3188 Hwy 64E /
\.
� �
DAVIE COUNTY HEALTH DEPARTMENT - � j ,;
, �- � \t,�..�:���:!-'��..
'iMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION ��,�` �
"Note: Issued in Compliance with G.S...of North Carolina Chapter 130—Article 13c.
' E f -�. � �r�r� �-�,1 � , Permit Number
;�> ,r, _ , , f '' ; 'r � :j ' •
Name�i.. ;� r;� �, ,;.%7;� ; , ;�,,, �� , r` Date � : 1 1 %' t� � p : �
� � — i � . t����
� ,�. , , . , ', , .
Location ' � —
. � �..� � z ,���.< r .��� ��--�� -���:.r 31�� G�S Hw�f �� C
Subdivision Name Lot No. Sec. or Block No.
,..�
Lot Size House `' Mobile Home _ Business _— Speculation
No. Bedrooms w�� No. Baths No. in Family '"�``� _
Garbage Disposal YES ❑ NO p'"� Specifications for System:
Auto Dish Washer YES p�NO fl -
_,
Auto Wash Machine YES �''�NO �� -��` ��` � ' �' %
�,• ,
Type Water Supply . ? ;=_ a_._:f_ __ r• ;.>�,:
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
�
;, C:
l�. ,,';.f�.� .
� ';
L, �._____.______._____�..�,�_ �
!__? '
' ,` _
__.. ._ ____ .....
��� __ ,
�_ , �:�
. -'�-r�Y� � �;' �''1 ' .
,.�...._..,..,.,.,�,�_. ��r � �
.�..K.,
h-�.. � �
- �
.. ___ ._ ___� ___.- _ .., _ :.f:
......�. ___.._
. . ..� ,�._,., _..�.-..� _-�. __
_ _._. _..._ . ..,. , �_-- -.�------.-.-.�_
� / i :.� ;� ��% , r�r���-.-.�
Improvements permit by � '
_ ,,;:
*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 day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by �l�}'*��'..�� �f .
- : l� .
� ''
� �
� �
� 2fld JG L t�
, ,
Certificate of Completion l��-z= �~�r-�'�' Date ! �7� 7 —_
r - ; 1
'The signing of this certificate shafl indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
��
�
DAVIE COUNTY HEALTH DEPARTMENT ���
/r .
, . �. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION ���=--`"�''�; .�;
^ .� . � :� �� . �..- _.
''Note: Issued in Compliance with G.S,_of North Carolina Chapter 130—Article 13c.
, , ,' ;:. t . .;, . _ � { _ ; _ Permit Number
f � ; ; --; ,.;.
� Name:{�' ��'�'���� �` ;r'�; � � r � -, ,�,,, � Date � ti `"�� ' r`r,:��;�
— — �..€:.
� Location ,4�'- " - • . . .. , . .. , • —
�
�_� r ;~,,'/�_ � �;�.r_. '�� -,._ ;,:! �
Subdivision Name Lot No. Sec. or Biock No.
Lot Size House •' Mobile Home _ Business Speculation
r
No. Bedrooms ��' No. Baths � No. in Family '"s`� _
Garbage Disposal YES p NO p�"� Specifications for System:
Auto Dish Washer YES 0 '^NO p �-, ,, ,,,',. , . _ �
Auto Wash Machine YES 0'f NO �� {�' � �" � `~` �' ! -
TYPe Water Supply /, i �=_ ,'.E._ _ {�,.•, , , ,_, ,',: ;
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
r
!�./` . t,�'E'� ..
f 'f,�f�,j�...
j �,, �____---�.___�_._.. __�
i �
� �
� i
, _. ,.---t-_____.--r..-----�--�
� --� �
__ ._ __-__.__./.. !
---- / ._ ______ ___._ . _ ---' i
� __----_ i
_'��`,�,.�..,�... ._...._..� �- '1,,
� � '
��,�_.._.___._._.� , � '
:x�
. ._.. . ,,., 1^,—'`- -� � } ^
� . 1� .. �` ��, . . . .
. .,...... _. _., . - _ -. .- .
.r....._.._ . .. :.. .
