993 Ridge Rd _ _ _ i�p. _ : _
a,'fF` .+1< - ..a.il"aA r.NP�t^ wMV�,�F� . . :�i .:-hv: .��E., _.l,f�1 � .'J »...- K...-+�rn. ' 4.- .:'Y"t, , af.v ♦.Yr.:�qi, a.. �FYr ::`y: i .
..: � 's� - �:�r - ..ti. . .
� -..S �_j" f E'!1"-.s+_ ,t;,,,�s
. :§;. ;.;. .�� � '.•. ', ��.._. ' •�., .'..- � '�; " ;.., ~ Y....� ..'.�. , .� ��- 1�1 �"�Z . . .
'AUTH�RIZATION NO. �� � �j' R DAVIE �COUNTY HEALTH DEPARTMENT
� :Environmental Health Section PROPERTY INFORMATION � '
� �Permittee,� _� , , , < r , P.O.Box 848 `
Name: � _.:� ' Mocksville;NC 27p28 ; Subdivision Name:
� Phone#.336-751;-8760 '
Directions to property:-� � i'' �l'�, Section: Lot:
AUTHORIZATION FOR
� .� � WASTEWATER .
,' .�'r � �'r �' � ��'` ' SYSTF.M CONSTRUCTION " � .Tax Office PIN:# -
, .
'Road Name: 'Z{p:,.
**NOT'E**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County'Envuonmental Health Section prior
to issuance of any Building-Permits.:This Forni/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits. .
` (ln com liance with Article I 1 of G.S:Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Sys[ems)
r� >� _ -
. . ����� .,1����r���� f�: • ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�- ,�`' } ^ IS VALm FOR A PERIOD OF FIVE YEARS.' '
" ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED �
• . . : . � . . , . :, ' ,'.
. , . . .
�, .;:� �, � -- ,..• �. . .>-, ;y i: , - . . , �: ,, . , , , , ..
_ , t. .:I .� : , : . ,. . . Pd�q-►7-Oz .:
� .
� -.... I
-�'� �:=�� , _-� � � ��, Q `�.�� DAVIE�COUNTY HEALTH DEPARTMENT
'%��'-�" '�,�; � �. IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
�P ,,,,y
er,�ri�[tee'•s-�_ .'. .
_. Name: �„ "; ,y;"%;_:_ _._.,_.__ ... . �� d: " � Subdivision Name:
_ i ; 1i
- ,. . . ,. r _; . .
� ,Di:riPns�to property: �'.;%��� s��� 'f r .- : . Section: Lof:
��_ . ;4;•� , IIVIPROVEMEIVT'
' = f l' ,�:,. ��..''�� � PERMIT Ta�c Office PIN:#
t'
�.=_ .
, i
, Road Name: Zip: ,
**NOTE**This Impmvement Permit DOFSNOT authorize the conshucrion or installation of a septic tank system or any wastewater system.An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUC'TION must be obtained from this Department prior to the
" construction/'u�stallation of a system or the issuance of a building pernut. �
-� (In compliance with Article 11 of G.S.Chapter.130A,Wastewater Systems,Section.1900 Sewage.Treatment and Disposal Systems) .
:. ,
�r' � ; i �,,;�' • , .., �, �'s"NOTICEsss TiIIS PERNIIT IS SUBJECT TO REVOCATION IF SITE
• 6 r"�r1'�r;.--. ,.l{ ,r` 7.r '��—r� i!�:' PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER `
,ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TfDS PERNIIT BEFORE
: INSTALLING Tf�SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE� #BEDROOMS��#BATHS_�#OCCUPANTS `�GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLFJSHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY�t) DESIGN WASTEWATER FLOW(GPD)� NEW SITE ' REPAIR SITE y
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTI-I LINEAR FT: .
