3035 Hwy 601NDAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
OPERATION PERMIT
Account #: 990005609 Tax PIN,BH #: 5823-06-0311
Billed To: Aubrey James Subdivision Info: �D35"
Reference Name: : LocatioNAddress• US H 601 N=270
Proposed Facility: Residence
PropertySize: 8.089 Acres
ATC Number: 5121
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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.
System Type: S.T. Manufacture rcwl Tank Dated Tank Size
Pump Tank Size
System Installed By: E.H. Specialist: "Oode:_JG�G�(y/(�
GPS Coordinate:
DCHD 11/06 (Revised)