705 Pine Ridge RdDavie County, NC f Tax Parcel Report I k.� �)-N Wednesday, October 5, 2016
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WARNING: THIS IS NOT A SURVEY
All datais 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 webslte shall hold harmless the
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Parcel Information
County of Davie, NorthCarolina, Its agents, consultants, contractors or employees from anyand all claims orcauses of action dueto
arising out of the use or inability to use the GIS data provided by this website.
Parcel Number:
N511OA0009
Township:
Jerusalem
NCPIN Number:
5745405118
Municipality:
Account Number:
41644000
Census Tract:
37059-807
Listed Owner 1:
JORDAN DAVID L
Voting Precinct:
JERUSALEM
Mailing Address 1:
705 PINE RIDGE ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE
COUNTY R-20
State:
NC
Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
1.38AC PINE RIDGE RD LOTS 9-14
Fire Response District:
JERUSALEM
Assessed Acreage:
1.38
Elementary School Zone:
COOLEEMEE
Deed Date:
11/1991
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001610408
Soil Types:
EnC
Plat Book:
0001
Flood Zone:
Plat Page:
088
Watershed Overlay:
DAVIE COUNTY
Building Value:
54940.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
19350.00
Total Market Value:
74290.00
Total Assessed Value:
74290.00
Davie County,
All datais 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 webslte shall hold harmless the
F-a
NCor
County of Davie, NorthCarolina, Its agents, consultants, contractors or employees from anyand all claims orcauses of action dueto
arising out of the use or inability to use the GIS data provided by this website.
Road Name: 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 Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
j ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
,
.AUTHORIZATION NO:,
lit t Dv
DAVIE COUNTY HEALTH DEPARTMENT
2 �2.�,-.✓
Environmental Health Section
PROPERTY INFORMATION
Permittee's /. --�
P.O. Box 848
-
Name:f�/;(�' V>rr��1��
Mocksville, NC 27028
Subdivision Name:
!J Phone # 336-751-8760
Directions to property:
Section:
Lot:
AUTHORIZATION FOR
WASTEWATER
Tax Office PIN:# - -
SYSTEM CONSTRUCTION
Road Name: 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 Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
j ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
T lY _��w
� �a•� w DAME COUNTY HEALTH D PARVMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's - -
Name: --,Y/ -"(, f.ff �i �.:% %'�/ ✓l Subdivision Name:
Directions to property:-' r Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: 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
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)
*fi 1NU111;15fifi.1kMrL�KMll1NNUBJL�UI 1U1(hVUUA11U1N1kN11h
r �y 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 _jam #BEDROOMS _ #BATHS _„[_ # 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 ROCK DEPTH INEAR FT./L r�
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAY%fppROVED EFFLUMT1 Fl
(S) IF 611 EELO11 FIPaISHED GRhDE*
"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 -P64} 63
K}�C?,60.
I OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. / 0 '� OPERATION PERMIT BY: 4�z DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 �1` (f 15)
�
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
_. Permittee's, -
Name: - M.,. f , r `
Subdivision Name:
Direetions to property: , Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# - -
Road Name: 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
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 IJ # BEDROOMS ;�? # BATHS _� # OCCUPANTS "'7 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
✓r
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 J %) LINEAR FTJJ_'�'�/
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT,,PIRMVEU EFFLUEtlT<"(S) IF 61 r 13ELOIJ FV41S i_1) ti1:�UE�
,l
"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 L$Dff,4) , 34-8760,
OPERATION PERMIT
SYSTEM INSTALLED BY:
`v
ai
AUTHORIZATION NO. 0 c` OPERATION PERMIT BY: DATE:
"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)
t
` DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR I PROVEMENT PERMIT (REPAIR) p/3
NAME a _7 PHONE NUMBER
ADDRESS 7zad_ / i lelllzyc G /Gc�, SUBDIVISION NAME
i�UG T Z' ' Me /,;(,/C- 02 %e_�'U LOT #
DIRECTIONS TO SITE A�y 4,011T G6 9cer T ���'��3y Cn/`�17 P/� e%��/�crX,
%°; �e %&a ,* C /fid . /e Mil � 7a 4
DATE SYSTEM INSTALLED � D /'T NAME SYSTEM INSTALLED UNDER
TYPE FACILITY //SC'-� NUMBER BEDROOMS �- NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING ll;a S>�� /�C5�
� ee�
DATE REQUESTED 21a116 O / INFORMATION TAKEN BY ;X�
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