1446 Milling Rd �avie County, NC Tax Parcel Report Monday, October 3, 201 E
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: WARNING: THIS IS NOT A SURVEY
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Parcel Number: H60000000211 Township: Mocksville
NCPIN Number: 5759221546 Municipality:
Account Number: 8302287 Census Tract: 37059-805
Listed Owner 1: PHILLIPS JUSTIN B Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: 1446 MILLING ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 1.064 AC OFF MILLING RD Fire Response District: CORNATZER-DULIN
Assessed Acreage: 1.06 Elementary School Zone: CORNATZER
Deed Date: 11/2014 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 009740317 Soil Types: GnB2
Plat Book: 11 Flood Zone:
Plat Page: 389 Watershed Overlay: DAVIE COUNTY
Building Value: 61560.00 Outbuilding&Extra 21220.00
Freatures Value:
Land Value: 15740.00 Total Market Value: 98520.00
Total Assessed Value: 98520.00
9t�M�E, All 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 inerchantability or fttness for a particular use.All users of Davle County's GIS website ahall hold harmless the
�T County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
�oUN�� 1�C or arising out of the use or Inabllity to use the GIS data provided by this website.
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Davie County Health Department
4�i sTt�' Environmental Health Section �
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�F��fn..:, � � i.�. BOX 040 . �;� � _..� •� .
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� ��. 210 Hospital Street ,
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� �,, Courier# : 09-40-06 , •, <�; ;
� � Mocksville, NC 27028
Phone:(336)-753-6780 Fax:(336)-753-1680
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Name: . rl �� ^ Phone Number �JJ�- �13—��� `l(�Home)
Mailing Address: ���� l�;,� ck-�_ (Work)
�����,�.�. � Q Email Address: � 5 f� '��Oi��l Cg�,��'zC��- C C�Y
Detailed Directions To Site: � � d OL-� \ � �!\ , \, ��
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Property Address• ��y,� �j�/�,�` � /\G-� �(► �/l C�L�,�-- � � � �
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under:�S��� �����\1,p � Type Of Facility: , �
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Date System Installed(Month/Date/Year): �.Q��j Number Of Bedrooms:_�_Number Of People:�
Is The Facility Currently Vacant? Yes � If Yes,For How Long? �
Any Known Problems? Yes � If Yes,Explain:
Please Fill In The Following Information About The NEW Facility: .
Type Of Facility: \ �(`� �� Number Of Bedrooms: Number of People
Pool Size: arage Size: Other:
Requested By: Date Requested: �'��l�" � �
(Signature)
. For Environmental Health Office Use Only
Approved Disapproved I �,/
Comments: �-�`� �l0!'1� � 6� idN �� �IC S' � -�?,�v
Environmental Health Specialist a-_ Date: �—�!�� �5
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*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 Check Money Order # Amount:$ Date:
Paid By: � Received By:
Account#: Invoice#:
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d--�� DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P.O.Boa 848/210 Iiospital Street
Mocksville,NC 27028
(336)751-87f►0
Account #: 990002628 Tax PIN/EH#: 5759-22-6542.01
Billed To: Justin Phillips Subdivision Info:
Reference Name: Location/Address: Milling Road-27028
Proposed Facility: Residence Property Size: see map
ATC Number: 3382 •
, AUTHORI�ATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MCTST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). T'his Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of
G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER CO�UCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: ,J�,/ Date: �
CERTIFTCATE OF COMPLETION
**NOTE** The issuance of t 's Certificate of Completion shall indicate the system described on ImprovemendOperation Pe it
has been installed n compliance with Article 11 of G.S.Chapter 130A, Section.1900"Sewage Treatment and
Disposal Systems,' but shall in NO WAY be t a a guarantee that the system will function satisfactorily for ny
given period of t' e. �
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Se tic S tem Installed By: �-/ ��
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Environmental Health SpecialisYs Signature: ��G�� Date: �G��(��
DCHD OS/99(Revised)