3206 Hwy 601NPermittee's . DAVIE COUNTY HEALTH: DEPARTMENT ,
Name: _ _ .(?(;� I-3 Environmental Health Section PROPERTY INFORMATION
P.O. Box 848 %
Directions to property:iJii I f Mocksville, NC 27028 Subdivision Name:
} �q Phone #:'336-751-8760
.1 C2%°�# ! Section: Lot:
i AUTHORIZATION FOR
r WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION
2410
AUTHORIZATION NO: A Road Name:_ �., i �1�� f t' ip: OL"
**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 compliancc withAxticle 11 f G .,�:hi#Eter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r E^� kv IS VALID FOR A PERIOD OF FIVE YEARS.
ENV IA EALTM UST DAYE ISSUED
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RESIDENTIAL SPECIFICATION: BUILDING TYPE N'` # BEDROOMS 3 # BATHS �� # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFFIICCATION: -FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: YesorNo
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ��W SITE REPAIR SITE Y
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL..TRENCH WIDTH ` ''�� ROCK DEPTH 12 LINEAR FT.
OTHER l ? -ODA/
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
w
OPERATION PERMIT.'
SYSTEM INSTALLED BY:
iy
AUTHORIZATION NO. Q A OPERATION PERMIT BY: / �' DATE: 10
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE TH THE, STEM DESCRIB ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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.
DctttD 02102 (Revised) 3-
n
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME I:C� �PHONE NUMBER
ADDRESS ��C� lG� SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS Z5 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING '.�1Gy'`0
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. 1193
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Parcel #: E300000104
Davie County, NC - Basic Estate Search
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Parcel #: E300000104 Account #: 62412000
Owner Information
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Tax Codes
BXF•
ROLLINS HAROLD L SR& ROLLINS SHIRLEY 3
nd:
ADVLTAX - COUNTY TA
arket:
206 US HIGHWAY 601 NORTH
ssessed:
FIREADVLTAX - FIRE TAX
Deferred •
MOCKSVILLE NC 27028
Property Information
Township
Land (Units/Type): 1.830 AC
CLARKSVILLE
Address: 3206 N US HWY 601
Deed Information
(— Local zoning
Date: 09/1968 Book: 00080 Page: 0145
Plat Book: Page:
Legal Description
PIN
1.828 AC HWY 601
5821029639
Property Values
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79,24
BXF•
1,24
nd:
25,65
arket:
106,13
ssessed:
106,13
Deferred •
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00080 0145 09 1968 WD Unqualified Improved 0
View Property 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=1464042 8/23/2016