1149 Wagner RdDavie Countv. NC
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Tax Parcel Rennrt
Tuesdav, October 11, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legai Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
MOCKSVILLE
Land Value:
Total Assessed Value:
WAKNllV(�: "1'tll5151VU'1' A SUKVI:Y
Parcel Information
E300000115 Township: Clarksville
5811846394 Municipality:
82520892 Census Tract: 37059-801
BECK STACY A Voting Precinct: CLARKSVILLE
NC
2702&0000
4.37 AC RALPH RATLEDGE RD(LIFE ESTATE)
4.18
9��'�' Davie County,
��UN'�� NC
10/2015
010020415
38840.00
45010.00
85450.00
Planning Jurisdiction: Davie County
Zoning Class: DAVIE COUNTY R-A,R-20
Zoning Overlay:
Voluntary Ag. District: No
Fire Response District: WILLIAM R. DAVIE
Elementary School Zone: WILLIAM R DAVIE
Middle School Zone: NORTH DAVIE
Soil Types: MnC2,Mn62
Flood Zone:
Watershed Overlay: DAVIE COUNTY
Outbuilding 8� Extra 1600.00
Freatures Value:
Total Market Value: 85450.00
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` DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME___ �C� � �P c �� PHONE NUMBER " / ��- �� 3 �
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ADDRESS 4 � �� SUBDIVISION NAME
ii l� G�S LI /��� LOT #
DIRECTIONS TO SITE (n v I �J i L) d 11 l� I.��ET u C_.�, -�� c{� I U O
"�b �� Gi ol /l c°.2 I�'�G� • �� e� 4� �� l�r � c�. 1 h o k. C�- � o n
DATE SYSTEM INSTALLED � 3°'y� y�saNAME SYSTEM INSTALLED UNDER �
TYPE FACILITY ��—�- NUMBER BEDROOMS NUMBER PEOPLE SERVED Z
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING_��� tt ��
DATE REQUESTED � i o�
INFORMATION TAKEN BY_� � '
This ia to certify that the iniormation provided io correct to the best of my knowledge, and that 1 understand I am responsible for all chargea incurced from this epplication.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93
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� AUTHORIZATION NO: �i �t �� J� DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee':� r P.O. Box 848
Name: J�/�"•::�I •f'r-', „ .. Mocksville, NC 27028 Subdivision Name:
Phone # 336-751-8760
Directions to property: /f�� %' � Section: Lot:
AUTHORIZATION FOR
, .��j��:-`f , � , ,��f �r, WASTEWATER Tax Office PIN:# - -
SYSTF,M CONSTRUCTION
,� , �' �''%' '� � �v��� 'rl r'i . F'� � � , , f ;� �` / Road Name: Zip:
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**NOTE** This Authorization for Wastewater System Consuuction 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 Counry Building Inspections
Office when applying for Building Permits.
(ln compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
. i ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�.� ���%, ,,.���i G�''�i;��'`�� ..�'. �: - �
''�� � � IS VALID FOR A PERIOD OF FIVE YEARS.
'�NVIRONMENTAC HEALTH SP�CIALIST DATE ISSUED
,: : ;; . � . . . . . . .
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1���� ..�� "� DAVIE COUNTY HEALTH DEPARTMENT
= � � TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
.�- Peimittee'�..,.��-
_ _; ,
:��Name: �� ;%.�f r ` Subdivision Name:
_ _r.
Directions to property: .+''r.�'/ 1'+ rf ,� .;.� �,�'- :; Section:
,. • •,e IMPROVEMENT
pERMIT Tax Office PIN:#
. ,! � � l"), ,f . , f ��
Road N
1
Lot:
Zip: �
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An .
ALITHORIZATTON FOR WASTEWATER SYSTEM CONSTRUCITON must be obtained from this Department prior to the
construction/installation of a system ar the issuance of a building pernut '�
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Sec6on .1900 Sewage Treatrnent and Disposal Systems)
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'$NVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
***NOTICE*'�* THLS PERNIIT LS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
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 # PEOPLFISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY � DESIGN WASTEWATER FLOW (GPD � l_' NEW SITE REPAIR SITE /�
-., ,
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH— ''� >�/ROCK DEPTH �/LINEAR FT.��
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENTPERMITLAYOUT �:APPROVETi EFFLU�f'JT FILTEff� �f�I��R�Si IF b" ��LQ=�� �=Ii`1IS?-f�13 G<;�D: �
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTI $�'STEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # I����������7G�4
l
OPERATION PERMIT
SYSTEM INSTALLED BY:
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AUTHORIZATION NO. � V�� OPERATION PERMIT BY: �� '7 DATE: S—1 s—�
**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 OS/96 (Revised)
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