2010 Hwy 601SPermitt DAVIEvCOUNTY HEALTH DEPARTMENT`+~
Dame: tf Environmental Health Section PROPERTY INFORMATION
P.O. Box 848'
Directions topropertv: �" f '.i: e� Mocksville; NC 27028 Subdivision Name: S `
Phone #: 336-751-8760
dl ,= . e / - • ✓, , ,': J�.j� Section: Lot:
��� AUTHORIZATION: FOR
.�
WASTEWATER,,
`SYSTEM CONSTRUCTION Tax Office PIN:# - -
AUTHORIZATION NO:2530' A Road Name: Zip:
-� **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 l I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
ff
��� '?!�-•` ��,,r'` _ '"`" lf� ��.,.? � ,.3 �,� IS VALID FOR A PERIOD OF FIVE YEARS.
CNVIRONME TAL HEALTH SPECIALIST DATE ISSUED -
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No"
LOT SIZE TYPE WATER SUPPLY _' DESIGN WASTEWATER FLOW (GPD) i3 7 NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL: PUMP TANK GAL. TRENCH_WIDTH � t ROCK DEPTH _LINEAR FT. 5=
OTHER �Pr��2% G ��• Ltf
REQUIRED SITE MODIFICATIONS/CONDITIONSy // / 1/�e.
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME `/�h /�r�/ / PHONE NUMBER
ADDRESS1�>LD -SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY--,#ZNUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY �h SPECIFY PROBLEM OCCURRING
DATE REQUESTED -!r,J' VL 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. 111M
41
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NOTE LOOK
Parcel #: L501 OA0001
Davie County, NC - Basic Estate Search
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Vwlew Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #:L5010A0001
Account #:50908000
Owner Information
uildin :
Tax Codes
BXF•
ILLER JOHN CICERO JR
nd:
ADVLTAX - COUNTY T
Market:
010 US HIGHWAY 601 SOUTH
ssessed:
FIREADVLTAX - FIRE TAX
eferred•
MOCKSVILLE NC 27028
PropertV Information
Township
nd (Units/Type): 0.510 AC
JERUSALEM
ddress: 2010 S US HWY 601
Deed Information
Local tonin
Pate: 10/1976 Book: 1990E Page: 0076
Plat Book: 0001 Page: 043
Le al Description
PIN
LOT 32 + P/0 31 MORRIS&HENDRX
5746077159
Property Values
uildin :
36,02
BXF•
nd:
20,00
Market:
56 02
ssessed:
56 02
eferred•
Sales Information
No. Book Paye Month Year Instrument Qual/UnQual Improved Price
1 1990E 0076 10 1976 WL Unqualified Improved 0
View Properly 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=1472074 8/3/2016