136 Vineyard LnDavie Countv, NC Tax Parcel Report Tuesdav, October 11, 2016
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: H60000002404 Township:
NCPIN Number: 5759662610 Municipality:
Account Number: 67846000 Census Tract:
Listed Owner 1: SMITH NATHAN F Voting Precinct:
Mailing Addtess 1: 214 VINEYARD LANE Planning Jurisdiction:
City: MOCKSVILLE Zoning Class:
State: NC 2oning Overlay:
Zip Code: 2702&7444 Voluntary Ag. District:
Legal Description: LOT 21.00 AC SMITH N PLT Fire Response District:
Assessed Acreage: 0.99 Elementary School Zone:
Deed Date: 2/2009 Middle School Zone:
Deed Book / Page: 007810317 Soil Types:
Plat Book: 0010 Flood Zone:
Plat Page: 059 Watershed Overlay:
Building Value:
Land Value:
Total Assessed Value:
9"�'�' Davie County,
���N��' NC
0.00 Outbuilding & Extra
Freatures Value:
15110.00 Total Market Value:
19610.00
Shady Grove
37059-803
WEST SHADY GROVE
Davie County
DAVIE COUNTY R-A
CORNATZER - DULIN
CORNATZER
WILLIAM ELLIS
WeC,WeB
DAVIE COUNTY
4500.00
19610.00
No
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���, � � �DAVIE COUNTY HEALTH DEPARTMENT
. � IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
-<:'N;OTEa lssued in Compliance with G.3. of North Carolina Chapter 130 Article 13c
�� Sewage,Treatment and Disposal Rufes (1.0 NCAC 10A .1934-.1968) Permit Number
� . Name �'//�) ��i���U�.._ ���,r�.' �.� � Date /�/.���1_ ;.Y��:� �t��3
. Location + /�/�.•.r' �rl'� r�/��rS' r .�� _-� ��'� � //�.�r
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�.:. ��1� � 1� r� � /`!. ��/. �/- r J� �� Qne
� : . Subdivision Name Lot No. �� Sec. or Block No.
Lot Size �.��� House Mobile Home _ � Business Speculation �l�-�
No. Bedrooms � � No. Baths � No. in Family ._. �
Garbage Disposal YES fl NO p� Specifications �for System: ,
Auto Dish Washer YES .ip NO p ��,�" Y: .�y�,�" „�-,}jl
Auto Wash Machine YES p NO fl� �
� Type Water Supply ���� _ ��C�i�-�/' �-7 �
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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Improvements permit by ���1�'��
'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 compietion. Telephone �: 704-634-5985. �
Final Installation Diagram: Sys efii In ta"fled by �����i�l�l� ��i,,.r�
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Certificate of Com letion � �f.��J Date f ��
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'The signing of this certificate shall indicate that the system described above has been installed in com.pliance 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.
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APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT ����
Davie County Health Department
Environmentai Heaith Section �
P. O. Box 665
Mocksviile, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. 3�M _��,�,�
� Home Phone `19 ��'• ^1- � 7 �-
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1. Permit Requested By _� �'t �'� '���-�%� __ _ Business Phone
2. Address �� 3 .�_� �� �� •�%�'1.0-<����.e �l C. :. 7 c� i 8�
3. Property Owner if Different than Above _
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Address _,.__��— ------------------- — --•—
4. Permit To: a) Install ✓ Alter� Repair__ �, 1,. �n• '
� �.
b) Privy____ Conventional� Other Type /�� 1�
Ground Absorption -
c) Sub-Division Sec. Lot No.
5. System used to serve what type Tacility: House_ Mobile Home � Business
Industry Other
b) Number of people �
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions r�� �-+ � — �� �`�`�—
Bed Rooms�— Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: fvumber of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)_ �
7. Number and type of water-using fixtures:
commodes urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Pubiic Private �� Community
�
b) Has the water supply system been approved? Yes No i►ti✓
9. a) Property Dimensions y9 �-�-� _
b) Land area designated to building site /• �� �� � �- �����—
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? �✓1�
What type?
This is to certify that the information is correct to the best of my knowledge.
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Date Owner Signature _
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property: __
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DCND (6•82)
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