2410 Hwy 601NPernuttee's c AVIE COUNTY HEALTH DEPARTMENT
Name �, " T'-1 f Environmental Health Section PROPERTY INFORMATION
_t J P.O. Box 848
Directions to property: ```''� ) C Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
C G• 0" + G Section: Lot: ic
AUTHORIZATION OR WASTEWATER � Z/
Office Tax OPIN:# - -
SYSTEM CONSTRUCTION
AUTHORIZATION NO: 003000 A Road Name: p:
**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 1 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
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # 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
SYSTEM SPECIFICATIONS: TANK SIZE X GAL. PUMP TANK GAL. TRENCH WIDTH , ROCK DEPTH LINEAR FT. ?� r
OTHER - % / je K.��-
its stated in 15A NCAC 18A-1960(5)
QUIREDSITE MODIFICATIONS/CONDITIONS: 'nc-p1m sgymprns may also bo used
IMPROVEMENT PERMIT LAYOUT I
-70-2-
31 ----- '1
PC
O FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT
FLL"G'`
SYSTEM INSTALLED BY: � o) I W 1' 04-0Af1- a X111
fj
AUTHORIZATION NO. jERATION PERMIT BY: DATE:
**THE ISSUANCE OFF T SIVIQRATION 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 02M (Revised) /.{ eaSr l� ( TO /
Permittee's ) PAVIE COUNTY HEALTh DEPARTMENT ���
„blamed y` f t ' `� "` �' �..� �� a Environmental Health Section PROPERTY INFORMATION �1A
,.-o ,' ` h f. �f �,� ,�` l P.O. Box 848
Direc6D, to pr6perty: Mocksville, NC 27028 Subdivision Name:
t ' ? Phone #: 336-751-8760
-°s_* L i4l �t d� r', 1� Section: Lot: c:
+•t.
AUTHORIZATION FOR
C a a WASTEWATER
Tax Office PIN:#
SYSTEM CONSTRUCTION � � / t � 1 t_,,, t ! (� (; j �J
AUTHORIZATION NO: 003000 A Road Name: Zip:,
V
1
**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 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
i
w,! -'�'i '//,r _ ��� <s✓' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE a� TYPE WATER SUPPLY U DESIGN WASTEWATER FLOW (GPD) 3 NEW SITE REPAIR SITE
Y, � ` t IV r
SYSTEM SPECIFICATIONS: TANK SIZE'AL. P MP TANK GAL. TRENCH WIDTH ROCK DEPTH 4A LINEAR FT.
I
OTHER
QUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
S t
If I
E
ll
\ FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT r -I G -L ct SYSTEM INSTALLED BY: -((
.,
r•
AUTHORIZATION NO./'y�,j�`-OPERATION PERMIT BY DATE:
17-
**THE ISSUANCEPODF S VaATION 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
f -WILL
7FUN ACTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
2/0 f%
DCHD 02 (Revised) dee-1
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
E gruea. tb;91ide q PHONE NUMBER -�3� /774W
ADDRESS M/0'
DIRECTIONS TO SITE
ON
Il Q SUBDIVISION NAME
Whi- °- h
LOT #
res
DATE SYSTEM INSTALLED 7 /qs� 41 NAME SYSTEM INSTALLED UNDER 2 If
7
TYPE FACILITYlouSe NUMBER BEDROOMS 19- NUMBER PEOPLE SERVED Z
TYPE WATER SUPPLY edU41(4 SPECIFY PROBLEM OCCURRING 1 116 416
A] 14k 11) 1,11"o AIA1711 AAI 114 19 d1eaYWUNd
DATE REQUESTED I2 I'7'O9 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
L(-e
Rev. 1/93 u V eca6 G -k, J� "
01
v
F
GoMAPS - Davie County NC Public Access
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Davie County, NC - GIS/Mapping System
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14 841 1-17=4 1'
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171
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http://maps.co.davic.ne.usIGoMapslmap/lndex.cfm?mainmapservice=gomaps&CFID=41... 12/15/2009
Parcel #: G300000074
Davie County, NC - Basic Estate Search
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View Oroperty Record for this Parcel View Map for this Parcel. View Tax Bill Information
Parcel #: G300000074 Account #:82517972
Owner Information
Building:
Tax Codes
BXF•
MCBRYDE BRUCE G& MCBRYDE BRENDA R
Land:
ADVLTAX -COUNTY TA
Market:
410 US HIGHWAY 601 NORTH
ssessed•
READVLTAX - FIRE TAX
Deferred:
MOCKSVILLE NC 27028
Property Information
Township
Land (Units/Type): 1.000 LT
MOCKSVILLE
[Address: 2410 N US HWY 601
Deed Information
Local Zoning
Date: 12/2001 Book: 00402 Page: 0213
Plat Book: 0001 Page: 092
Legal Description
PIN _
•�
1.03 AC HWY 601 LOT 2
5820545212
Property Values
Building:
70,6201
BXF•
01
Land:
17,10
Market:
87 72
ssessed•
87,72
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00402 0213 12 2001 QC Unqualified Improved 0
2 1999E 0030 12 1998 WL Unqualified Improved 0
3 00396 0655 11 2001 WD Qualified Improved 87,000
View Property Record for this Parcel View Mao 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=1469665 8/17/2016