3107 Hwy 64EPermittee s,,,/, ,, f DAVIE COUNTY HEALTH DEPARTMENT
riazrle: '�"�-'' ✓ . t %• �%�<" i-.5 Environmental Health Section PROPERTY INFORMATION
w� h�✓f_ P.O. Box 848
Directions to property. r' 'tel Cr' Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760 Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION - -
` AUTHORIZATION NO: 002587 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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE 16Z # BEDROOMS # BATHS # OCCUPANTS 4-- 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&& ��"�EW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK' AL. OTRgN WIDTH ` 1 ROCK DEPTH LINEAR FT.�� (/{i
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
FOR FINAL INSPECTION OF THIS
OPERATION PERMIT
CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
SYSTEM INSTALLED BY:
AUTHORIZATION NO. t VOPERATION PERMIT BY: DATE:112
=�
**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) Cie_c�C "� 3.-7 Sr 10 ✓ a 9 g
�- 4 frni e s w DAVIE. COUNTY HEALTH DEPARTMENT
athw '.r : • r' t > Environmental Health Section PROPERTY INFORMATION
rM i r P.O. Boz $48
•'` =~'-! �'%
• ''. Directions to property: % ivlocksville,. NC 27028 Subdivision Name" ,
Phone #: 336-751-8760
Section: Co[:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION
0 002502 �� Zip: ,
'AUTHORIZATION NO: t� Road Name:
" t **N7" 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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
f ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
•' (% ,r, , f; -'' 1 / �` !�' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE _z # BEDROOMS _ # BATHS # OCCUPANTSGARBAGE DISPOSAL: Yes or No
-j
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY ! DESIGN WASTEWATER FLOW (9/1`D)° NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK �CiAL.',TRE5 WIDTH, ``' ROCK DEPTH 4r LINEAR FT.� '
.(
OTHER' -
i
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
FOR FINAL INSPECTION OF THIS SYST
OPERATION PERMIT
Im
)r -
CALL
CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
"SYSTEM INSTALLED BY:
AUTHORIZATION NO. l QPERATION PERMIT BY: DATE: ' J
**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 ANYPIVEN PERIOD OF TI,ME.
DCHD 02102 (Revised) �C LI= .7 g O. V ^ ✓ -ice �� g g
��
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
'AIR)
I DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
OBERO
N NAME
LOT #
TYPE FACILITY !► NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY����/
This is to certify that the information provided is correct to the best of my knowledge In t I nderta
snd I am resp sible for all charges incurred from this application.
......,.�...,� ..� .......�" .... ...�....r..�. 1< I/ ( l rsr\
r-H�,
Rev. 1/93
Parcel #: J705OA0001
Davie County, NC - Basic Estate Search
a Basic Search Real Estate Search Tax Bill Search Sales Search
View Property Record for this Parcel View
Mao for this Parcel View Tax Bili Information
98,78 0011
BXF:
Parcel #: 3705OA0001
Account #:82523722
Owner Information
arket:
Tax Codes
eased:
HILDRESS LISA MARIE
Deferred:
ADVLTAX - COUNTY TA
Unqualified
107 HIGHWAY 64 EAST
70,000
FIREADVLTAX - FIRE T2
AX
00172
NC 27028
01
1994 NW
Property Information
Improved
Townshi
Land (Units/Type): 12.830 AC
00587
FULTON
ddress: 3107 E US HWY 64
2004 WD
Unqualified
Deed Information
0
Local Zoning
Date: 12/2004 Book: 00587 Page: 0649
0785
10
Plat Book: Page:
Qualified
Improved
Legal Description
PIN
12.791 AC OFF FORK BIXBY
5777191523
Property Values
uildin :
98,78 0011
BXF:
11,22
Land:
6713
arket:
17713
eased:
17713
Deferred:
1992 WD
Sales Information
No.
Book
Page
Month
Year Instrument
Qual/UnQual
Improved
Price
1
00165
0697
10
1992 WD
Unqualified
Vacant
70,000
2
00172
0378
01
1994 NW
Unqualified
Improved
0
3
00587
0649
12
2004 WD
Unqualified
Improved
0
4
00145
0785
10
1988 WD
Qualified
Improved
65,000
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
< Return to Basic Search
Page 1 of 1
95.v
®rio
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=1487044 6/22/2016