OTHER � � xJ��'. _
REQUIRED SITE MODIFICATIONS/CONDITIONS:
nv�Pxov�Errr Ex�rrr.nYov����OVED EFF�LIl�tJT FILTER� �RISERtS) IF 6" BELQW FINISHEU GRABE�
EFFL
/I�� �`� . �" ` �,J�'J���Q'`r I
�V � 1 ��d�✓ �
� ;�<<A - , �- �= �,( .�,�� �-h� .
�`.� �, , ����� :
�'l`� � / 6� �
�1 s� �
,�,1v,� _ �,� %� ,
�,��,��,������ �. , : . �
C.,� ; �f �,� �'�� t
� ��� G�o�� �� �'
� � .
, �j� Jfi �' _ . : •
���r`. � �,tJ�-S� � /�. �d rVP tr/
�� � �
�. �.s �����
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL IIVSPECTION OF THIS SYSTEM
_ BETWEEN 8:30-9:30 A.M:OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#ISS(7(�4)�i3A:8Z6Q _
' (336)751-976a
OPERATION PERMIT -
. SYSTEM INSTALLED BY:
'.-- 2 � "b'�'�+�'�. , . � ���.�;� '
. � � �u�
�, e+�.� 2 �►c?� �� :.P`-r�.� �� `� �
� � � �,,�, 1� � ,�=. �o�t--c��v�i �
orJ . e2��ti�, �— �`�� . ,
,: : �r� s�� i8' .
:' L t�L� �'1�: �i�G �� � . ,
. �aT �l`�� �7 p.l�'� � /J-SQ3�
! � �� . ',
��G.,�7�,,,` ( � t+�,�}�
/� �-M�... �
AUTHORIZATION NO. �I, OPERA ON PERMIT BY: D : G`_�
**THE ISSUANCE OF THIS OPERATION P IT SHALL INDICATE AT THE D ED A VE HAS N INSTALLED CO PLIANCE
WITH ARTICLE I 1 OF G.S.CHAPTER 130 ,SEC7'ION.1900"SEWAGE TREAT'ME D DISPOSAL SYSTEMS", HALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT TE�SYSTEM WII,L FUNCTION SATISFACfORILY FOR ANY GIVEN PERIOD OF TIlvIE.
DCHD OS/96(Revised)
, ' �XISY�^�b S�S7�� � �3 P.�D(�-QS]
� - ..•�'�'` DAVIE COUNTY HEALTH DEPARTMENT � �""P ' ' ��
� IMPROVEMENTS PERMIT AND CERTIFICATE �OF COMPLETION
�.
*Note: issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
� � Permit Number
Name � ;/�vr�� (� ;•;t;f ;,,�:i j Date ,_lili �-,+ Jc} ;`1<;�� � ��7��
Location I�� .��; i�, .�-, ,�, r,>.,� , •, , �� f (,�!�,..sr :, 1 �;�-• ,�i;c.:r-�i�
Subdivision Name Lot No. Sec. or Block No.
Lot Size ����� ^ `'`'r' House Mobile Home `'�� Business Speculation
No. Bedrooms � No. Baths 7"� No. in Family ��
Garbage Disposal YES �, NO p� Specifications for System: <-�{_1!;} �� ��,�� ��'' ' '�
Auto Dish Washer YES p ;NO ❑ fvr:,:� �t��,� ��t.�� r-,;��:., c�:� ;� ,r, � . -
Auto Wash Machine YES pr NO �p .v- ts��} or•f c::.�.j�. ��s �s�
I,�J,• r. c, v ' * " �
Type Water SuPP�Y _ � �-' h ,�� Y i r� ,;; ����,1�,
*This permii Void if sewage system described below is not installed within 36 months from date of issue. �
/ � :
;
�
. /
_.. _____.._. .�.___.._._..______..._.�,, f�'
1
"l��irli� 4 �Z.... � �,
�.__ .......�_____ __._•----�—..Y...__
��`
,.��. - ^
t,•,.�_ ...( __.-.....__��:.�� �._ < <..> •
I____�... �`��• _�� �.
