4507 Hwy 64W�MT�"+��j'yR 3e5k�.i�tYi v � "` r1s� �t r}FiA v � y.�.ai.9�.i 'f . �� .a•w+" �a+ . +�:.�(.��ki.,iYkm .a+4iirrr` �'�4 �t, °agrf�w ,+��. .� �.^�- !A� t`.'� .'tis:w�:� ,.,r+�a>,�.i =7�
" �s �,� t Yr��� � � �� �
. AUTHORIZATION NO ��,� '�/� DAVIE COUNTY HEALTH DEPARTMENT:
-` �.Environmental Health Section PROPERTY. RMATtfJN
�, Z 1�i /U, �--''
; Ferm�ftee s �` �� �, P.O. Box 848 �
' ' 'Name ��:�-�t--T� � �._..lR��� Mocksville, NC 27028 ` ' ' � Subdivision Name:
�� � .. . ,i�A.� .. . .
' �` •' ' � ,_:: Phone # 336 751 8760 . '
Directions to property � ��� 1°� � - , .Section . Lot;
, ., AU �R ,
.,.#� � THORIZATION F ', .
��� i`G��� S: S�(;� � WASTEWATER' ' Tax Office PIN:# •�
� ` a . . SYSTEM CONSTRUCTION : : " ' -
Road�asb� � i.�`I . �ip.2- 7.�� C)
**NOT'E** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Secuon prior
�- to issuance of any Building-Permits; T'his Form/Authorization Number should be presented to the Davie Counry Building Inspections
Office w6en applying for Building Permits. ' "
;��n•compl�ance��w .Article 1'of G.S; Chapter 130A, Wastewater SyStems Section .1900 Sewage Treatment and D�sposal Systems)
%"! I
�'` Q ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
, ,. .
,>, �: I 1 � '. IS VALID FOR A PERIOD OF FIVE XEARS:'.' ,,
- ENVIRON HEALTHSPE (ST '•" : DATE ISS ED �
, � . �' . . � _ , _
7.
i J' DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY MRMAT ON
Subdivision Name:
r;l irections to property?iU� l� => I Section: Lot:
M - IMPROVEMENT
rE1 . ;j 1`, PERM Tax Office PIN:#
!—
`�1Road N m� (s� � � L.�`� L;�� �4r+"Lip.•� � = ' �+
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank systemor 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 1,1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** TELLS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRO HEALTH SPE IST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TELLS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 14CU, # BEDROOMS_ # BATHS , i, #OCCUPANTS 'S GARBAGE DISPOSAL. Yes of No
COMMERCIAL SPECIFI TION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No.
LOT SIZE 1 WATER SUPPLY DESIGN WASTEWATER FLOW (GPD K NEW SITE REPAIR SITE ' r
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTHL' ROCK DEPTH t U ' , LINEAR FT. �200 .
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: 1�-V �i1�*1G MAP i 1^� ►.� IC J�S j'VT. F—�-c-+ (]' '
r1
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
' APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
,NAME S Utt K PHONE NUMBER -71)4 S4 31
ADDRESS 4S'6-1 US 4vil 64 We.sT YYtodc. Z?DZ% SUBDIVISION NAME
i
LOT #
DIRECTIONS TO SITE 64to - PN%T W, Ate -U 60 140 -C,41rauchI 3 =y 6rus,.—c— le -EL -Alm khtc-
ac Cc
DATE SYSTEM INSTALLED lgtol NAME SYSTEM INSTALLED UNDERWe,
�-
A'4A ^^1 1
TYPE FACILITY—}I htAe— NUMBER BEDROOMS a' C) NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING r-em.&I I2,, b rw-
6'j Iz lr,Wl^- also reA6--V1 D14 -b -rt
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 from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1193
Parcel #: J100000013
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Parcel #:3100000013 Account #:8305844
Owner Information Tax Codes
IKKALA AMBER N ADVLTAX - COUNTY TA
507 US HWY 64 WEST FIREADVLTAX -FIRE TAX
MOCKSVILLE NC 27028
Property Information
Township
nd (Units/Type): 0.540 AC
CALAHALN
ddress: 4507 W US HWY 64
nd:
Deed Information
Local Zoning
Date: 12/2015 Book: 01006 Page: 0827
ssessed•
Plat Book: Page:
Deferred:
Le al Description
PIN
1 LOT US HWY 64 W
4797592236
Property Values
ulidin :
80,73
BXF•
83
nd:
1263
Market:
9419
ssessed•
94 19
Deferred:
06
Sales Information
No.
Book
Page
Month
Year
Instrument
Qual/UnQual
Improved
Price
1
00338
0475
06
2000
ED
Unqualified
Improved
47,000
2
00978
0005
01
2015
TD
Unqualified
Improved
0
3
01006
0827
12
2015
WD
Unqualified
Improved
0
4
00359
0191
02
2001
WD
Qualified
Improved
55,000
5
00670
0133
07
2006
WD
Qualified
Improved
96,500_
View Prooertv Record for this Parcel View Map 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.asvx?grid=1486918 7/12/2016