
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
Parcel Number:
J400000034
Township:
Mocksville
NCPIN Number:
5737480497
Municipality:
Account Number:
42731250
Census Tract:
37059-806
Listed Owner 1:
KHUTH KHORN
Voting Precinct:
SOUTH MOCKSVILLE
Mailing Address 1:
241 SHANNON DRIVE
Planning Jurisdiction:
MOCKSVILLE
City: LEXINGTON
Zoning Class:
MOCKSVILLE OSR
State:
NC
Zoning Overlay:
Zip Code:
27292-8422
Voluntary Ag. District:
No
Legal Description:
LOTS 1-5 JERICHO CHURCH
Fire Response District:
MOCKSVILLE
Assessed Acreage:
0.64
Elementary School Zone: MOCKSVILLE
Deed Date:
3/1992
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001630049
Soil Types:
CeB2
Plat Book:
0003
Flood Zone:
Plat Page:
067
Watershed Overlay:
MOCKSVILLE
Building Value:
75560.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
13900.00
Total Market Value:
89460.00
Total Assessed Value:
89460.00
OI�M iF
Davie County,
All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
NC
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.
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME xw-� 4.0ri✓ PHONE NUMBER 63Y �/ ?
ADDRESS /� G `� `%-� Glial SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY hvttl�-- NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY~ SPECIFY PROBLEM OCCURRING gin L,,2 !�5
DATE REQUESTED /O 9 INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT,
Rev. 1/93
AUTHORIZATION NO. 10 9 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Permittee's �; % P.O. Box 848
PROPERTY INFORMATION
Name: �� !, 1,L /`Z> Mocksville, NC 27028 Subdivision Name:
l Phone #: 704-634-8760
Directions to property:fe�T_'t = ' f : ,lit:' ( Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION �p
Road /Name: 1 -
7 oag�CnnZ
**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 Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r
4" ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
L4 I' l l IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMEN'IAI `IiEALTII SPECIALIST DATE ISSUED
#4= ; DAVIE COUNTY HEALTH DEPARTMENT
y; * MI
IMPROVEMENT AND OPERATION PFR�S
Derm�ttet s �/ !
lame •; r' i'; ' �.' �'., f :,�
Direction§ to property:
PROPERTY INFORMATION
Subdivision Name:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Roadf Name: n 2l C. L101.�'. 'Z
Ip: _ q
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. 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 G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTACHEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE #BEDROOMS: -Z_# BATHS �7 #OCCUPANTS _ GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ��C
i ROCK DEPTH 1 INEAR Fr -I-- iv
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
/] �!
"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 (704) 634-8760.
OPERATION PERMIT
V� IL SYSTEM INSTALLED BY: 1)D h K % C-
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AUTHORIZATION NO. oR R OPERATION PERMIT BY: DATE,
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH YSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 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 05/96 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
t " IMPROVEMENT AND OPERATION P1E;RMIT,S
Permittee's , -
Na�iie: Y i
Directions"lo property:'.>''
PROPERTY INFORMATION
Subdivision Name:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name:^ 1� t C �$ti Zip: ,q 0r1
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. 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 G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED' SYSTEM CONTRACTOR MUST SEE TMS PERMIT BEFORE
RESIDENTIAL SPECIFICATION: BUILDING TYPE
COMMERCIAL SPECIFICATION: FACILITY TYPE
INSTALLING THE SYSTEM.
# BEDROOMS �=_? # BATHS :-2_#OCCUPANTS L- GARBAGE DISPOSAL: Yes or No
# PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITEy
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH , ? r! ROCK DEPTH LINEAR Fr_�"
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
A)
t_
"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 (704) 634-8760.
OPERATION PERMIT / `w ; K `
SYSTEM INSTALLED BY: MO
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0114
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
,
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH YSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 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 05/96 (Revised)
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