3098 Hwy 64EV
7
Perrn ttee's D,AVIE COUNTY HEALTH DEPARTMENT
Name: t� /111P �% 5'1r 4'L_el T Environmental Health Section PROPERTY INFORMATION
ff P.O. Box 848
Directions to property: r l� Mocksville, NC 27028 Subdivision Name:
3 0? Un ! " Phone #: 336-751-8760
Section: Lot:
! AUTHORIZATION FOR
E!n WASTEWATER Tax Office PIN:# t -� 13
SYSTEM CONSTRUCTION
AUTHORIZATION NO: 002987 A Road Name: Y G �Zip: J iu 1
**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 complice with Article II of S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
�./% // 12 �y1 ✓'" ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
ci•�''`' f///� G ' ' G y IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS #BATHS —# OCCUPANTS GARBAGE DISPOSE: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
to � �'1
LOT SIZE 13' // TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) 366 NEW SITE REPAIR SITE
G
SYSTEM SPECIFICATIONS: TANK SIZE Y X[ GAL/ROCK DEPTH /1 LINEAR Fr.
TANK GAL. TRENCH WIDTH r; C ,
�
OTHER L/moi C GSI !/r1 11 / ,;;' «[L^ 0,e �5
As stated in 15A NCAC 1EA.irC0t5
REQUIRED SITE MODIFICATIONS/CONDITIONS: accepted Systems may al5a be use
IMPROVEMENT PERMIT LAYOUT ` -�a G �. 1 -j N O r
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. .
OPERATION PERMIT D � -L
�r n— � ��SYST M INSTALLED BY: �G
3
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HORIZATION NO. PERATION PERMIT BY: DATE:
'V_ /z7—/
IE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
i ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
02102 vised) �3 7
I-
WPermiltee s :; .' " DAVIE COUNTY HEALTH DEPARTMENT
Name: ( r (. Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions to property:.' F- U Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760 «w
Y' Ye.,' * C....,_ Section: Lot:
_ AUTHORIZATION FOR I ;%r y
is`4/' ii WASTEWATER
( SYSTEM CONSTRUCTION Tax Office PIN:#
3�,7 ✓ v�•
AU'T'HORIZATION NO: 002 9 8 7 A Road Name: y l.. 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 S. Chapter 130A. Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
/` i s -' --• ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
E VIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE- # BEDROOMS '�; # BATHS # OCCUPANTS 3 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PF,OPLE # PEOPLF/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE/ TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) 360 NEW SITE REPAIR SITE
r
y//J G � '
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK –�' GAL. TRENCH WIDTH ROCK DEPTHJ ,C LINEAR FT. ��ll
OTHER 1U� 1 f ftil /1 /+✓"1 It lS� i� ' � � `� 1 �O IV t)J-P I (
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT 0 N tI `! I ) #,I
Yt` P_ k/ `� t��. G f j
( X Crf C , r I ! `l 5 �<- ICIA I�5 1 t,
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
TION PERMIT (/ �l r'( ��)) ((�� AA � V -
�UVVI KSYSTEM INSTALLED BY: Me a (A I if
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HORIZATION NO. q6-PI-1PERATION PERMIT BY: DATE:
rIf
IE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
H ARTICLE I1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
,RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
02M (Revised) / /f ',• R
NAME
ADDRESS
DIRECTIONS TO
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
ADDI 1/1A'r1nK1 CnD 16ADOM/CIIACAI7 DCDIIAIT /9EPAIR)
fe
DUMBER �a'" &/3'7Z
Z
C 2? 02-f
>ION NAME
LOT #
f07 ztc
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I /
DATE SYSTEM INSTALLED �d NAME SYSTEM INSTALLED UNDER
TYPE FACILITYJ�US& NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING /01w
C ONeva-�.
DATE REQUESTED q--0-07 INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge, and that 1 understand I am responsible for all charges Incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT.
Rev. 1193
"AUTHORIZATION NO: 1287DAVIE COUNTY HEALTH DEPARTMENT � ��'sei
Environmental Health Section PROPERTY INFORMATION z 3�
Permitt_ee's - _ P.O. Box 848
Name: �� fc:►�lA Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
Directions to property: 1t tra4 Section: Lot:
AUTHORIZATION FOR
6n, ti-�, ti1 � � WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION
Road Name: fl L -JY CaqC Zip: -2104?
