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AUTHORrZATION NO: DAVIE COUNTY HEALTH DEPARTMENT
.1255 Environmental Health Section PROPERTY INFORMATION
Permittee's // �/ p� P.O. Box 848
Name:- L 'l W 1. y .. Y 04 Mocksville,NC 2702.8 Subdivision Name:
r
'hope #: 704-63478760
Directions to property: Ht,il' Is � -it) Wro Section: Lot:
AUTHORIZATION FOR
-T,' r� (fU j J ["IW t(tib l WASTEWATER . Tax Office PIN:# _
SYSTEM CONSTRUCTION
rC17 M tj,,t)<c G lJ 1-c- f -r ry Z ZZ Z) Road Name: AC -11 0'e M W Zip: 2 07,1?
**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 11 of - :S`Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
' J ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ,
+ ,r-•
klh� IS VALID FOR A PERIOD OF FIVE YEARS.
ENV90NA TA tIZTH SPEd ALI DATE I SUED
**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.
DCHD 05/96 (Revised)?
DEAVIE
UNTY HEALTH
A TU IMPROVEMENT OPERATIONPERMITS PROPERTY INFORMATION {
reenflittee`s
nlaxge y " ''`'Ca Subdivision Name:
Directions to property:; . r f _ ' `1 s �x... t i �"'= ' .) i; �` ''' Section: Lot:
IMPROVEMENT
I.. PERMIT Tax Office PIN:#'°
Road Name: `- Zip:
**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
constractionfinstallation 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)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ,
ENVBtON11-I$N17AI, HEALTH SPECTALIST'DATE I SUED
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
- INSTALLING THE SYSTEM. i
RESIDENTIAL SPECIFICATION: BUILDING TYPE i # BEDROOMS # BATHS # OCCUPANTS'` -GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT -:*SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY �E�!- DESIGN WASTEWATER FLOW (GPD)COCi fJEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH 1 2 LINEAR FT.. -
OTHERl���r tlJTlt?�a
,REQUIRED SITE MODIFICATIONS/CONDITIONS: C ��myrr VGcra-yf 4.#-2�-t
OPERATION PERMIT
t-,41lto - t7 bl9ct%r
f SYSTEM INSTALLED BY:
Grp rpt /5 /2,p
c/,2i ,ojx/. C'a..jo.(rYf-9d� I7A� rr�j Iil�c✓/ y -a.., /fir n.
% vwc f� .►LAw• S� y� �� �vd��L� rCc. ai C a ,(* - %G� /f � � /moi
r! 1%.� �•s-mss- �i�rv/I �. C u� %i"''!�. fv . ►��,. i �t►� f/1U um� Syr Lx/+ta t�iU�t
W r(
SA � � y
$t r H/ � n. � Sw� 7tiRi+ /( x vort• �i� L. ac, �c�s.�-�a� tce-�' .-.. •Gli�lS mid �rwb� ���� "` � °%2"' ,�/1�0�/
n � (,�-« � ; •cam
--------------
c�
AUTHORIZATION NO. OPERATION PERMIT BY: , ' DATE:
"THE ISSUANCE OF THIS.OPERATIONPERMIT SHALL INDICATE THAT THE YS M DESCRIBED AB 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 05/96 (Revised).,
��P C�a S LAST Pa -o, -S;�-7S A�rdL �o
11
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION '
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAMEr.til' 11�'�� �Y�a� PHONE NUMBER
ADDRESS 2Z2'� �C $DAN SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE IS -M�
DATE SYSTEM INSTALLED 2 NAME SYSTEM INSTALLED UNDER QTS
TYPE FACILITY NUMBER BEDROOMS It3ATONUMBER PEOPLE SERVED 3
TYPE WATER SUPPLY IAt%L-l.— SPECIFY PROBLEM OCCURRING Ll th, w45 LJUr-
�t� Z PLAt=S
DATE REQUESTED 3 Ih ' INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENTS
Rev. 1193
Ale ZcY, 51& pIW!'/fir
4 Davie County Health Department
�►8 t fi Environmental Health Section
P.O. Box 848
C'
210 Hospital Street
Courier # : 09-40-06
F- Mocksville, NC 27028
,In
Phone: (336) - 753 - 6780 Fax: (336) - 751- 8786
ON-SITE WSTEWATER CERT CATION FOR DWELLING
(Check One) Re odeling Reconnection
Name: LNh r7 3e�tca �P.e1hk7 Phone Number &336) 5 9,F h46 J(Z (Home)
Mailing Address: J,9,9,2 h! C I-1 ryu 80/ N - (Work)
ck6L)$ I / e . N 4'70 -'P Email
�W `t M /
Detailed Directions To Site: �rn e- J s� �r� / , [ a5 Jr �lr✓ f b 1'i» n�7�» d .
Y'I :!!� a 3//0 m,
Property Address:.
