3218 Hwy 601N (2)4
Pern'rittee s:%• DAVIE COUNTY HEALTH DEPARTMENT
Name: f ` it ` QEi Environmental Health Section PROPERTY INFORMATION -
,- P.O. Box 848
Directions to property: '" d Mocksville, NC 27028 Subdivision Name:
-.-�. Phone #: 336-751-8760
r Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
A SYSTEM CONSTRUCTION Zl C!SyWV fd Q -
AUTHORIZATION NO: 002636 A Road Name: Zip: D==
**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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
�,1 ✓� r �1 r1 ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE hl # BEDROOMS �2- # BATHS —!M,_# 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 GAL. PUMP TANKGAL. TRENCH WIDTH ? ROCK DEPTH LINEAR FT./Sy
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
S
� _ t• b
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ONWE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT'; '1 �o�
SYSTEM INSTALLE Y: ' LW
�J
.-Q
AUTHORIZATION NO. —2L2—�"PERATION PERMIT BY: DATE: 41a
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT T E JQ DES IBEDVABCUHAS 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 02102 (Revised)
Perrtil�t`' , '- DAVIE COUNTY HEALTH DEPARTMENT
o ' h ` Q�eS Environmental Health Section PROPERTY INFORMATION
:.Name:
P.O. Box 848
Directio s to pro erty:.,— Mocksville NC 27028 Subdivision Name:
Phone k 336-751-8760
Section:
AUTHORIZATION NO: 002636 A
Lot:
AUTHORIZATION FOR
WASTEWATER — Tax Office PIN:#
SYSTEM CONSTRUCTION ?,M' l(Sf1W—F1-F0
u Road Name: 41,n Le, / -1 /,,
n Zip: 1=X21
**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 Fonn/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.] 900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
1
RESIDENTIAL SPECIFICATION: BUILDING TYPE hl # BEDROOMS # BATHS —!V,_# OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
a -
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD NEW SITE REPAIR SITE _
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GOAL. ,,TRENCH WIDTH ` � ROCK DEPTH LINEAR FT.
/S r�
OTHER �////`� Pd � f J : •. , .
a
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
` S
i t6
1
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON E DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT T o�
SYSTEM INSTALLE Y:_-.._��_.�JY�IAIy j�
O�
90Q'/ 4 "&Tb Cf t4MAb IN
AUTHORIZATION NO. J-LS—LA— OPERATION PERMIT BY: % DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE S DES RIBED AB HAS BEEN INSTALLED IN OMPLIANCE (\
WITH ARTICLE I 1 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)
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME �✓--� PHONE NUMBER
ADDRESS �02�%�" s� �G SUBDIVISION NAME
IyIo , / x-&1116,G�� s , LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED 614A a�NJAME SYSTEM INSTALLED UNDER S
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVE
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING -f rzAG'i ,�
DATE REQUESTED AM/P ( INFORMATION TAKEN BY
This is to certity that the information provided is correct to the best of my knowledge, and Pat I understand I am
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Fiev. 1/93
ft:j., -P 3939
for all charges incurred from this application.
Parcel #: E300000103
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Parcel #: E300000103 Account #:40732000
Owner Information
Tax Codes
ADVLTAX -COUNTY T
FIREADVLTAX - FIRE TAXCKSVILLE
NES BOBBY RAY& JONES PANSY M
[2118US HIGHWAY 601 NORTH
NC 27028
BXF:
6,33
Property Information
Township
Land (Units/Type): 9.954
ddress: 3218 N US HWY 601
CLARKSVILLE
ssessed:
161,56
Deferred
Deed Information
Local Zoning
Pate: 01/1900 Book: Page:
Plat Book: Page:
Legal Description
PIN
19.954 AC HWY 601
5821039034
Property Values
Building:
6540
BXF:
6,33
Land:
8983
Market:
161 56
ssessed:
161,56
Deferred
Sales Information
No Sales Data found.
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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tobR�
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
--147 8/23/2016