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AUTHORIZATION NO: Q g 8 3 DAVIE COUNTY HEALTH DEPARTMENT `
''- Environmental Health Section PROPERTY INFORMATION
Permittee's " ' P.O. Box 848
Name: a
Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760 _...:.,,..
Directions to property: 0 t Section: �'"" "" Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
p
Road Name: Zip:��a�0
**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 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
, t
a�'i•/�+d+ f �C 1,h" ti.�.iS 'r^'r`1lrY`r ""'vx x ..r _,t r .'tx - + x ' 8; Tom.:-• _..s i__ h i^t D
•i»{rr17 �: y y t0 is t --l• �r.--r kr K!"�V"k-Mxb y �. 'n T .°•..y .. f .,,:t 7 u -zyr �.,.
"� `- DAVIE COUNTY HEALTH DEPARTMENT '' ' U
IMPROVEMENT AND OPERATION PERMITS
Permmeets "`' PROPERTY INFORMATION
r Name'. t�.,$)_ ��, ��..". Subdivision Name:
1 Directions to property: Section ...._ .. Lot:
IMPROVEMENT
•�l ate., PERMIT Tax Office PIN:# —
Road Name: Zip; Ida 0
*,*NOTE" This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit
(In compliance with Article I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r-•. ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
.$ ``� •ta` » "`"' �� " f PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER :
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE V' # PEOPLE # PEOPLE/SHIFT h -L # SEATS INDUSTRIAL WASTE: Yes or No
r. r
LOT SIZE TYPE WATER -SUPPLY DESIGNWAST•EWATER FLOW (GPD) NEW SITE REPAIR SITE _
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANKGAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.
r
OTHER >„ w
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEJLTH 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.
—44
OPERATION PERMIT a4 £ N p
At
SYSTEM INSTALLED BY:
�h 4 v '
6d
ro
AUTHATION NO.. O � � 3 ` OPERATION PERMIT BY: \ DATE:
ORIZO l7 1
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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)
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DAVIE COUNTY HEALTH DEPARTMENT .,
h '` 7IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Name. - _.. b , -.t �:� . .^ s �, Subdivision Name:
Directions to pibperty: p ' ., `� �' ' Section•Lot•
s ` IMPROVEMENT
PERMIT Tax Office PIN:#
A C�
Road Name: �% `�` c' Zip: of r%c�0
**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
construction/installation 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)
0.
k t _1^17 ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
i PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS -# OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT h—L # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGI-j,WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
A 'Q11 � 00
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.
OTHER ...
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEW;NINT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THEDAY OF INSTALLATION. TELEPHONE # IS (704) 6348760.
t
OPERATION PERMIT .• C tJ 2; �—
ti SYSTEM INSTALLED BY: _
ci@PN -k r
-
AUTHORIZATION NO. ` ,PPERATION PERMIT BY: � S.fSy� DATE: LO
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE.HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A; SECTION .1900 "SEWAGE TREATMtNT 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.
rN`Nrl A9106 M-;.. N
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
WOR HEET FOR SEPTIC SYSTEM REPAIR PERMIT
NAME i PHONE NUMBER
ADDRESS - % SUBDIVISION NAME
SUBDIIVVI,SION LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED
NAME SYSTEM INSTALLED UNDER�d
SPECIFY PROBLEMS OCCURRING
DATE REQUESTED -J 0 -\� INFORMATION TAKEN BY
Parcel #: M5100B0001
Davie County, NC - Basic Estate Search
i
Basic Search Real Estate Search - Tax Bill Search Sales Search
View ProQCrty Record for this Parcel- View. Mao for this Parcel View Tax BIII Information
Parcel#: M5100B0001 Account #:23614800
Owner Information
Buildin :
Tax Codes
BXF•
EDGEWOOD BAPTIST CHURCH
Land:
ADVLTAX - COUNTY TA
Market:
O BOX 57
ssessed:
FIREADVLTAX -FIRE TAX
Deferred:
OOLEEMEE NC 27014
Property Information
Township
Land (Units/Type): 1.720 AC
JERUSALEM
ddress: 7465 S NC HWY 801
Deed Information
Local Zoning
Date: 02/1973 Book: 00090 Page: 0101
Plat Book: 0004 Page: 030
Le al Description
PIN
LOTS 24-37 EDGEWOOD SECTION 1
5745276981
Propertv Values
Buildin :
192,91 01
BXF•
2y66
Land:
26,91
Market:
222 48
ssessed:
222,48
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00090 0101 02 1973 WD Unqualified Improved 0
View Property Record for this Parcel View Mao 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/itsnetfView.aspx?prid=1469124 8/25/2016