3354 Hwy 158/z+-�.v., —�'r� w.. � z.. :•r•:^.r c .. -. -•�. .a _ n -«,s q:._ at, . J,. .', wY t - .K :. .:
;A . ORIZATION NO: ,146 6 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee'S P.O. Bq,:,
848
Name: �' (/I°�./%SGr%% Mocksville, NC 27028 Subdivision Name:
Phone # -3361775178760
Directions to property G✓' �-�t� Section: Lot:
// AUTHORIZATION FOR
f •f,�l,%,���, /� �l�,/ WASTEWATER -
ONSTRUCTION Tax Office PIN:#
Aa
SYSTEM C
�c 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 Forin/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 SPECIALIST, DATE ISSUED
**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 (7016l'u X
(336)751-8760
OPERATION PERMIT O - s ✓1 n
DCHD 05/96 (Revised)
NAM
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
ec.JSo nrn
PHONE NUMBER
ADDRESS -c`` i -5 �%`1 SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
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
Parcel #: T600000067
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Parcel #: F600000067 Account #: 53868000
Owner Information
Building:
Tax Codes
BXF:
NEWSOME ANN R
Land:
ADVLTAX - COUNTY T
Market:
354 US HIGHWAY 158
ssessed:
FIREADVLTAX -FIRE TAX
[Deferred:
MOCKSVILLE NC 27028
Property Information
Township
Land (Units/Type): 1.230 AC
FARMINGTON
ddress: 3354 US HWY 158
Deed Information
Local Zoning
Date: 12/1999 Book: 00321 Page: 0828
Plat Book: Page:
Legal Description
PIN
1 AC HWY 158
5850487417
Property Values
Building:
93,8101
BXF:
Land:
26 01
Market:
119 82
ssessed:
119 82
[Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00321 0828 12 1999 WD Unqualified Improved 40,000
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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/itsneWiew.aspx?prid=1476685 6/8/2016