944 Hwy 64W t/XO
Sir DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
Sanitary Sewage Systems Permit Number
9'5 '1 .,,-I�lal Date /2--27- N2
7927
Location _ - 'gar F' �., /�? /�/ i ��/ Clr✓
Subdivision Name Lot No. Sec. or Block No.
Lot Size -- — House Mobile Home ---_ Business -- Industry
No. Bedrooms —No. Baths _� No. in Family�_— Public Assembly Other
Garbage Disposal YES p NO Ea�- Specifications for System:
Auto Dish Washer YES [P NO
Auto Wash Ma':hine YES a] NO
Type Water Supply __----_--
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
SYSTEM.
5
Improvements permit by — �1—
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number: 7 -6 4-6985.$760
Final Installation Diagram: S I a y
v'
r
Certificate of Completion — Date
'The signing of this certificate shall 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 -
L -
-IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION t
" 'NOTE Issued in Compliance With Article_II of G.S.Chapter 130a
,w Sanitary Sewage Systems
Permit Number
J ti..
N 7
Name C' �!'lrl�rv�°�a y��"/ ,!� s� C2/ /� ��✓ �" 9 2
�,-��j, ,� /' � _�— Date
'Location
Subdivision Name Lot No. Sec. or Block No. r
Lot Size -- _ House _jam Mobile Home --__ Business Industry J
No. Bedrooms —.No. Baths _ — No. in Family_ — Public Assembly Other
Garbage Disposal YES ❑ NO B-� Specifications for System:
Auto Dish Washer YES NO ❑ .
I Auto Wash Ma^hine YES NO ❑ ����–'�� ` ` i
Type Water Supply _— f�✓� /� ----- ---
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
SYSTEM.
l `
t -
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.,
1:00-1:30 P.M. or 4:30-5:00 P.M.on day of completion.Telephone Number:7 -6 4-6985.'W f60
Final Installation Diagram: S m I a y
4
r
Certificate of Completion Date 3/ Ar/
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall to NO way be taken as a guarantee that the system will function
`satisfactorily for piny given period of time. w
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME Sr�l�/` PHONE NUMBER
ADDRESS ` Gv 6 Y SUBDIVISION NAME
OZ/,`, LOT#
DIRECTIONS TO SITE /-o
a
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
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, d that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT' 9��J2�/f2 P
Rev.1/93
0
Parcel#:I400000058 Page I of 1
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Parcel#:I400000058 Account#:4452000
Owner Information Tax Codes
OFORTH BARBARA ANN ADVLTAX-COUNTY T
/O BARBARA ANN BARNEY FIREADVLTAX-FIRE TAX
OCKSVILLE NC 27028
Property Information Township
ts/Type): 1.140 AC MOCKSVILL�d�nd(CURI
dress: 944 W US HWY 64
Deed Information Local Zoning
Pate: 04/1973 Book: 00090 Page: 0271
Plat Book: Page:
Le ai Description PIN
1.14 AC HWY 64 5738079230
Property Values
uildin 10109
BXF•
nd: 19 56
arket: 120 65
ssessed• 12065
eferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00090 0271 04 1973 WD Unqualified Improved 0
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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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=1465693 6/30/2016