Please Fill In The Following Information.Al o t The EXISTING Facility: e' 6V 0 -oo —0�7 Lo, � ole,
Name System Installed Under: Type Of Facility: 14 o L.L lls ft
Date System Installed (Month/Date/Year):
Number Of Bedrooms: a Number Of People:_
Is The Facility Currently Vacant? Yes Q 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: 17 b t.f.b 1 e Cep" d, a Number Of Bedroom r Number of People_
Requested By: ��i �. /`C P.L7�YL- Date Requested: 10 -,24 -1.3
(Signature
For Environmental Health Office Use Only
Appro Disappr;17
t
Comments: /' J O _,_.r{il.0 `� f�'yL�l � � dii11+�1
\'Environmental Health Specialist Date: /dam- —Z3
*The signing of this form by the Environmental Health 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 Check Moneyder #_/ -` `''/ (A Amount:$ U U Date: lV�I_Cl I K—)
Paid By: Received By:
Account #: 7i Invoice
Printed:Oct 28, 2013
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied
warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie,
North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or
inability to use the GIS data provided by this website.
- 4)dw .
,---v0
1 �y� tiM��
NOV-04-2013 14:08
P.002
PA,GE9R.G
01192
DAIS! CnVKTY
0.
7tar 3!92 P M.
STATE OF
119974
DATE T�7
$76 . � � aeW m r M otpoo.193 '�,� 267
NS()UNA
Real Estate
Excise Tax ,r
Esetet T=,
Recording Time, Book and Page
TaxLot No...........................................................................................
Parcel Identifier No...........,...............................................................
Verifiedby........................................................................
County on the .:.............. day of ......................................... ............ ,..., 19............
by............................................................................................................................................................................................................................
Mail after recording to ..........Cs b t .......X222..US.. !Y..BQ ..i ztxl.-..M }SSV�17Gr.., G..27�i?R...........................................
....................................................................................................................................................................................................................................
This instrument was prepared by ....................................SALLY W. SMITH, TEN COURT SQUARE,MOCKSVILLE,NC 27028
..................................................................................................................................
Brief description for the Index
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this Al,--..., day of ........................ Febzuary„••,.,•...:_.....,• 19...97...., by and between
GRANTOR
Nannie S.Harpe and husband, Joe C. Barpe
Frances S. Powell and husband, R.P.Powell
John A. Seats and wife, Belle S. Seats
C.Lamar Seats and wife, Cheryl M:Scats
Angela Seats Stauffer and husband, Dan Stauffer
John A. Seats and Nannie S. Harpe,
Co -Executors of Estate of Sadie Ii..Seats
GRANTEE
Lynn Keeton and wife, Betty Keeton
Eatrr In appropriate block for each party: name, address, and, if appropriate, character of entity, ea, corporation or partnership.
The designation Grantor and Grantee as used herein &hall include said parties, their heirs, successors, and assigns, and
shall include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that
certain lot or parcel of land situated in the City of ............. .............................................. ........... F.....armington•_•,,,•....,... 'Township,
...
Davie ...................................... County, North Carolina and more particularly described as follows:
attached
s( 7/
rite: swa
DEED 'MANS= CHEnCKM
N.f.. Bar Auoa Fu,mNo.3AW1977.w..wuam,ece_.....,,,.. �n.vaum.�. x. c. rrws GATE 3"10.-47 BY''aY C%%—AIJ
TAX SUPERVISOR
TOTAL P.002
• NOV-04-2013 14:08
P.001
Beginning at an existing iron pin said iron being the southeast comer of the within described
tract southwest comer of Kevin C. Benfield (DB 190, page 479); thence North 78 deg. 56 min.
55 sec. West 128.91 feet to a point in the asphalt of NC Highway 801, said point being the
Southwest comer of the within described tract and in the line of Bleeker B. Strand (Deed Book
165, page 300); thence North 12 degs. 49 min. 20 sec. East passing through an axle at 17.71 feet
to an iron for a total distance of 416.46 feet ,said iron being the northwest comer of the within
described tract and in the line of Bleeker B. Strand; thence with, the Strand line South 79 degs. 04 .
min. 30 sec. East 119.83 feet to an iron ; thence South 11 deg. 34 min. 15 sec. West 416.54 feet ...<_
to an iron, the point and place of BEGINNING, containing 1.189 acre, more or less as surveyed
February 12, 1997 by C. Ray Cates, Reg. Land Surveyor.
For reference see Deed Book 27, page 411 and Tax Map C 5 77 . For further reference see the
line agraement contained in•17ecd8o-ok'170,'page 476.-Da`vic County Registry: ...._. _ ... _
91h
98 An
Parcel #: C500000077
Davie County, NC - Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search 0
View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: C500000077
Account #:42300000
Owner Information
uiidin
Tax Codes
BXF•
ETON LYNN& KEETON BETTY
[222
Land•
ADVLTAX - COUNTY TAXI
arket:
NC HIGHWAY 801 NORTH
ssessed:
READVLTAX - FIRE TAX
eferred•
OCKSVILLE NC 27028
Property Information
Township
nd (Units/Type): 0.930 AC
FARMINGTON
ddress: 2222 N NC HWY 801
Deed Information
Local Zoning
Date: 03/1997 Book: 00193 Page: 0267
Plat Book: Pa e:
Le al Description
PIN
1 LOT HWY 801 Ed
5842881169
Property Values
uiidin
9211
BXF•
3,02
Land•
22,90
arket:
118,03
ssessed:
118,03
eferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00193 0267 03 1997 WD Qualified Improved 38.000
View Property 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.aspx?prid=1460406 1 9/22/2016