__.._._-.�.._..__.--�..--_... . � . ._.. �.,..� . . . . .
� :..:.,,,.._.._..-:-_.. _ . .. . .
. .... .....--'- . .
I '-_
, ......- --..._.,-..,_. . . / .
1._ ! '_.,.
Improvements permit by %' { ' �-�
,;
"Contact a representative of the bavie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by ��`��1.G�
" 3 k .�60 x/� ��
Certificate of Completion��2_� Date r'/�� 79
J�r�
#The signing of this certificate shall indicate that the system described above h s been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
,._„� �I2,1�d � t r�. ��
( �
� � . II���
, . _ �. �'r�� C�Q
' .��, ��� � Da�ie County Health Department �u5`'� '
�`���s f�` nvironmental Health Section _ d
�f .. �Q `� '°►�� �'.O. Box 848 . � °
� x !`, ����
� x"` '' ��� 0,�,� 210 Hospital Street �'
� �
Q�. � `� �� �- �Courier# : 09-40-06 �,
P�QR ��;t,�� Mocksville, NC 27028
Phone:(336)-753-f�0 Fax: (336)-753-1680
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
� � �
Name: f � PhoneNumber��/' ��"..Q�Sff/J (Home)
MailingAddress: �f� us ��� (�' `t"G ��� � (Work)
i - h`
� ' � +e /vC �0�� Email Address:
Detailed Directions To Site: -� � 'T ��'��� � �
Property Address•�I �.�� � Q���
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: /'�7Z��G/'ILlll�f/j �II2�O �Type Of Facility: �u��
T l97R
Date System Installed(Month/Date/Year): Number Of Bedrooms� �Number Of People:
Is The Facility Currently Vacant? Yes 'f o If Yes,For How Long?
Any Known Problems? Yes No If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: 1/�N.((._���/K�11�AG��� L��C, c Number Of Bedrooms: Number of People
� �
Pool Size: �Ox V � Garage Size: Other: NQGV �,�I�0
�Requested By: � Date Requested: ��' 3 '�1
gnatur � , �
For Environmental Health Office Use Only _..
Approved Disapproved
omments:
Environmental Health Specialist Date: � 2��
*The signing of this forni by the Environmental Heal Staff is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash eck Money Order # % , Amount:$ ���L� Date: /
Paid By: ,/r � Received By: �
Account#: . "�L+ Invoice#: ��G'�� /
Pazcel#: J7120A0023 Page 1 of 1
o���
Davie County, NC - Basic Estate Search �ou���.
;� Davie County Web Site
Ba�ic Search Real Estate Search Tax Bill Search � Sales Search �
View Pro�ertv Record for this Parcel View Ma�for this Parcel View Tax Bill Informatfon
Parcel#:J7120A0023 Account#:82526440
Owner Information Tax Codes
FRANZESE ANTHONY WILLIAM&FRANZESE TRACY LYNN ADVLTAX-COUNTY T
188 US HIGHWAY 64 E READVLTAX-FIRE TAX
DVANCE NC 27006
Pro e Information Townshi
nd(Units/Type): 2.430 AC FULTON
ddress: 3188 E US HWY 64
Deed Information Local Zonin
ate: 05/2006 Book: 00661 Page: 0871
lat Book: Pa e:
Le al Descri tion PIN
2.433AC HWY 64 5777280071
Pro e Values
uildln : 87 61
BXF•
nd• 33 12
Market: 120 73
ssessed: 120 73
eferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00045 0160 01 1900 WD Unqualified Vacant 0
00393 0892 11 2001 WD Unqualifled Improved 0
00661 0871 05 2006 WD Un ualified Im roved 133 000
Vlew Pro�erlv Record for this Parcel View Ma�for this Parcei View Tax Bill Information
«Return to Basic Search '
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(nformation. All information contained herein was created for the Davie County's internal use. Davie County,
its employees and age�ts make no warranty as to the correctness or accuracy of the information set forth on thls site whether express or
implied, in fact or in law, including without limitation the implied warranties of inerchantability and fitness for a particular use.
If you have any questions about the data displayed on this webslte please contact the Davle County Tax Office at(336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=1460819 6/16/2016