1892 Jericho Church Rd Davie County;NC Tax Parcel Report Tuesday, January 24, 2017
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WARNING: THIS IS NOT A SURVEY
- Parcel Information ��
Parcel Number: K300000044 Township: Mocksville
NCPIN Number: 5727641672 Municipality:
Account Number: 12900620 Census Tract: 37059-801
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Listed Owner 1: CAROLINA BIBLE CAMP&RETREAT Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: C/O JERRY SWICEGOOD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 5.47 AC JERICHO CHURCH RD Fire Response District: MOCKSVILLE
Assessed Acreage: 5.52 Elementary School Zone: MOCKSVILLE
Deed Date: / Middle School Zone: SOUTH DAVIE
Deed Book/Page: Soil Types: SeB,EnB,IrB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
O uu�RAll data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
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 Davis,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
MoD NSC NC or arising out of the use or Inability to use the GIS data provided by this website.
,.FAVI NTY HEALTH DEPARTMENT
ame: I)L-1 AA t `L- , r VA ' vironmental Health Section PROPERTY INFORMATION
:.�t:�1�.1a b °�,,a-I P.O. Sox 848
Directions to property: Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION - -
AUTHORIZATION N0: A Road 1 e 11-x%�14-Co Zip:2'?���.A.
**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,l l of S.Chapter 130A,:Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
All_
,/ � ��E) IS VALID FOR A PERIOD OF FIVE YEARS.
FNVIRONoiI T ,L HES L-fAF ''PCIALIS. DATL ISS�JED
RESIDENTIAL SPECIFICATION:BUILDING TYPE L1005--#BEDROOMS,,_#BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SSPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS .INDUSTRIAL WASTE:Yes or No
LOT SIZES•`� �PE WATER SUPPLY 9�" ' DESIGN WASTEWATER FLOW(GPD) "`'
ANEW SITE REPAIR SITE I
SYSTEM SPECIFICATIONS: TANK SIZE 1000 GAL. PUMP TANK GAL. TRENCH WIDTH 3(-0 DEPTH 19 LINEAR FT. Z�t
OTHER �J c� �.-i�71}��l�►.� "/�
REQUIRED SITE MODIFICATIONS/CONDITIONS: .
IMPROVEMENT PERMIT LAYOUT
8c X3C. .K($
l SD' �O
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**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:- �Iy��
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AUTHORIZATION NO.ZMAOPERATION PERMIT Y: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT T EM DESCRIBE AB VE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSA STEMS",BUT SHALL IN NOWAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 01/02(Revised)
to
'A DAVIE COUNTY HEALTH DEPARTME E E
Environmental Health Section
PO Box 848/210 Hospital Street ! 01-1 2 8 2003
Mocksville,NC 27028 t�i
Phone: (336)751-8760
ENVIRON AENTU 11EALTH
ON-SITE WASTEWATER CERTIFICATION FOR D �n4zEcouNiv
reck One) REPLACEMENT❑ REMODELING ❑ �RRELCONNECT/ION ❑
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Name: Phone Number: ` 0 i����— ! �� 2 (Home)
Mailing Address: �7�2 �a' +� �3G"tel�7 27� (Work)
cbud" GV 2-701
etailed Directions To Sit Sa(; k,-
Property Address:
Please Fill In The Following Information About The Existing Dwelling. -,
Name System Installed Under: Type Of Dwelling:
Date System Installed(Month/Day/Year): Number Of Bedrooms:—,3 - Number Of P ple: _= j
Is The Dwelling Currently Vacant? Yes❑ No m/ If Yes,For How Long? /
Any Known Problems?Yes❑ No 2If Yes,Explain:
Please Fill In The Following Information About The New Dwelling.
A���J
Type Of Dwelling: l umber Of Bedrooms:fW! Number Of People:: Q�
Requested By: �.�/� Date Requested: ` 2O
(Signa e)
For Environmental Health Office Use Only
Approved ❑ Disapproved{ ❑
Comments: r4'[.U�U '—`� �C, e-) , /c, 7W-/Vx-
D F f L..11%.
Environmental Health Specialis -✓ Date i 1 73
"The signing of this form by the Environmental He th 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❑ Money Order❑ # Amount: $ Date:
Paid By: Received By:
Account Invoice #: �
004117
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