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372 Pleasant Acre DrDavie County. NC Tax Parcel Report I M M Wednesday, October 5, 2016 316- I I ,y 324 V�> Z'7 t,, r- r 383 332` , r`\ % 356 �. 997 3.007/ L�4O15 / 372 -397 t --AV-0 406 414 r 432 II, WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: M600000007 Township: Jerusalem NCPIN Number: 5745967739 Municipality: Account Number: 82532147 Census Tract: 37059-807 Listed Owner 1: MILLER RUSTY Voting Precinct: JERUSALEM Mailing Address 1: 372 PLEASANT ACRE DRIVE 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: Legal Description: Pleasant Ac dr Fire Response District: Assessed Acreage: 2.55 Elementary School Zone Deed Date: 6/2010 Middle School Zone: Deed Book / Page: 008290793 Soil Types: Plat Book: 10 Flood Zone: Plat Page: 208 Watershed Overlay: Building Value: 107310.00 Outbuilding & Extra Freatures Value: Land Value: 29510.00 Total Market Value: Total Assessed Value: 136820.00 1r.! JERUSALEM COOLEEMEE SOUTH DAVIE WeC, PcB2, RnD DAVIE COUNTY 136820.00 91 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 merchantability or fitness for a particular use. All 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 ag daims or causes of action due to r'pUNq NC or arising out of the use or Inability to use the GIS data provided by this website. ,• .„ r _ ia., -i: +..1 d,r.. ':. �, r;� r 'a° , ..�.. ._� '�. a: �i'� •-T ----- j ►� vow.- 2.3 2z3 2.00 t. AUTHORIZATION NO., 5. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's nr' .,w„ / P.O. Box 848/�J Name:``�,� Mocksville, NC 27028 Subdivision Name: /' [^ Phone # 336-751-8760 Directions to property: Section: Lot: AUTHORIZATION FOR }� ,t -i (� �'.s 1, WASTEWATER L = i Tax Office PIN:# SYSTEM CONSTRUCTION _ 6 Road'NameZip' �Cy? **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 applyir �n for Building Permits. (In compliance with Article 11 �f G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) = - �,.. ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION 1i ,� s` ---K . _. /' ,, � -,.J V IS VALID FOR A PERIOD OF FIVE YEARS. ENVIROKM N 'AL�H ALTH S EC(LIST DAT ISS ED DAVIE COUNTY HEALTH DEPARTMENT /410 IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee's Subdivision Name: Directions to property: IMPROVEMENT PERMIT Section: Lot: Tax Office PIN:# - RoadName: t L.L **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 6f G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) "^ ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITEPLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER (MENTAL IjEALTH SPEQti LIST DA ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE �� INSTALLING THE SYSTEM. , RESIDENTIAL SPECIFICATION: BUILDING TYPE# BEDROOMS ±�L— # BATHS :�L # OCCUPANTS —�J— GARBAGE DISPOSAL• es r No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZI TYPE WATER SUPPL4 ! 1 NT`( DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE -�, GAL. P(�UM�P TAN\K GAL. TRENCH WIDTH �� ROCK Dc—E,PTH LINEAR FT. OTHER '� S 1 `.-1 &0Tl ()'ilr" ;�[ 1 j /� L (_ 1 t~� 1, D . M T.1 REQUIRED SITE MODIFICATIONS/CONDTI'IONS: , IMPROVEMENT EERMIT LAYOUT KAPPROVED EFFLUR-4T FILTERS *RISER(S) IF C T'ELG. FR-4U"11M ERPD77 - 1 N 1\1 LAA) PA 1�c3+�1G G� T _ FfLaaT` "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 (764j99$1O&ib )C (336)751-8760 OPERATION PERMIT N SYSTEM INSTALLED BY: S� 4L,, -,zo Sox 3c.' xtz V 0 * -sfl -1>66K �xls,-t r-1 C -D Foca F -1;g> L-asi " �A . AUTHORIZATION NO. —I&�' i)PERATION PERMIT BY: DATE: / p "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE S DESCRIBED AB AS BEEN INSTALLED I COMPLIANCE WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATME AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BETAKEN ASA GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05196 (Revised) ; 4} DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS Permittee's y 1 j Name: L Directions to property: IMPROVEMENT b q PERMIT PROPERTY INFORMATION Subdivision Name: ! Section: Lot: Tax Office PIN:# Road Name: i t.i - Zip: **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (In compliance with Article 11 pf G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ` I ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE M ( ( PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPEgIALIST DA T$ ISSfIED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE 1INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE . #BEDROOMS #BATHS . j #OCCUPANTS _ GARBAGE DISPOSAL�.Yes p No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No 1( LOT SIZE TYPE WATER SUPPLN( _ 1N7 Y DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE r• SYSTEM SPECIFICATIONS: TANK SIZE GALE. