2026 Hwy 64W (2)•: uY;'ar• ,,.,, i:'�. .yt'r '4.. r } ;a � . ���Y y.':a1 .; ,`�- �.. is .*, t' .`t a„t;.;
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DAVIE COUNTY HEALTH DEPARTMENT
r
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**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)
v NAME I� it r i°s7 dl PROPERTY ADDRES k - 1 W - DATE
LOCATION aw. A- l
SUBDIVISION NAME LOT NUMBER SEC./BLOC( NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE ^� # BEDROOMS , � # BATHS __q/ t OCCUPANTS „.V GARBAGE DISPOSAL: Yes/Ne.-
COMMERCIAL SPECIFICATIONJ: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS'` INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY 45dl_1 DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TAW SIZVeTa GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH l� LINEAR FT. �� v
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
n
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT 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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED BY C\” NO, 11R. O Ste
�� tN T � ►.
AUTHORIZATION NO. C)CD Ck% 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 FUNrCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95
rj K4 ` T DAVIE COMITY HEALTH DEPARTMENT
IMPROVEMENT OERMIT and OPERATION PERMIT
f , . IMPODyeiW- PERMIT .
This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater ,
syq m. %'t�I 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. l
AIn compliance with Article 11 of. G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems),
NAME . �,IT%%/i/I Jr`�I �f�/' + PROPERTY ADDRESS 40. DR1E
LOCATION
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER:
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes/No-
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No:s
LOT SIZE TYPE WATER SUPPLY %/,// DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE {�
.SYSTEM SPECIFICATIONS: TANK SIZF,t�c'•7f� GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH, LINEAR FT. ? '
_-' OTHER
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:WI :30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED BY ► C \ Vp 1?t O S�
F
14 0 Us,o
c
V,
.,
AUTHOR ITZATION NO. `t 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 SATISFPCTORILYiFOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95 i
.. ... ,r: -s .: ,ter .• .. _."ti4: 3 ,
�0
y: Davie County Health Department •�
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
+� Mocksville, N.C. 27028
AUTHORIZATION FOR YASTENATER SYSTEM CONSTRUCTION
`} (Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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.***
AUTHORIZATION NUMBER%No ugiNE DATE �
NATE ON IMPROVEMENT PE IT (If different than above)
SITE LOCATION
COMEINTS/COmITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
***NOTICE*** THIS AUTHORIZATION FDR WA TEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF.FIVE (5) YEARS.
ENVIRONNf fAL HEALTH SPECIALIST SATE —
DCHD.10/95
_ •�;-'.{ ray ,.y ,. � �. a 4 ;,.. u ,. u, '. _
ADDR
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
PHONE NUMBER
BDIVISION NAME
LOT #
DIRECTIONS TO SITE On �✓
/1511- & � I�A,41,lr
DATE SYSTEM INSTAALLLLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY XJP1tre NUMBER BEDROOMS�Z NUMBER PEOPLE SERVED
TYPE WATER SUPPLY get'/f SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY &2z
This is to certify that the information provided is correct to the best of my knowiedg ,and at I understand I am responsible for all charg s incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93
Parcel #: H300000059
Davie County, NC - Basic Estate Search
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Parcel #: H300000059
Account #:82519324
Owner Information
BXF:
Tax Codes
nd•
EAFORD JOHN E ETAL& SEAFORD PAULINE P
arket:
ADVLTAX - COUNTY T
ssessed:
026 US HIGHWAY 64 WEST
eferred:
READVLTAX - FIRE TAX
Unqualified
MOCKSVILLE NC 27028
0
Z
Property Information
0893
Township
nd (Unitsfrype): 28.630 AC
Unqualified
CALAHALN
ddress: 2026 W US HWY 64
3
00431
Deed Information
08
Local Zonin
Date: 09/2002 Book: 00438 Page: 0748
Improved
0
Plat Book: Page:
00438
0748
Legal Description
2002 WD
PIN -------
0.26 AC HWY 64 LIFE ESTATE
0
5719931895
Property Values
Buildin :
10191 0011
BXF:
1,24
nd•
153,05
arket:
256,20
ssessed:
127,16
eferred:
129,04
Sales Information
No.
Book
Page
Month
Year Instrument
Qual/UnQual
Improved
Price
L
00149
0104
06
1989 WD
Unqualified
Improved
0
Z
00431
0893
08
2002 WD
Unqualified
Improved
0
3
00431
0899
08
2002 WD
Unqualified
Improved
0
4
00438
0748
09
2002 WD
Unqualified
Improved
0
5
00438
0751
09
2002 WD
Unqualified
Improved
0
View Property Record for this Parcel View Mao for this Parcel Vtew Tax Bill information
Page 1 of 1
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1-0
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
h"://maps.daviecountync.gov/itsnet/View.asvx?grid=1479282 7/13/2016