222 Rocky Dale LnDavie County, NC
Tax Parcel Report I H p 1 Thursday, October 6, 2016
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: E50000002301 Township: Farmington
NCPIN Number:
5841437153
Municipality:
Account Number:
8300792
Census Tract:
37059-806
Listed Owner 1:
MG GALLINS FAMILY LLC
Voting Precinct:
FARMINGTON
Mailing Address 1:
4625 COUNTRY CLUB ROAD
Planning Jurisdiction:
Davie County
City: WINSTON
SALEM
Zoning Class: DAVIE COUNTY R-A,R-20,H-B-S
State:
NC
Zoning Overlay:
DAVIE COUNTY QD
Zip Code:
27104
Voluntary Ag. District:
Yes
Legal Description:
85.486 AC OFF FARMINGTON
Fire Response District:
FARM I NGTON,WI LLIAM R. DAVIE
Assessed Acreage:
87.05
Elementary School Zone:
PINEBROOK
Deed Date:
8/2015
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
009970068
Soil Types: ArA,SeB,MrB2,EsC,EnB,MsC,ChA,WATER
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
82880.00
Outbuilding 8r Extra
Freatures Value:
5810.00
Land Value:
383830.00
Total Market Value:
472520.00
Total Assessed Value:
166510.00
1@71
NCAll 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 theCounty of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
1. or arising out of the use or Inability to use the GIS data provided by this website.
1401
AUTHORIZATION NO: ' DAVIE COUNTY HEALTH DEPARTMENT
r- Environmental Health Section
Permittee's V�l / P.O. Box 848
2r3°soo
PROPERTY INFORMATION
Name: Mocksville, NC 27028 Subdivision Name:
)�hone #: 704-634-8760
Directions to property:���^�P? Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
Lf �� %��/� , ,/,' SYSTEM CONSTRUCTION - I
5 `I Pi ��r �e�W/ Road Name: AOgk m y
**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)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH S ECIALIST DATE ISSUED
w ; DAVIE COUNTY HEALTH DEPARTMENT
•%= IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
A Permittees:
Name . 1/a
a
`r
Directions to property:
adfec11�
Subdivision Name:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: %leC1'L NM l�-p:J'
**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
F ' f?,• i �� "j �' Gia'' 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 # BEDROOMS ' # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE: Yes or No
1
LOT SIZEt� i1 C TYPE WATER SUPPLY A- DESIGN WASTEWATER FLOW (GPD) 15519Y4 NEW SITE REPAIR SITE �� }
SYSTEM SPECIFICATIONS: TANK SIZE fZ GAL. PUMP TANK GAL. TRENCH WIDTH <yl ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
d Id
t.�
i�
v
"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:
AUTHORIZATION NO.'VT OPERATION PERMIT BY: 161WDATE:
"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
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Name: Subdivision Name:
rr
Directions to property: - Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
f ,f
6:F Road Name: 1`9 Cr't1 /j� I Zip: l r 1 �
.. t
**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 pen -nit.
(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.
a+
RESIDENTIAL SPECIFICATION: BUILDING TYPES # 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 �ffC' " DESIGN WASTEWATER FLOW (GPD) �NEW SITE REPAIR SITE .�
SYSTEM SPECIFICATIONS: TANK SIZE) GA1Lf. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH= LINEAR FT.
OTHER !/
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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 7
SYSTEM INSTALLED BY: - Gam c /6 nit
S
Jct� y�
AUTHORIZATION NO. 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)
bile-dc4+ 13Y-%Mzr - 0 ek+-t Ll q1- 3@70 1) V4-4-
FOR IMPROVEMENT PERMIT (REPAIR)
NAME na�,e ReauLS L Uww4_) PHONE NUMBER Qjlt'- WOE
ADDRESS Z 2-2- RotXt/ za It L.4�.y►-1-, YA d SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE Fd rw►R ocI d -g.4 LA., - *mw Y1-, . -Ra-e•
T S (fie ritw.� f� 1�•
DATE SYSTEM SYSTEM INSTALLED 19 L i NAME SYSTEM INSTALLED UNDER wa!, k Rea.t►;S
TYPE FACILITY Yv\� l NUMBER BEDROOMS Zf 3 NUMBER PEOPLE SERVED Z
TYPE WATER SUPPLY W SPECIFY PROBLEM OCCURRING
c-, �1` r-
4ruC'_ . P .
DATE REQUESTED INFORMATION TAKEN BY
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
. Y; ;- : r . _�, .. '-�"� Vis.._ � ., . ---N ,. . , - • ;..� - ,_-,;
Z;zo
AUTHORIZATION NO: 169 0 DAVIE COUNTY HEALTH DEPARTMENT
invironmental Health Section PROPERTY INFORMATION
tee's J P.O. Box 848
Name:6 �/!) VIS Name Mocksville, NC 27028 Subdivision Name:
tet,. Phone # 336-751-8760
Directions to property: /r!r'"/'/�' / Section: Lot:
` AUTHORIZATION FOR
[` WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:# - -
Road Name: L "Zip• 0
**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) .
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�t c' ✓` / . / '� "i .r IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
169 0 DAVIE CQUNTY HEALTH DEPARTMENT
41P IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittees ,/
Name: 11 Subdivision Name:
I
Directions to property: `A ; �` /`
IMPROVEMENT
Section
Lot:
PERMIT,* Tax Office PIN:# / o� ��
RoadNae /y ip d1 o
kj
**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)
. r ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION 1F SITE
1 �� ,• ,•;/' 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 # 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 —9G ROCK DEPTH LINEAR Fr. p,: ,.•s v' ""
OTHER A
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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 (336)751-8760.
OPERATION PERMIT
V
gL
e
SYSTEM INSTALLED BY: S Il ena�'�u N,J
9//-d
AUTHORIZATION NO. OPERATION PERMIT BY: 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)
r -
"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 (336)751-8760.
OPERATION PERMIT
V
gL
e
SYSTEM INSTALLED BY: S Il ena�'�u N,J
9//-d
AUTHORIZATION NO. OPERATION PERMIT BY: 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)
69 DAVIE C DUNTY HEALTH DEPARTMENT
IMPRO ;EMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's + j
Name:_ •'� ,r�/•�' Subdivision Name:
Directions to property:
Section:
IMPROVEMENT
Lot:
PERMIT, Tax Office PIN:#
Road ame• 'Cl 1
6
**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)
0 ***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 # BEDROOMS ? # BATHS _ # OCCUPANTS � GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yess or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE !f
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH —' ROCK DEPTH LINEAR FT. c!
1--:W
OTHER A - 2k
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
�r
"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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: Pn vv� c�. �U N ►J
AUTHORIZATION NO. r 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)
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION �
W RKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT
NAME t, -PHONE NUMBER
ADDRESS a SUBDIVISION NAME
SUBDIVISION LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED Q
NAME SYSTEM INSTALLED UNDER
SPECIFY PROBLEMS OCCURRING
DATE REQUESTED' INFORMATION TAKEN BY
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