2164 Hwy 158{ ' +"'�' P �•' . fit. ,� l �.. s. ,�� � i r..7e•" z�'Kr: `t[t n.:'e 9 -.:.F .c . w '-Y'r+'Y :,` ! Y'i5 a't n - .a. " _ �; r _ _
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AUTHORIZATION NO--�t
w F DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section , PROPERTY ATION
'Permittees (�1 U
P.O. Box 848 '3= 2l�
Name: " 1, Ll 1 L`1 v� --
Mocksville, NC 27028 Subdivision Name:
Directions to pr ert b�)� • to Phone # -336 751-8760
P P Y =' Section: Lot:
AUTHORIZATION FOR
1 C, C.>rl.Gt}� F ItJ L,C I # WASTEWATER
#
SYSTEM CONSTRUCTION Tax Office PIN:
ZI{p�lc `aluf l S
Road Name: �' Zip: 4, l
**NOTE** This Authorization for Wastewater System Construction MUST $E ISSUED by the Davie County Environmental Health Section prior
to'issuance of any Building -Permits This Fom�/Authortzation Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(ln coinpliance ith. il' le 11 f GChapter, 130A. Wastewater Systems Section .1900 Sewage Treatment and Disposal Systems)
*NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A"PERIOD OF FIVE YEARS.
IRON ' & H • TH S ECIAeST, DATE I SUE
f:
r '� �;� ww-+r �, y.a..d� .a !`�y. sY; ,x � ,.:. ,;f .:w.E r'F. k_+'"^ �.,-t,�.. ,• ',a
' 8 6 Id DAVIE COUNTY. HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY IN 0R1lxATION
e;InitCee's f,'rfi t ,.a .. !"� 3- �. (�_ U�
N�me:� �` �M • { 1� i ''"'"" Subdivision Name:
' 1��ctions tooeDSection: Lot:
IMPROVEMENT
t iol� PERMIT Tax Office PIN:#
. k.F
A. Road Named t (� Or. 1 ! c , `rZIP
**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
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
tNVIRONMENtAL.HEALTH SPECIALIST DATE I SUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
.: INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS _Z # BATHS Z # OCCUPANTS GARBAGE DISPOSALCeor 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 SM.
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.
OTHER�
REQUIRED SITE MODIFICATIONS/CONDITIONS: �'� , acr, 0000 - =i ^" , Do ecol t'' ;
-IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUENT FILTER*. *RISER(S) IF 6" BELOW FINISHED GRADE*
,�% i1►'.c.-t 1 •tom
` '�� l>r�.��L ��t SIL-,•. ,'�'"'
M-
L)tJat� W to
**CONTACT A REPRESENTATIVE O E 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 (7" YjYM&. x
(336)751=8760
DCH l 05/96 (Revised)
1
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME • Q PHONE NUMBER
`r 1
ADDRESS SUBDIVISION NAME
LOT # lrr
DIRECTIONS TO SITE a-4.- 4�>
!2 -3 S �cs~.r to it.e--.-a. �. s.�`�2-e • S.-+ �'.r — `�-.� d
c a c,...- kc'4-� j
ATE SYSTEM INSTALLEDaur —NAME SYSTEM INSTALLED UNDER Z/'c �y-K� • r � "'
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED , p
TYPE WATER SUPPLY C SPECIFY PROBLEM OCCURRING
_e J A-)
DATE REQUESTEINFORMATION 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 incurred from this application.
1
SIGNATURE OF OWNER OR AUTHORIZED AGENT 1
Rev. 1193 r 00
�.cQf S U 5F✓
Parcel #: G5OOOOO124
Davie County, NC - Basic Estate Search
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View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: G500000124
Account #:79964000
Information
62,5601
Tax Codes
6201
MARION A& WILLINGHAM WINNIE R
21,6301
ADVLTAX - COUNTY T
84,8101
EOwner
164 US HIGHWAY 158
84 81
READVLTAX - FIRE TAX
MOCKSVILLE NC 27028
MEI,
Property Information
Townsh[
Land (Units/Type): 0.850 AC
MOCKSVILLE
ddress: 2164 US HWY 158
Deed Information
Local Zoning
ate: 06/1981 Book: 00113 Page: 0867
Plat Book: Page:
Le al Description
PIN
84AC HWY 158
5749390412
Values
in :
62,5601
rLandProperty
:
6201
:
21,6301
et•
84,8101
ssed:
84 81
eferred
Sales Information
No. Book Page Month Year Instrument Qua[/UnQual Improved Price
1 00113 0867 06 1981 WD Unqualified Improved 0
View Properly Record for this Parcel View Map for this Parcel View Tax Bill Information
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Davie County Web Site
All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned public information sources should be
consulted for verification of the Information. All information contained herein was created for the Davie County's internal use. Davie County,
Its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or
implied, in fact or in law, including without limitation the implied warranties of merchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=1466645 6/8/2016