� � -+..._.._�.__,_„__._......._. t
�-`,,. ' -_.,."'1.,)
' c�•,� � .:;r<
i' '
v►ti• i ( t r,,<, •:� � n�� :�.�
';.1 V.�`r c.'�t i ; I� l. ..:, 1 7:'1 ti r..�
�, ,'�t. ( » �.l:l
�
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.
Final Installation Diagram: System Installed by��w`����'� ��1�' i ����
P N h ' �� � � �
��i1m , �t r� 3'�� � �
���� � � �
i ,, � ���.�f.
,zy �
._�..�...--- � ���
., t.
,
�� :
�
� . � -- ��
� r I���Y'''` � � �
Cenificate of Completion Date�
�
"The signing of this certificate shall indicate that the system describgd above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way b�taken as a guarantee that the system will function
satisfactorily for any given period of time.
� • •` �
_. ►
. F • � . . . . .� '� � ./�1 .
���- �`� `
� � �/
�uly 10� 1981
To whom it may concern;
This is to cer�ify that I� Paul Bowman, give David Gearhart permission
.�
to install a ground absorption sewage' disposal system on my property located
on Ridge Road� two miles south of highmay 64 west.
������ ��,
/ �'�-"`"l. ��r/ �'�'�'Yu-��
�
Paul 8owman
,I.l���� — ,?.��a.�-� ,� !6�L�-'��'
% i�- �I
' ' DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION �
� APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME --Ju r`�^� '���-^'�—� S PHONE NUMBER �
�
ADDRESS_ �f �3 �� c�-. � • SUBDIVISION NAME
. -
I�^-a c��-$ v� l� LOT #
DIRECTIONS TO SITE �
>
�
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING �
�
1
'J
DATE REQUESTED INFORMATION TAKEN BY � �—
�
This ia to certify that ths intormation provided is corcect to the best of my knowledge,and that I understand I am responsibie for ail charges incurred from this application. .{,�
�h/
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.i/93
_ _
. .�,
� .. f ..-..T �):...w.—ra.+.'r=7w y _ _ , �.+.,.,.,eaa.... , . . �.4+...ri a,. �r - . �:. .. . . .... .
... . ,_ .. . '"�""�t 1� . . , .,.. . ` � . . `t . . 7<•q��y,,... �i^'a•'i�i,. �,w�i'. . . -e�w' '�+E'.-:fi�",f``;' ^"+.�:v,�.� y,r�- V
'AUTHORIZATION NO: ,# �� �'DAVIE COUNTY�HEALTH DEPARTMENT
`` �'T �� Environmental Health Section � PROPERTY INFORMATION
-� Permittee:z-�""' � (� ��,/ :- P.O.Box 848
Name:�f��.J/'�T� !.� �„;., Mocksville,NG27028 Subdivision Name:
_ ��3 j Phone# 336-751-8760 :
Directions to property: V .r`% � t� ' Section: ' Lor.
�- - AUTHORIZATION FOR • .
,��/c:•i I- � ��. � WASTEWATER _ -
/�� ��� � Tax Office PIN:#
,SYSTF,M CONSTRUCTION
, : ` `_ ' ' Road Name: Zip: :
.
**NOT'E**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
- to issuance of any Building-Pernuts This Form/Authorization Number should be presented to the Davie County:Building�Inspections
, Office when applying for Building Permits. .
(ln compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatmenf and Disposal Systems) '
� , _
f ' ` ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
��L,. , ',�' ,�'f ���� ,' _��� ` .IS VALID FOR A PERIOD OF FIVE YEARS:
ENVIRONMENTA HEALTH SPECIALIST DATE ISSUED
' .- /r . . � . : . . . ..._._._ : . . . . AEED 800K�.:T..PAGE.�� .
. . � . �M.ii To: �,��r 5 z Z 9. �,��"�T.,..,�,�.,i��L� -C'-�-3Y� ��� �
. • � �WARRANTY DEED–Form Wll�601 � ' Printed aad for'We by Jama Williami E�Co.,Inc.,Yadkiriville,N.C.
