4551 Hwy 601N':.:f . ^x..-� M a. . :' `x J.-.'.ti.I-..'Y"? . i., . +i l_ / 'irt .'div 9 r .'-S.,i •1. ._ y.rL
' k DAVIE COUNTY HEALTH DEPARTMENT
z. IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**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 136A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME l/51i.O .44 1/f�'d, ( PROPERTY ADDRESS O� /' DATE
LOCATION 'lS OC,�s !/. Il
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS BATHS # OCCUPANTS% GARBAGE DISPOSAL: Yes(.
COMMERCIALSPECIFICATION: FACILITY TYPE # PEOPLE # PEDPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY 4ClP// DESIGN WASTEWATER FLOW (GPD) %?45_ NEW SITE REPAIR SITE JZ
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH2' ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CDNDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT ERMIT BY _
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i t a�ovp (a✓��
tq
D� 7iOn �
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEAL EPARTMENT FOR FPAL INSPECTION OF THIS SYSTEM BEN
8:30-9:30 A.M. OR 1:WI :30 P.M. ON THE DAY OF TAL ATION. TELE # IS (704) 634-8760. '`�
S TEM INSTAL'E S I��nv�nnN. N N r0
e
a
i
OPERATION PERMIT
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AUTHORIZATION NO. jVja OPERATION PERMIT BY DATE
--ae
**THE ISSUANCE OF THIS OPERATION 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 FICTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
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DAVIE COUNTY HEALTH DEPARTMENT
'IMPROVEMENT PERMIT and OPERATION PERMIT
a'
"IMPROVEMENT PERMIT
**NOTE** Pit improveient permit DOES NOT authorize the construction or installation of a septic tank system
or any wastewater
systei. 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 B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and
Disposal Systems)"
Al
NAME PROPERTY ADDRESS
DATE'
LOCATION
SUBDIVISION NAME LOT NUMBER'' SEC./BLOCK-NUMBER
.
RESIDENTAL SPECIFICATION: BUILDING TYPE _ic° # BEDROOMS ,t_ # BATHS '`% # OCCUPANTS GARBAGE DISPOSAL: Yeso
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT, # SEATS 'INDUSTRIAL WASTE: Yes/No j
•
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW.(G1?) ' _ NEW SITE
i.
REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ® G �` ROCK DEPTH.
LINEAR FT.
OTHER
REOUIFED SITE MODIFICATIONS/CONDITIONS:
N
IMPROVEMENT RERMIT BY
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY H
8:30-9:30 A.M. OR 1:x-1:30 P.M. ON THE DAY OF
OPERATION PERMIT
FOR
cp lin,
CO
IAL INSPECTION OF THIS SYSTEM
E # IS (704) 634-8760.
�
S TEM INSTALLE S 1 to wed. %A 0 10 a s
p
AUTHORIZATION NO. ^A OPERATION PERMIT BY __ �%Y DATE !' f
**THE ISSUANCE OF THIS OPERATION 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 SATISFACTOFILY.FOR ANY GIVEN PERIOD OF TIME.
DCHD 10'95_..
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Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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.***
NAME ObtJ ct ///7 S DATE �� f, f H��RIZRTI � NUMBER ,- n
012
NAME ON IMPROVEMENT PERMIT (10 different than above)
SITE LOCATION '
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
y
**MICE*** THIS AUTHIORIZRTIDN F WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. ,
IRONENTAL TH.SPECIALIST ; . DATE
DCHD 10/9S
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•t• DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAM
PHONE NUMBER
ADDRESS /va/ Af /#14t 27c 2 SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE (-ealW - /'jj `I ntbe vk &Z l&A-lima- eil,'
DATE SYSTEM INSTALLED-J�ehu 1972 NAME SYSTEM INSTALLED UNDER �—
TYPE FACILITY `ltiu- NUMBER BEDROOMS -3 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY ��'va�t wG� SPECIFY PROBLEM OCCURRING_ Veld �SIIW pl.L 4, f
DATE REQUESTED �%'a''11's�NFORMATION TAKEN B
This is to certify that the information provided 13 VOrrect 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 #: C300000078
Davie County, NC - Basic Estate Search
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Parcel #: C300000078
Account #:82521178
Owner Information
Tax Codes
Building:
HILUPS BOBBY L TRUST& PHILLIPS REBA A TRUST
ADVLTAX - COUNTY
10,23
551 US HIGHWAY 601 NORTH
READVLTAX - FIRE TAX
TT
Market:
OCKSVILLE NC 27028
Assessed:
Property Information
Townshi
Land (Units/Type): 26.043 AC
CLARKSVILLE
Address: 4551 N US HWY 601
Deed Information
Local tonin
Date: 07/2003 Book: 00497 Page: 0206
Plat Book: age:
Legal Description
PIN
4.170 AC HWY 601
5823008314
Property Values
Book Page
Building:
73,4701
BXF:
10,23
Land:
128,7701
Market:
212,4701
Assessed:
103,60
[Deferred:
108,87
Sales Information
No.
Book Page
Month Year Instrument
Qual/UnQual Improved Price
1
00497 0206
07 2003 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/itsneWiew.aspx?prid=1483728 8/23/2016