168 Little John Drive Lot 21Davie County. NC
Tax PnrrtPl RPnnrt
Thursday, December 29, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
WAKiV11V(T: TR1b 1S INUT A SURVEY
_ Parcel Information
D7010A0021 Township: Farmington
5862359383 Municipality:
74304250 Census Tract: 37059-802
TURNER JACK F Voting Precinct: SMITH GROVE
168 LITTLE JOHN DRIVE Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R-20
NC Zoning Overlay: DAVIE COUNTY QD
27006-0000
Voluntary Ag. District:
LOT 21 FOX MEADOW
Fire Response District:
0.56
Elementary School Zone:
1/1900
Middle School Zone:
001310380
Soil Types:
0004
Flood Zone:
134
Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
SMITH GROVE
PINEBROOK
NORTH DAVIE
GnB2
DAVIE COUNTY
No
F-61
Davie County,
NCor
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arising out of the use or Inability to use the GIS data provided by this website.
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•esrnitc's-�"" V^ .i'' ' . DAVIE COUNTY HEALTH DEPARTMENT
Name:t —1-141 Y� " ,�L.�/,L�� i� � Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions to property" y �1 �" � :
i Mocksville, NC 27028 Subdivision Name' : / ' 1'..� f � c/
' Phone #: 336-751-8760
;iele �''� Section: "' . . '' Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION -
AUTHORIZATION NO: 2497 A 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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
li✓'` ,� IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE _, # BEDROOMSj, #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 Y
9'
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK G L. TENCH WIDTH— ROCK DEPTH LINEAR
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
c
**CONTACT A REPRESENTATIVE OF THE DAVIE C(
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M.
OPERATION PERMIT
I / __.=, t../"
ALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
TEM INSTALLED BY:
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: v'
cd
**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 02/02 (Revised)
wo
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME`1 Pok) % 141A. PHONE NUMBER
ADDRESSUBDIVISION NAME -��
A-1210 LOT #
DIRECTIONS TO SITE / yDArP 0,,7 )07`
DATE SYSTEM INSTALLED ME SYSTEM INSTALLED UNDERGni✓lel-
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY 06 SPECIFY PROBLEM OCCURRING
DATE REQUESTED / �% INFORMATION TAKEN BY
e- -A
This is to certify that the information provided is correct to the best of my knowledge, a7th?.�l understand I am res
SIGNATURE OF OWNER OR AUTHORIZED AGENT -,q✓
Rev. 1193
for all charges incurred from this application.
DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
Environmental Health Survey For Sewage Treatment and Disposal Systems
Subdivision Name F0 X %R -N �o w Lot # D� I Block or Section
Date System Installed Name of Installer
Number of Previous Owners
Name of Present Owner Number of People
Address
Phone No.
System Originally Designed For System Now Serving
No. Bedrooms_
No. Bathrooms
Dishwasher
Disposal
Washing Machine
No. Bedrooms_
No. Bathrooms _
Dishwasher
Disposal
Washing Machine
Number Times Septic Tank Been Pumped Average Monthly Water Usage
Present Condition of System
Any Known Repairs to System, If So When and By Whom?
Comments:
Environmental Health Official Date