**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 whep 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
o, , r'-"/' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPE QD5T DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS #BATHS LLL#OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or
No
LOT SIZE `' TYPE WATER SUPPLY �t11" DESIGN WASTEWATER FLOW (GPD. NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ! LINEAR FT.-
OTHER n> –4P—T G -3 60 >e_
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT J
17 f ;;: "T 2,7 Z L
U�
a5'
SuL�rj
S �6
1
T
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT 40f -u 'TSS �M
SYSTEM INSTALLED BY: ° • a
�r t •
0
N�
r
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: t
**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 05/96 (Revised)
�+`"'t ..: � •, °5'"h '"="r; ,_;,.,t3 Sv'M,.> v �,ia r:.--R` i.,.4.;; ,per=�, -'. r. „c>+.ti h.. � 5..,.-�.-//////,,
..y _ Y ♦ 1 lam(
" 'AUTHORIZATION NO:7 DAVIE COUNTY HEALTH DEPARTMENT' $�
," ; Environmental Health Section PROPERTY INFORM -30
Permittee's - :. P.O. Box 848
Name. Mocksville, NC 27028 Subdivision Name:
- - Phone #: 704-634-8760
Directions to property:04�"'"— Section: Lot:
AUTHORIZATIONWASTFOROR
SYSTEM CONSTRUCTION Tax Office PIN:# - -
Road Name:
&4C Zip: 2 �b
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
rill �C� IS VALID FOR A PERIOD OF FIVE YEARS.,
ENVIRO I$EgTAL HEALT11 SPE rAL ST DA ISSUED
�j�j]]�� \ iL ". `M J .. . . .. . i -'i'+ '. �•'w N. .+ v r .T �',::� a i., - �. �.. """ -" +.� .. .. y/ _ ,/-/.."J ) `
12 8 7 DAVIE COUNTY HEALTH DE .�ARTMENT
�Y
IMPROVEMENT AND OPERATIOR PERMITS PROPERTY INFO AMO
Subdivision Name:
�Drrectrons to praperly Section: Lot:
IMPROVEMENT
R�r U1 PERMIT Tax Office PIN:#
t
�k Jy U q
Road Name . Zip:
**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 comphance'with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
P „+�`�'"`" """"`-•'4 (1r� ° PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRO TI IENTAL HEALTI'f SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 9 �— # BEDROOMS -3 # BATHS I # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFTr� # SEATS INDUSTRIAL WASTE: Yes orNo
LOT SIZE TYPE WATER SUPPLY OLLL— DESIGN WASTEWATER FLOW (GPD) �NEW SITE i` ��( PAIR SITE
r 11 i 1 1
SYSTEM SPECIFICATIONS: TANK SIZE • GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH (� LINEAR Fr.
OTHER I —;; ZSiQ•+P--A.)T1P,3 bo)L
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT 'flu
/no x 3�• xiz'
Bl.o
A11
S ��
t/
a
t=e.o•vT
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT �vT GMM
SYSTEM INSTALLED BY: 40 "' o
1.6
'J
T
�%
AUTHORIZATION NO. I Zg OPERATION PERMIT BY: DATE: 9
**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 05/96 (Revised)
1287DAVIE COUNTY HEALTH DE .ARTMEN�'
Mr'"`�_. IMPROVEMENT AND OPERATIOR PERMITS PROPERTY INFORMA'ITON—��r�
Permlttee'.s , .
11,E ^k `"�`A(:.; .
{,Name: Subdivision Name:
Directions to property:— Section: Lot:
" IMPROVEMENT
'A � y� L'-1 PERMIT Tax Office PIN:#
Road Name: y t^J„ k Zip:” t/
**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 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTHSPECIAr IST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
L, INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE lW%# BEDROOMS 3 # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL,S(—PEECCIIFICATION: FACILITY TYPE
# PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: ,Yes or No
LOT SIZE � TYPE WATER SUPPLY wt't-)`'" DESIGN WASTEWATER FLOW (GPD) NEW SITEPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH l 2 LINEAR FT.
OTHER �1 1i l�t�iT ► o ..1
REQUIRED SITE MODIFICATIONS/CONDITIONS:
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION1TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SME Tezza&
SYSTEM INSTALLED BY: `e
T, ,
T,
!
AUTHORIZATION NO. Zb / OPERATION PERMIT BY: tj DATE: 1 .9
**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 05/96 (Revised) §'
is �.. ,:. S ..... "•r .�•
3.OD
�' DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) �+
NAM ry-L- �teu/�t.►li - PHONE NUMBER 147- d r� %IP—
ADDRESS 901e hlklla- V14. S- SUBDIVISION NAME
DIRECTIONS TO SITE �'�`�•
&-.
W"
LOT #
DATE SYSTEM INSTALLED Sl%s NAME SYSTEM INSTALLED UNDERy
TYPE FACILITYNUMBER BEDROOMS NUMBER PEOPLE SERVED 7
TYPE WATER SUPPLY-;i(JJZAC
SPECIFY PROBLEM OCCURRING � 5�� •�
`Y r V
DATE REQUESTED 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 om this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93
4
Parcel #: J712OA0028
Davie County, NC - Basic Estate Search
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View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #:3712OA0028
Account #:8301215
Owner Information
Tax Codes
Buildin :
EWART TERRY LYNN & STEWART THOMAS JERRY
I0TCOCKSVILLE,
ADVLTAX - COUNTY T98
1,99
US HIGHWAY 64 EAST
READVLTAX - FIRE TAX
arket:
NC 27028
essed:
Property Information
Deferred:
Township
[Land (Units/Type): 12.210 AC
FULTON
ddress: 3098 E US HWY 64
Deed Information
Local Zoning
Pate: 04/2012 Book: 2012E Page: 0217
Plat Book: 11 Page: 314
Leaal Description
PIN
13.116 AC HWY 64 12.21AC
5777180133
Property Values
Buildin :
90,12
BXF•
1,99
Land:
97,90
arket:
190,01
essed:
190,01
Deferred:
Sales Information
No. Book Page Month Year Instrument Qua[/UnQual Improved Price
1 2002E 0146 03 2002 WL Unqualified Improved 0
2 2012E 0217 04 2012 EF Unqualified Improved 0
View Property Record for this Parcel View Mao 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=1459731 6/30/2016