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7099 Hwy 801SHEALTH DEPARTMENT RELEASE Davie County Health Department N d rA�o� r 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: James W Tutterow Address: 7099 NC Hwy 801 South City: State2ip: Mocksville NC 27028 Phone #: (704) 245-8382 PERMIT VALID 0 6/ 0 2/ a 0 2 1 UNTIL Property Owner. James W Tutterow Address: 7099 NC Hwy 801 South City: Mocksville State2ip: NC 27028 Phone #: (704) 245-8382 Property Location & Site Info rmatlon FAddresS7099 NC Hwy 801 S Subdivision: Phase: Lot:sville NC 27028NGLE FAMILYTownship: Directions g Hwy 601 South, left on H 801, Home on right s: # of People: 'Water Supply: WA Basement: n Yes Q No "Proposed Improvement: Back Patio, Fireplace and Deck Type of Business: Total sq. Footage: No. Of Employees: This release in no way expresses or implies that the existing subsurface sewage treatment and disposal system serving the site will continue to function for any period of time. Applicant/Legal Reps. Signature Required? OYes ONO Applicant/Legal Reps. Signature; *Date: _ *Issued By: 2140 -Nations, Robert Authorized State Agent:_ *Date of Issue: 0 6/ 0 a/ a 0 1 6 **Site Plan/Drawing attached.** Hand Drawing OlmportDrawing I Drawing Type: HEALTH DEPARTMENT RELEASE Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Health Department Release CDP File Number.' 218-054 -1 County File Number: Date: 06 / 0 2/ 2 0 1 6 Olnch Scale: OBlock O N/A �r rcayc r- Ui a opi - IJ I- ��I l � rcayc r- Ui a Davie County Health Department 4 18 -Environmental Health Section :- ECE1V P.O. sox 848 210 Hospital Street U��Courier # : 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Fax: (336) - 753-1680 Name: '. (' Phone Number 7d -;I qr- 53-3 9 a (Home) Mailing Address: 170 ?7 AlW0 1 Sou (Work) Email Address: Detailed Directions To Site: Frbw— M m Lkoo'Sy dl c 0.0 fab/ -90 u T "-O e9- rcCLS v C,01-0•eos Please Fill In The Following InformatiioLn About The EXISTING Facility: Name System Installed Under: Type Of Facility: Date System Installed (Month/Date/Year): /qS-9 6(S-7 Number Of Bedrooms: 3 - Number Of People: Is The Facility Currently Vacant? Yes 0 If Yes, For How Long? Any Known Problems? Yes Co/ If Yes, Explain: Please Fill In The Following Inf rmation About The NEW Facility: Ij�'FMA4 AfCA, -leap koe, s a a rod 44 Type Of Facility:13adpw 1e -id �t4ef-/be-e-I - Number Of Bedrooms: Number of People 'Pool Size: Requested Disapproved Garage Other: Date Requested: VA For Environmental Health Office Use Only Environmental Health Specialist Date: *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 Money Order # Amount:$. Paid By: bill— Received By: - Account #: Invoice #: Date: "i CW ` rE �'o U N� s Printed:May 11, 2016 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. • Parcel #: M503OA0014 Davie County, NC - Basic Estate Search 1 Basic,Search Real Estate Search Tax Bili Search Sales Search View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: M5030A0014 Account #:8305206 Owner Information BXF• Tax Codes Land: EROW JAMES WARREN EMOCKSVILLE Market: ADVLTAX - COUNTY TA ssessed: 099 NC HWY 801 S eferred• FIREADVLTAX - FIRE TAX Unqualified NC 27028 0 i 00993 0672 Property Information 2015 WD Township nd (Unitsfrype): 5.250 AC 56,500 JERUSALEM ddress: 7099 S NC HWY 801 2003 WL Unqualified Deed Information 0 Local Zoning Pate: 07/2015 Book: 00993 Page: 0672 Plat Book: Page: Le al Description PIN 1 LOT HWY 801 5746610036 Property Values Building: 69,1601 BXF• 3,4901 Land: 49,17CI Market: 121 82 ssessed: 121,,8201 eferred• 2002 WD Sales Information No. Book Page Month Year Instrument Qua[/UnQual Improved Price 00441 0902 10 2002 WD Unqualified Improved 0 ! 00442 0899 10 2002 WD Unqualified Improved 0 i 00993 0672 07 2015 WD Unqualified Improved 56,500 I 2004E 0137 08 2003 WL Unqualified Improved 0 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Page 1 of 1 oo� ,�, v 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/itsnetfView.aspx?prid=1454532 8/31/2016