� � . �` �•.STATE OF NORTH CARdLINA, Davie County. . '
. • ' ". '.THIS DEED,�Made chu 6 day of Juiy ' �19 81 �by aad betweta '
. �PAUL; BOWMAN and wife,. .CHRISTINE C.�BpWMAN. ��f ��
�• i', ' Y�AC�a�¢KxD�esx��ereina[tercalledGrancor,and DAVID ALLEN GEARHART atld wlfe, PHYLLIS A�. `
• G EAR HA R T. " __o�. � D8 V t e . Counqr and Sute of North Cuolina,fiereinafar '
• , .,c+ticd G�aricee;whosc permanent mailinQ addreu b � � . � ; .
��a����**��x*��,�x���xTEN����*****�**�x***
' � WITNESSETH: 1'lut thc Gnncor,for and ip eonsideration of tht wm o( � .Dollu� '
� � • anA ochcr j�ood and valu�ble considrrations to him in hand paid by the Crantee,the�eceipt whercof i�heteby icknowledgcd,hai`ivcn,`ranied,barpined,�old
.�ud corircyed,and.by tlrcx'preunti doe:give,'rrant,baryµin,ull,convey and eonfum unto the Cnntee,hb heici andlor tucceNort and aui�ni,premi�n in •
' ff • •G�1.��n� ' Townsl�ip,__�$�l�e Councrt Noich Cuo►lna,deuribed u follown: . ,
'� • • • . • : , ' • .. , ' , • ; '
" ` � � ' . . , • BECINNING at an iron, ptn in •the •canter of SR 11591kciown ae the Ridge
� � � . ' , '.Roadl. the Northweet coraer of JoAnn W[lliama (D'eed •Book 81, page
; ;'• •i•. . :, � � ?91 and runntng t�Pnce with Willlame ltne South 18 degreee 44 minutee
. ' .! �., � �. � � 25 seconds West•393.36 •feet to an tron pin, JoAnn Wtlltame' South- �
' i . , '� weet corner; thence North 36. degraes 09 �minutee O? secoade Weet • ' '
� ! � • : �•��� 100 ,feet.to a point. .a�new corner; thenca North. 18 dsgrees 44 mTnutes ;
• ' �. . ' 25 geconda ,East 393. 36 feet to a potnt in the ceater of SR 1159� a new
� , .� .corner; thence with the �center of.SR 1159 rtght of way South 36 degrees
. ' , � ' � 29 minutes, 36 aeconds Eaet 100 feet to THE POINT AND PLACE OF
� � . „ . ' , •, - THE B�EGINNING, containing 0. 903 acree� , more or lees, and beiag a �
' : ; ' . �� portton of those ,lacids deacribed by deed recorded� in Deed Book 90, , .
• �' ' � ' � .paga 157� ' Tract •2� Davie County Regletry..
( • , .. , , � � � •.
. �' �� • ' TOGETHER, VIFITH, the above coriveyed lande there Is, aleo conveyed a .per- • •
. �•, " , � . •.petual e�aement•for the diacharge of domestic eewerage emanating • ;
�•, . . ' ' �,from any reeidence� m�dular homd� or moblle home lecated on eatd � ,
, . . '. premtaea as te reaeonabiy .aeceesary to: uee the eama upon eoiI of • '. , ',
� .� . suitable perculatton capaciLy ae Indicated� by the Davie County Health �. • • . �
� ' � • • " . Department �wned by the graatore�heretn, sald" easement to be per- � .�•
' ' ' � ' '� �.petual and appurtenant to t:�e landa abova deacrtbed and to run with �.
' � ,� � , � . • � ' the� eame� in the hands of. all peraon� whom9oevor. in perpetuity. It •
'�� '� . bsing .uad�ratood •and �agreed'.that thts easemant ehall, be for oc�e resldaaca
i ' . : . oaly. . . , • ,' . . ; � .
".� :; . . .. • : . .. � . • . . , : . . • . .
, . . . _ . . , . . , .
