997 Hwy 801N` DAVIE COUNTY HEALTH DEPARTMENT _
IMPROVEMENTS PERMIT AND :CERTIFICATE OF COMPLETION -�`-
`NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c i �• ( �
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
N r� Lam` ��,�� Date 5036
Location n �,� -�� �'�� �� �� c e
Al T�
Subdivision Name Lot No. Sec. or Block No.
l
Lot Size 110 - `;,�>� House V� Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family_
Garbage Disposal YES ;0 NO Specifications -for System:
Auto Dish Washer YES p' NO '0
Auto Wash Machine YES N� NO -0
Type Water Supply
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
_ a
�~ Y
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.
X
Final Installation Diagram:" System Installed by
�
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.
pie
^ c�D APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT X12
Davie County Health Department `V�Q ,P
Environmental Health Section dG0
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
1. Permit Re nested //a Pt C e /� r
2. Address ft, f' � , By
i
Z?0d-6
Home Phone pq"f-J-yo.b
Business Phone 767 -?,Vo /
3. Property Owner if Different than Above
Address
4. Permit To: a) InstallA*lterV Repair '
b) Privy Conventional_je�Other Type
Ground Absorption
c) Sub -Division Sec. Lot No.
5. System used to serve what type facility: House__��_Mobile ome ' Business
Industry Other—
b)
ther b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions 3 `' k yO
Bed Rooms Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes urinals
lavatory showers
14(-
garbage disposal IVA
washing machine
dishwasher I sinks I
// `
8.. a) Type water supply: Public Private Community �C" J7 I c o JA
b) Has the water supply system been approved? Yes `� No
9. a) Property Dimensions 3 ° K
b) Land area designated to building site '
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? A16
What type?
5
This is to certify that the information is correct to the best of my knowledge.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Hai V S. d -V _5A v*---
Directions to' property:
DCHD (6-62)
Parcel #: C70000002902
Davie County, NC - Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search Q
V,tgw Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Parcel#:C70000002902
Account #:61126000
Owner Information
BXF•
Tax Codes
Land:
DDLE C VANCE
Market:
ADVLTAX - COUNTYTA
02 GRIFFITH ROAD
Deferred:
READVLTAX -FIRE TAX
DVANCE NC 27028
Property Information
Township
nd (Units/Type): 1.581
FARMINGTON
ddress: 997 N NC HWY 801
Deed Information
i— Local Zoning
Pate: 08/1987 Book: 00139 Page: 0224
Plat Book: Page:
Le al Description
PIN
1.65 HWY 801
5862375220
Property Values
Building:
01
BXF•
910001
Land:
29A55
Market:
38essed•
38
Deferred:
Sales Information
�No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00139 0224 08 1987 WD Unqualified Vacant 0
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
« Return to Basic Search
Page 1 of 1
oa�r�
®rio
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/itsnettView.aspx?prid=1478875 9/14/2016