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7345 Hwy 801S}'ermittee'��� DAVIE COUNTY HEALTH DEPARTMENT Naine: � � 0j el Environmental Health Section PROPERTY INFORMATION P.O. Box 848 Directions to -property: Mocksville, NC 27028 Subdivision Name: Phone`4:336-751-8760 Section: Lot: AUTHORIZATION FOR 1!V �LOel 4/6 WASTEWATER Tax Office PIN:# - �52-70/q SYSTEM CONSTRUCTION l3ys ,�/ (� AUTHORIZATION NO: �� 2615 1� Road Name C ��` ��`S' Zip: L7o2�r **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 l l of G.S. Chapter 130A,Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE hi # 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 /y1°�� DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL."'TRENCH WIDTH ROCK DEPTHLINEAR �©b i o OTHER P REQUIRED SITE MODIFICATIONS/CONDITIONS: FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. OPERATION PERMIT 1 YI SYSTEM INSTALLED BY: 1�^ ,C1 VA0 J AUTHORIZATION N�A�OPERATION PERMIT BY: DATE: y: *"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE C WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION1900 "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. Dct D,02W (Revised) DAVIE COUNTY HEALTH DEPARTMENT. � f % "��_ Dei PROPERTY - Nagier�. Environmental Health Section INFORMATION P.O. Box 848 y0 Mocksville, NC 27028 Subdivision Name: Phone #: 336-751-8760 Section` Lot: ^' AUTHORIZATION FOR WASTEWATER C'oo%�ytPe N� SYSTEM CONSTRUCTIONi< Tax Office PIN:# - 4 0 2 01y 73ys Ne /Iwt/ Bo�S• AORIZATION NO: A Road Name. Zip: 2%o2 X i **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 Fo►m/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with'Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS , # BATHS �2_ # OCCUPANTS f1 GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No � " LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)` NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL.'"TRENCH WIDTH �,' CROCK DEPTH LINEAR Fr, / is � OTHER! REQUIRED SITE MODIFICATIONS/CONDITIONS:" IMPROVEMENT PERMIT LAYOUT FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: ` t J AUTHORIZATION NQ►OPERATION PERMIT BY: � V DATE: ` . t THE ISSUANCE OF THIS OPERATION PERMIT SHALL, INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE e' WITH ARTICLE 1� `,OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BE TAKEN AS A 1 GUARANTEE THAI ,T,HE SYSTEM WILL FUNCTION,Ah§FACTORIL'Y"AOR°ANlf GIVEN PERIOD Ol TIME. t DCHD 01102 (Revised) , —. k is � .. ... FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: ` t J AUTHORIZATION NQ►OPERATION PERMIT BY: � V DATE: ` . t THE ISSUANCE OF THIS OPERATION PERMIT SHALL, INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE e' WITH ARTICLE 1� `,OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BE TAKEN AS A 1 GUARANTEE THAI ,T,HE SYSTEM WILL FUNCTION,Ah§FACTORIL'Y"AOR°ANlf GIVEN PERIOD Ol TIME. t DCHD 01102 (Revised) , —. 60,e, WOeWik-S-% i uhfi/someoNe Comes• j -,j ir& rN6reenatvraDAVIE COUNTY ENVIRONMENTAL HEALTH SECTION /� L jj��APPLLICATION FOR IMPROVEMENT PERMIT (REPAIR) NAME Ger-4rud� 1J. UQOe (helnealka), PHONE NUMBER ADDRESS /.3TS /VC /i w�I ���-f IRC&Ae SUBDIVISION NAME LOT # Dl S• ,- D DIRECTIONS TO SITE r1 f1l 0i'WQ l nli'yel ��� -S, ase oN GeA, & 07f ee A f'OLV dd /-, DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY- AQUS-e- NUMBER BEDROOMS -� NUMBER PEOPLE SERVED TYPE WATER SUPPLY Wul SPECIFY PROBLEM OCCURRINGes NoWar ;1- . u �he �� ;v csleral DATE REQUESTED INFORMATION TAKEN BY �R �Q/hLCa 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 AGEN;�I; '�1�r�� . '01t� 11111P_A ) Po 4 Parcel #: M5070A0006 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search. Q View, Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: M5070A0006 Account #: 82530562 Owner Information 95,92 Tax Codes 4,57 ARWICK JEANNE BODE & WARWICK JOE R JR 27,76 ADVLTAX - COUNTY TA 128 25 129 EDGEWOOD CR 128,25 I READVLTAX - FIRE TAX Unqualified OCKSVILLE NC 27028 0 >_ Property Information:9 0179 Township Land (Units/Type): 2.230 AC Unqualified JERUSALEM ddress: 7345 S NC HWY 801 3 00784 Deed Information 03 Local Zoning ate: 03/2009 Book: 00784 Page: 0927 Improved 0 lat Book: age: 2003E 0129 Legal Description 2003 WL PIN 23 AC HWY 801 0 5745396109 Property Values Book Building: 95,92 BXF• 4,57 Land: 27,76 Market: 128 25 assessed: 128,25 Deferred: Unqualified Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price L 00328 0903 03 2000 WD Unqualified Improved 0 >_ 00604 0179 04 2005 WD Unqualified Improved 0 3 00784 0927 03 2009 WD Unqualified Improved 0 1 2003E 0129 05 2003 WL Unqualified Improved 0 View Property Record for this Parcel View Man for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 4 N.77� riot; 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=1467387 8/24/2016