.� i. ,� . . _ � . . • NO TAXABLE CONSIDERATIQN STATED ' � . � ��
' '. � . ; ' .. . •, �" � • . . . ' . .. �
. . 1 , , The abore land wa�conveyed to Cranto�by _.See Book No. ,Pa�e
• � � TO HAVE ANO TO Hl)LD Tlu abore druribed'prcm4�e�,wtth aU the apputtenancet theceunto belonQi�`,or in any wiu apQertalnln�,unto the Gtanfee,hi1
� •�• •: heGs and/oi iucccuon andassigns forcvet.� � • •
• ' AnS the_Cnntor cuvcnonts that he trici:ed of uid premixs in fee,�nd hns�he ri�ht to conrey the ume(n fee dmple;that aid p�emlx�ue hee[rom en•
' i �' ' eumbranecs(witli.the exception�above ttatcd,if any);,and thac hc wilt war ra n t and defend the uid,title to the ame againtt the Iawful ctalmf of all penon� '
F�I . whomsocvcr. � . . . . • . .. ,
` Wl�en icfcicnc.is madc t�i tl�c:Crantor or Crontec,thc ungular diall i�uludc the Plut�l and the maiculine�hnll Inelude the feminine ot tho neuter:
�• � : IN ESS HEItEr � T�,c Craneur 6as h.rewuo tt�lib hand and se�l,the day and yeu fuit above wtitten. .
� � �� /�r�L}�'�'L�' (S6AL) ' � (SBAL)
. '. � . ' '
, ! �..._�Q43��Y1'u?11�._, • (SEAL) � . (SEAL)
{ E .�^Q� _
y . 'STAT£OF l�f��u'uNA SV� �I�—�—COUNTY. . .
'- � � ��. �� MA2`l �„i_K��� S L�l A,��,a _,a Notuy PuL:ic of uid County,do hereby certify that
' ' < . � PA�IL BQWMAN and w'ife. CHRISTINE C. BOWMAN � �
� • Crqntot;perwn�lly apprared befure nic this day and acknow edged t6e execution of th orc`oi �deed. � /
' . .'I .. . •Witnas my hand and nourial ual,thts t6e�..�� Jay of ,19�.L_.
i • My Commission Expur.s: . � ' ,I!�;•� ��,�,,•�f �Y� ,N.P.�SEAL�
. ��. ..,�lyll�-
- � .� ' � ierm txpues March 3U. .
, STATE OF NORTH CAR041NA ' COUNTY, • ,
, : .? ' , 1, . . ' . ' �a Nocsry PubUc of said Councy,do hereby certify thar
. . ,ti . . . ' . . . . . . . . —
� � •• �Crantor,peiwnnlly appcued 6eforc me c6is day�nd acknowlydged d�e ezccuHon of the forc�oin�dced.. • •
� .��! S`• Wimess my hand and notarial ceal,this the. • day of ,19_.
� .� � My Commiuion Expiress• . ,N.P.(SEALJ
S1'ATE�OF NORTH CAR0I,INA, DdV�.2 rpV�y,
: • �� ' . •
'! The fqregoine certificate(�of �rv L. ICrE:t1331�1CJ, NotatY Publie of Suffolk C�ounty, 13LW YO�t�C. . .
• •�• � i�(�«rtified to be�correct: This tnstrumenc was preun�ed foc re�utration tbL '' 27th day of_a711111 , �19.��
j • � t . .at 2.235 � ?0}QO.,P.M.,and duly recorded in che o[fice of the Register of Deed�of ��e • • . County�
,.' .•�. ' No�th Carolina,in Book' 114 ,Page 309 , . � •
; , � This the 27 dag of J�y ,A.D.,19 gl. � • � . . . •
:` • . � .T_ x_ 4„i}� • � ey -
• • ' � Rcgistcr of Uecd� � � ' �Q�Q�iYi Deputy ReQuter of Deedt '
� :Th�soeeddrawnby GEORGE W.� MARTIN, Attorney at Law. Mockeville, NC 27028 :
'. � � .. � � ' � ' • � . . � . . � � '. d
' : .1 ; •,..,.: . �. ' � ... .... " ':".�' .�.,....��.. ; _...._. �.«� : � . , .
