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1331 Liberty Church RdDav >.016 9 h� Iyp All data is provided as is without warranty or guarantee of any idnd either expressed or implied Including but not limited to the Davie County, Implied warranties of merchantability or fitness for a particular use. Ali 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 np tl t3� NC or arising 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 D200000031 Township: Clarksville NCPIN Number: 5812163214 Municipality: Account Number. 82517586 Census Tract: 37059-801 Listed Owner 1: ALLISON ANTHONY RAY Voting Precinct: CLARKSVILLE Mailing Address 1: 1331 LIBERTY CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -AR -20 State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 1.000AC LIBERTY CHURCH RD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.87 Elementary School Zone: WILLIAM R DAVIE Deed Date: 1/1989 Middle School Zone: NORTH DAVIE Deed Book / Page: 014740100 Soil Types: Mn132 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAME COUNTY Building Value: 40190.00 Outbuilding 8r Extra 1610.00 Freatures Value: Land Value: 14630.00 Total Market Value: 56430.00 Total Assessed Value: 56430.00 9 h� Iyp All data is provided as is without warranty or guarantee of any idnd either expressed or implied Including but not limited to the Davie County, Implied warranties of merchantability or fitness for a particular use. Ali 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 np tl t3� NC or arising out of the use or Inability to use the GIS data provided by this website. AUTHORIZATION NO: Q %3 6 „ DAVIE COUNTY HEALTH DEPARTMENT b Environmental Health Section PROPERTY INFORMATION Permittee's 1;Z P.O. Box 848 Name: �f •S , i w Mocksvia, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property:' 0 la \ u r� Section: Lot: AUTHORIZATION FOR y. �.. WASTEWATER x Office PIp�,.# ' 'SYSTEM CONSTRUCTION Ta� Road Name" - —ter=� ,, �: Zip:- **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 $uilding Permits: (In compliance with Article 11 of G.S. Chapter, 130A, Wastewater Systems, Section. 1900 Sewage Treatment and Disposal Systems) . ***NOTICE***THIS AUTHORIZATION FOR.WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permi �e�'s • �'' {r , � Name: s� ,! . a t'ti ...°.�;. t ' Subdivision Name: Directions to property:J. C� t "_W`� .': ; � Section: Lot: IMPROVEMENT "NN'.k` r _s PERMIT Tax Office P�# - Tee: p t �1 2A ar-44 -Rea V p5 lTe.al� iT14— • Road Names Zip: "'10,., **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 beobtained 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 THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE o -,)M . # BEDROOMS ia. # BATHS # OCCUPANTS _ GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No t LOT SIZE �'"�� TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH I g 4 LINEAR FT. .. OTHER_ REQUIRED SITE MODIFICATIONS/CONDITIONS: **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. SYSTEM INSTALLED BY: AUTHORIZATION NO..0 OPERATION PERMIT BY: DATE: ' l 1 **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 "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 b .'' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Penrutliee's � Name: +' ; Vit', : ; ? " # + Subdivision Name: Directions to property: i f ' `S Section: Lot: — IMPROVEMENT ,, :. ; ...,... PERMIT Tax Office PI# • i � -� ,' tl,... �... 1 �Pn .., .�►'c- � _1 i ��l ,_,_ u ark. "��. v�l�.. tcoaa zip: **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 constructionfmstallation,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) r.erwr�mrnra:rr m[Trro rrronw,nm m caro n+nm m� rn�r<r�n � mr�wr n+ arrmr. •.:;,' .., =w i ..., �' ' , r PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUELDING TYPE In ,)M # BEDROOMS # BATHS —# OCCUPANTS _ GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE_ TYPE WATER SUPPLY Q0 DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. L) OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT J . ` 4 1l ? "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 SYSTEM INSTALLED BY: ✓�-�b A�S�3' " I )c Y P O US R ,...» ......,...-. .............mow+" C. AUTHORIZATION NO OV) VQ OPERATION PERMIT B,Y.1: y—^'`" DATE: l L1 *w 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 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BETAKEN ASA GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) NAME_ ADDRE& Qaz'� JWA a% z� DAVIE COUNTY ENVIRONMENTAL HEALTH SEWON APPLICATION FOR IMPROVEMENT PER EPAIR) ONE NUMBER BDIVISION NAME /8o ca U). ��Cv\ 11@ LOT# DIRECTIONS TO SITE 10 ( N - 0 vl� - O) C DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY � � g� NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY----C,-SPECIFY PROBLEM OCCURRING DATE REQUESTED -�u " 91 INFORMATION TAKEN BY This is to certify that the information provided is correct to the best of my knowledge, SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1/93 for all charges incurred from this application.