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160 Midway St1)4vie County, NC Tax Parcel Report as MLko Friday. September 30. 2016 Building Value: 1146650.00 Outbuilding & Extra 1000.00 Freatures Value: Land Value: 42210.00 Total Market Value: 1189860.00 Total Assessed Value: 1189860.00 No WAK ENE: THIN IS 1VUT A SURVEY 1@7 NC Parcel Information Parcel Number: N5010D000401 Township: Jerusalem NCPIN Number: 5745031591 Municipality: COOLEEMEE Account Number: 75248000 Census Tract: 37059-807 Listed Owner 1: VICTORY BAPTIST CHURCH Voting Precinct: COOLEEMEE Mailing Address 1: PO BOX 686 Planning Jurisdiction: COOLEEMEE City: COOLEEMEE Zoning Class: COOLEEMEE RS State: NC Zoning Overlay: Zip Code: 27014-0000 Voluntary Ag. District: Legal Description: 6.70 AC MIDWAY ST Fire Response District: COOLEEMEE Assessed Acreage: 6.70 Elementary School Zone: COOLEEMEE Deed Date: 1/1900 Middle School Zone: SOUTH DAVIE Deed Book / Page: 001180515 Soil Types: EnB,MsC Plat Book: Flood Zone: Plat Page: Watershed Overlay: COOLEEMEE Building Value: 1146650.00 Outbuilding & Extra 1000.00 Freatures Value: Land Value: 42210.00 Total Market Value: 1189860.00 Total Assessed Value: 1189860.00 No 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 wobsite shall hold harmlesstheCounty 1@7 NC of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to out of the use or Inability to use the GIS data by this website. or arising provided Davie County Health Departnient 4 18 r Environmental Health Section ; P.O. Box 848 k� kms` 210 Hos itll Street Cotu-ier # : 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 Far. (336) - 753-1630 ON-SITEWASTEWATER CERTIFICATION (Check Once) Replacement Remodeling Reconnection Name: t)ie-6r- y &pji� (i�� r� ` Phone Number 33 —any ` d o?17 (Home) Mailing Address: (Work) C, ooIced e, . A)C a7o�y Detailed Directions To Site: �..�',\\ fie_ t/`f ��\� �•. C`��ih�-, Property Address: 160 Please Fill In The Following Information About The EXISTING Facility: ��1� �� Name System Installed Under: Type Of Facility: (.. h a d[_I/I Date System Installed (Montb/Date/Year): /Q .S Number Of Bedrooms: 'Number Of People: Is The Facility Currently Vacant? Yes If Yes, For How LonC Any Known Problems? Yes EDIf Yes, Explain: Please Fill In The Following Information About The NEIV Facility: Type Of Facility: I� CCC L� /ICI f V�� Number Of Bedrooms:_=�Number of People o Garage Size: Ot Requeste Date Requested: (Signature) For Environmental Health Office Use Only Approved Disapproved Comments: Environmental Health Specialist ,� / � Date: *The signing of this fonn 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 Check Money Order # Amount:$ «Date: Paid By: " !_ Received By: Account #:��'j (� to Invoice #: c 0 :li.:f x'rr J :...rYk..:.u.•s'.•.:.,;ye... 1..-n':.��,-.} r _'\. a ;i:,_ _—-'..-.. � a ^.�.f.. '1 —....,.•+�:..�...'-.. .. _ DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Name / <___t ��T C Date_ , - k r"e 4267 Location i - r Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms z No. Baths No. in Family _ Garbage Disposal YES ❑ NO ❑ Specifications for System:--:,--, Auto Dish Washer YES ❑ NO '❑ `��:,� Auto Wash Machine YES F] NO �❑ Type Water Supply' _ *This permit Void if sewage system described below is not installed within 36 months from date of issue. i I V p1 C y i Improvements permit by �.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 day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: System Installed by a rrti '3j�dLw.o..c �MW f Certificate of Completion - YAa" Date *The signing of this certificate shall indicate that the system described above has been installed 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. .-- _ DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'VOTEr Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage-Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Name Date 4267 Location k , t Subdivision Name Lot No. Sec. or Block No. Lot Size -- House Mobile Home _ Business Speculation No. Bedrooms -- No. Baths — No. in Family _ Garbage Disposal YES ❑ NO ❑ Specifications for System: , Auto Dish Washer YES ❑ NO ❑ a Auto Wash Machine YES ❑ NO -❑ Type Water Supply __— *This permit Void if sewage system described below is not installed within 36 months from date of issue. i Improvements permit by *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 day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: System Installed by 3 F JRJ I_ 2 Certificate of Completion �— Date "The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way betaken as a guarantee that the system will function satisfactorily for any given period of time.