.,i , . . ' , , . . • . . ; . .• ' • � ' . . . . .
1 . . 1 � 5� . , . , . . ' ' . . � . . .
1' , , . � . . , .
AUTHORIZATION NO: ; � +� ��'DAVIE COUNTY HEALTH DEPARTMENT
•�- � Environmental Health Section PROPER"i Y INFURNIATION
,, �Pir � .ie:s�--'"' (� �j P.O.Box 848
• Name:�r��-J/�il- r � Mocksville,NG27028 Subdivision Name:
' .,' � Phone# 336-751-8760
Directions to property: � � . �'% ' '� <<� Section: Lot:
AUTHORlZATION FOR •
: �� � ��( /;�j �'� WASTEWATER Tax Office PIN:#
�' �'� � t �' SYSTF.M CONSTRUCI'ION - —
Road Name: Zip:
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pemuts.This Fonn/Authorization Numlxr should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(ln compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
; �J ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�=',u;:.."t_<�y., ;��.,'�;'�.��f �i;� , �j� ,. - �l IS VALID FOR A PERIOD OF FIVE YEAItS.
ENVIRONMENTAL HEALTH SPECIALIST 'DATE ISSUED
__ . . __ ., _,,.�.,�,: . __ .. , .._: _ �.;.._.....,_.._..._�....,Y:.._....::�__.._.�.
RESIDENTIAL SPECIFICATION:BUILDING TYPE fJ� #BEDROOMS�#BATHS�#OCCUPANTS .r"' GARBAGE DISPOSAL:Yes or No
r...._ ._ ..._
�
I COMMERCIAL SPECIFlCATION: FACILIT'Y T'YPE #PEOPLE #PEOPLFJSHIFT #SEATS INDUSTRIAL WASTE:Yes or No
I LOT SIZE TYPE WATER SUPPLY� DESIGN WASTEWATER FLOW(GPD)� NEW SITE REPAIR STfE � �,
„ ,p i�
i SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ,�� ROCK DEPTH� LINEAR FT�
� '
i OTHER
I
REQUIRED STTE MODIFICATIONS/CONDITIONS:
1MpRovEMErrrP�rrr.nYov�r�ARPROVED EFFLUENT FILTER* �RIsERtS) IF 6" HELON FINI5HED �
�
; �x���:� �bJ:a��r��' %�;s s,sr�� r����r�'�E
i � � ,r�
I � ��-,G�i��.�� `�.�„� s t�✓
; � � F u�,o,, ,•;�f �����,,� y.
,
, �
��y�1i 6 Ow7 d T '
n ��.,� �, ;�� �
S•
�r o�`
i .
��w T �
�
I
i
:'CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPE x'�{��YSTEM
, BETWEEN 8:30-9:30 A.M.OR I:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IC'��1�����7607fi@
d it tl
,
� OPERAT70N PERMIT �
;
• SYSTEM INSTALLED BY:
i
i r'/i.:•�;
� / j
1
� . 1,n ,. •. . ,' � . � . . � � . ' -. . . ..
i
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
•'Tf�ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
W[TH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMEIV'T AND DISPOSAL SYST'EMS",BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96(Revised) '
�
i
. �
� ' DAVIE COUNTY HEALTH DEPARTMENT
. � !. � • . _. .
• . IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
.�� .
• � 'Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13a
Permit Number
�'�j ; � �' �,�
Name - t_ f;��r,; •��� :1 r�.,' Date ... ;����� j ) ,�'; ° � rx•,y� �
r• l
�ocation Ir`r,� . ,� ;= ;' ��, �. :s ;ft (,'%c_.1 � ,.. �:, ,, �,.�
�
Subdivision Name Lot No. Sec. or Block No.