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH /K- r LINEAR FT. /GC OTHER / 7~'.t i lr�Tl < N i ' F n L L (. t t. � + 0. 0 rv,1 r,3 , REQUIRED SITE MODIFICATIONS/CONDITIONS: 1 OSI/� L L U,a L"C- 1 LJ �-�t` t '5"' IMPROVEMENTPERMIT LAYOUT (_jr_t jr1.r)%JE1) EFFLU[RIT FILTER *RIE'Yt (G) I1= i." Ecl_011 FItJI-e�X D GRPIPE# •'5C�L,,.-e-,-,-,`..�,,.....,. • r 1-ivr►��. til � k..-;x-1`'�Ztnt���1 .I���..,���. **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 (7M �0%?"X ( 336) 751-8760 OPERATION PERMIT 'tic. 1'I F c SYSTEM INSTALLED BY: AUTHORIZATION NO. ''OPERATION PERMIT BY: DATE: 241 )01 **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE YSTEM DESCRIBED AB VAS BEEN INSTALLED 1 COMPLIANCE WITH ARTICLE 1 I 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 FUNCTIOI f SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. �I 4i tt ii11 DAVIE COUNTY HEALTH DEPARTMENT . Environmental Health Section tro �f t^-- PO Box 848/210 Hospital Street G 3 Mocksville, NC 27028 4 Phone: (336)751-8760 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑ Name: Vb>-Co exL' Phone Number: A4- ll'��r� (Home) Mailing Address: L�ikSts�T /��- D2 (Work) Mxc.'!:�J1 l cJG 270z-�g Detailed Directions To Site: LP01 S 7-;b &Z S4 J7- - ACS D2 4 #372-- Property 72 -Property Address:% Please Fill In The Following Information About The Existing Dwelling: Name System Installed Under: C L-1) Type Of Dwelling: Date System Installed(Month/Day/Year): 2D i�L'S� Number Of Bedrooms: Z Number Of People: Is The Dwelling Currently Vacant? Yes ❑ No 2"" If Yes, For How Long?, Any Known Problems? Yes ❑ No 0"_ If Yes, Explain: Please Fill In The Following Information About The New Dwelling: l �1 Type Of Dwelling: ft0 JS %:1_' Number Of Bedrooms: Number Of People: �f Requested By: Date Requested: (Signature) For Environmental Health Office Use Only Approved ❑ Disa �.prr%oved ❑ CnmmPnts- [L AI � P M -Ir ��-� ) -ZA o _170 Environmental Health 0 *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: CashX3 Check WUoney Order ❑ # ; 9 Amount: $ S '� Date: Paid By: C`�( Received By: Account #: /.20/ Invoice #: 232 �� La, 0'�— A DAVIE COUNTY HEALTH DEPARTMENT !. Environmental Health Section k PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 y�v ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑ Name: LCC S.i e/ 4 G -/� Phone Number: 2PP'4- �`�©/ (Home) Mailing Address: �� �C��•SU �! �1��� />�� (Work) Detailed Directions To Site: tel.' 1 6'0 11 • U Property Address: l 1;%v e Please Fill In The Following Information About T; 1 Name System Installed Under: -6 i % k•e�jr Date System Installed(Month/Day/Year):lT �Gr Is The Dwelling Currently Vacant? Yes ❑ No �-' Yes, Fox A Kn P bl ? Y r-1XT_G1�If Y E 1' '/'ate �,� ���'r'� S��C �°/J�-.-�.-�• I ��::-'J 1j1�� ,� - ny own ro ems. es o es, xp am. Please Fill In The Following Information About T]h , Type Of Dwelling: A0 u S C_ Number Of Bedrooms: 2�— Number Of People: Requested By:g2zle -'l Date Requested:' (Signature) For Environmental Health Office Use Only Approved E� Disapproved ❑ Comments: s�`�%l-� SAS >d Z�.� ��� '"�, i�2�,v... ;Jn E F.i.d re,c -, 1 -if Environmental Health Specialist -�"' Date '"'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 CYCheck ❑ Money Order ❑ # Amount: $ Date: ae i F • '�' 't. Paid By: !�- �.« `� /.. s:l Received By: / Account #: � 0 / Invoice #/ r DAVIE COUNTY `HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION -Note: Issued- in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name � • W � U-�--�1� . 281-26giI � _ Date .;t... �.� r ��; 6 9 Location Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms 3 No. Baths No. in Family Garbage Disposal YES fl_ NO O' Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES Ej' NO ❑ Type Water Supply u' �-�- *This permit Void if sewage system described below is not installed within 36 months from date of issue. 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 IZ,.:f mpa_u �059 i4 A Lt- Certificate ` Certificate o; Completion �� Datez/ *The signing of this certificate shall indicate that the system describe4 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.