2696 Hwy 601S Permtttee's,: a DAVIE COUNTY HEALTH DEPARTMENT PROPERTY INFORMATION
Name.. zcG}; ,yi Environmental Health_ Section
i ► ^✓ T ' P.O: Box 848'
C�
r •1 Directions to property f - ✓J✓rtes' Mocksville,NC 27028 Subdivision Name:
r Phone#:336 751-8760
.� c. / �r ,✓' 1 M jt'....'%y. Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# -
r� s SYSTEM CONSTRUCTION
t`AUTHORIZATION NO: 1 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 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
7?' e-Y IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMfi�, #BATHS #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 TANK GAL.,TRENCH WIDTH ROCK DEPTH ,LINEAR F rw
OTHERIle
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OFT.HIS SYSTEM
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS (336)751-8760.
OPERATION PERMIT
SY& I L ED BY:
IJ
AUTHORIZATION NO _�y
OPERATION PERMIT BY: DATE:
**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 SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 02/02(Revised
L
02
-� DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION ' /I - T fe be ''%
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME d14 41,4, C C*k*1_.) PHONE NUMBER
ADDRESS 2 ( I (P L!" In D l s SUBDIVISION NAME
k\'O-C /1-5-y t 1 � ZJ LOT #
DIRECTIONS TO SITE c S —7-1', nL6 ed r e'- — C s
&Y e_1 ate' . - .G 1- --
DATE SYSTEM INSTALLED i NAME SYSTEM INSTALLED UNDER D✓ 4
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY—C=14—SPECIFY PROBLEM OCCURRING SSC ��c� 6h
4 C=&d� J w -}-a -
TE REQUESTED` / '" Os INFORMATION TAKEN BY,
This is to certify that the information provided is correct to the best of my knowledge.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1193
for all charges incurred from this application.
Parcel #: M5060B0026
Davie County, NC - Basic Estate Search
,Basic Search Real Estate Search Tax Bill Search Sales Search
VieW Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: M5060B0026 Account #:33860000
Owner Information
uildin :
Tax Codes
BXF•
HEAD BOBBY LEE& HEAD CAROL C
Land:
ADVLTAX - COUNTY T
Market:
O BOX 425
ssessed:
FIREADVLTAX - FIRE TAX
Deferred•
OOLEEMEE NC 27014
Property Information
Township
Land (Units/Type): 1.070 AC
JERUSALEM
Address: 2696 S US HWY 601
Deed Information
Local Zoning
Pate: 07/1987 Book: 00139 Page: 0024
Plat Book: 0003 Page: 108
Le al Description
PIN
LOTS 1A-8 HOLIDAY ACRES SECTION 1
5745690950
Property Values
uildin :
76,44 CCII
BXF•
2,88
Land:
18,90
Market:
98 22
ssessed:
98,22
Deferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00139 0024 07 1987 WD Unqualified Improved 0
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
« Return to Basic Search
Page 1 of 1
n0 U Nle,
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=1476899 8/2/2016