-r ;•
Lot Size �� =� �<<-� House Mobile Home _ Business Speculation
No. Bedrooms '� No. Baths �•� No. in Family
Garbage Disposal YES ❑ NO p�! , Specifications for System: f�''�>�' �i �%" '" ' ��
Auto Dish Washer YES , NO p � ' � " `'
Q .�C��:) ;�' :.: �; 1 r
Auto Wash Machine YES [] NO �
Type Water Supply :-..)�• r ! -- �-,. i�:�•• . �!, , -�� r� ; , -
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
_._----------� ~- ....,._,__
,-'' - ...�.--�----.-_._ _�.,_.
,- ��_.
,`
, ��.-
� , ,..,...,..._--_...�..._
,_ z�.,_._.._.,..-_-----'"
� -�
:`.f
�___._�___.__._.__._..�.� .w__..�_
;
� � �
i.�.__.._..,....__.__._._______..._..__.�.__.�__. `
. �
�, � .►
_. . �; ; . -
i._>1 � .
'i s
� ��
Improvements permit by -��' ����"'�~
Y
*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.
Final Installation Diagram: System Installed by
r�����.��,�...� �;;r�_,.��� -r ��'i.�}..
�,,,,,�..._...._....._.._.....y._..._._..�..._,,. �
r"
�" �.�--__„_.,...�._.._,
,-.--""`"--•- `�
� �.--``�Y _ ........ �.. � (
,r ----. ...,
�...'. ... .. � .... . ' .. .__ . `! ,l-' « . .Y.�t . . 4 �'1
,1 ' :�'^ � � '.
. ' . ��.�.� � . '
. `
� , r
_._.___ __�_....�.__�__....___... ., ;
1
�
. . �_ ___.. �-___�,�_._.�
��-�t; ; � .� _ .;�: �
Certificate of Completiorl:�+��"'�'�� Date � { '�
s �
"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.
� • r
,� ,. ,� . . � '�, � .
V �✓ .
. ��0��� ''r::. � , . �
��a,�" ��R
. � � . .
.t . .
� . . . �
. . . , . �
' . . . D�EO COOY��4 FAGF V O wT
,,.:.; . �onTx c�i�oi.INA ��;'�L�. J S (,-r�',�� f/1�/1 '. � oc. K�di �� �-��.
i . �
�
� DA��Ir .rOU:vTY EASEMENT �"�d7 ��
� � 7'ill.5 F:A51?M�N? madc and entcrcd lnto thle :J� day •
�._ .
of P.�l�;u5t, � ►�?83 by and hetwecn PAUL BOWMAN and his wifc� .
� C�TRLS'I'INE 3301�YMAN� parties of the fixet part; and PI-�YLLIS A , �
. �
_ � ' GF:ARtI/1R'I',. party ��f thc second nart: � , '
. • . �
� W IT :V ESSE TH : �
• • i
. Thal [or and in considcration of lhe sum of. Onc ($1. 00) 1
Dollar �ancl c�thcr t;ood and valuable considcrations �aid hy party of .
� the second par.t lo parties of the first part the receipt of •::nich ts '
' hcreby ackno�vleds�ecl� said parties of th� ::::,: part do hcreby give
^.-. � � and �rant unto the said party of thc secand part, �1�er heirs and asai�ne �
. i . �
� j � ', a perpctual easemenl t;o make reasonable use of the water comin� '
, . . • frotn a a•cll locatecl on property bclonging to p�rtics ot thc firet part .
� and dc��rribcd by decd reeordecl in I�eed I3ook 112, pa�;e 873 and to �
. ' , i
<•oiiy�ru�•t, n�lintai» ancl rcpair ncrc��ary pumpe ancl walcr llnes ' ' !
I
. . � }
� . � , dc:.si�;nccl t�� trarisport and remove water from said.well to property �
• �
belori�;in�, tc� parly �f �he second part deacribed by Deed recorded in '
. ;
Lced. 13ook 11-�. na�;c 309� said easement to be appurtenant to eaid 0.903
• • acre tract recorded in Deed I3ook 114� page 309 and to run with �he
MARTIN AND VAN HOY •
ATTDi:NEYS AT lAW ��'�
. b��CKSVi�LE,N.C. .
�, .
t
� ' .
. . . ,
. ' �
. i
. • . �
' ' l
�
. ; , ,
i .
i �
, � , •
DCED$00lS�l�f'ACc".�T .
. eame in the hande of all persons whomsnever.
� To have and to hold said right and easement :c> hcr thc said � . ,
party of the second part and her successors in title forever. �
, ,
" IN TESTIMO?'JY WHEREOF, said PAUL IIOWMAN and his wife,
CHRISTINE BOWMAN have hereunto set thcir hands and scals to lhis .
casemcnt thc day and ycar first abov� writtcn.
" �!�n1�.a.U�.v,-�� _� ��b�,.r•vr���•�r:-, (;iEA L)
� , .
, � � .f
%�;� � ;';!G> �;/ri': �'L (SEAL) .
5TATE OF NORTH CAROLII�IA� ,t�!L .,� i' COUNTY. �
I� ..�;l.//�_/i.�i'r� �•f���/'/ . . � Nc�tary Public of .said Coun�y, dc� hereby
certify that P�AUL IIOWMAN, party of the firal part, personally appcareci ' '
' before me lhis day and acknowled�;ed thc ex�ruti�n c�f the fore�:��inE; , �
instrument. �
� Witnc�a my hand and nolarial seal, thi� thc ,.; _ day ul.Au�;u��t; l�►�s3. � �
My commie�ion expires: .''.��s:� ��."•' � � ' •' ` ' -• �
�'•�4��p • & 1! Notary Publi: 03ti� :'�'�a
. ; Itce�:'�'i�.ti�.='�:�f'.:..
. C�t':"h'��P���p
""'� �.:, ,. -r. .,b�Y •
STATE F NOR7H CA�20LINA ,� ��..� COi3\TY� �� �4H•y',~, ����� � R���� �` tdt
�+ � [.-1>i�t Iti_
I. ���=�us�GL� j � a Nolary Public of haicl C�,uniy. dc� hc:ruby
certi that CHRI5TINE F30WMAN, p�rly of lhe firal �ar�, pc�i•5unally appcar�ct
� � before mc �hie day and acknowled�ecl� lhc exccution ��C th�� i��r�,�;�,in�; ins�rumr.►�t.
. WttneaA my hand and notarial ecal� �his-�ehc � ciay �>f r'1i� u�t, 19.K3. .
\ % . �/:� • , .
MARTIN ANDVAN HOY My Aummie��i�n expirca: .. .. � :��L!(_��•__ � : .
ATTOIINEY!AT IAYI ���(��t,� ; .� N��tnry l��tl)I I�' • •1 ..
� MOCKiVIIIE,N.C. ..{. . •
� ' ; . ..,.��1��;,,
. . :,,,�;,,� :
NOATN CAROLINA, DAVIF. COUN'CY
Thc to«�;ocoR«►��r���«c.> ot Frances.�, Z'�C8C11�, 8 NOtEiIy PUu11C Of Dc7Vl� COLli1L:x �JiCl
; . Jatt�ea F., PY17�tt .. . .. .... . . Autaty.Public(sX of I3UriC�: C,x,nry
i1Lt�ra) ccnihed tn bc torrar. 'fhi� instrumcnt was prc►rnccd (or rcKiittation ih�. 9� dry a! �t�r , 1��3.. ,
�t 10!1� A.�1.,7iK�A.,ond duly r�.ordcd in �h�:oiTicr ol �hc Rcgis�cr.�f ikrdi o( DA\'lli Cc)UN1'1', \ut�h'(:.;rcilina io D�x�L �� , .
�,,�� �a3 . � � �
�n,�s <<� Ath. �Y or October. . . n.n., t�83 �._�/ ,
; �. �:. snnrti � . uy;��.c� ,../,,,ll��`�.r�-ra.� .
REGISTER Op DCEDS A�51STA:��; RI:G151'LR UP ACl:Da ' .