1620 Underpass RdParcel #: E811OB0003
Davie County, NC - Basic Estate Search
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Parcel #: E8110B0003
Account #:82517982
Owner Informatio� Tax Codes
ERNEST BARBARA R ADVLTAX - COUNTY TA
100 CASTELLUM SQ FIREADVLTAX - FIRE TAX
INSTON-SALEM NC 27127
Pro e Information Townshi
nd (Units/Type): 1.000 LT SHADY GROVE
ddress: 1620 UNDERPASS RD
Deed Information Local Zonin
Date: 05/2001 Book: 0001E Page: 0158
Plat Book: 0003 Pa e: 101
Le al Descri tion PIN
LOT 3 GREENWOOD LAKE 5871948904
Pro e Values
Buildin : 139 00
BXF: 1 03
Land: 47 50
Market: 187 53
ssessed: 187 53
Deferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 OOOlE 0158 05 2001 WL Un ualifled Im roved 0
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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
consuited 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 inerchantability 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.daviecou.ntync.gov/itsnet/View.aspx?prid=1459565 10/12/2016
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AUTHORIZATION NO. � � � � ' . �� ' �i�� �� `�
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DAVIE COUNTY HEALTH DEPARTMENT ��^- � ��
" • Environmental Health Section PROPERTY INFORMATION
Permittee's� . �-` .,,4r,,_ P.O. Box 848
Name: a-��� :=�- �- ����:��_��.�-� Mocksville, NC 27028 Subdivision Name:
Directions to property: 1� �' �-- ��,� C�"'����:t'�� ` Phone #: 704-634-8760
� � � AUTHORIZATTON FOR
�l �5�•. � `.°`�';`:"_�'��� �1� cE� WASTEWATER
_ ti SYSTEM CONSTRUCTION
Section: Lot:
Tax Office PIN:#
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Road Name�� �. ��.� n��.• z.. �� �ip:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pemvts. This Forrn/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)
�� �'"...,� „� � ***N01TCE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
-s,��`� ".I� �..,,,.yy�'��_ � Q'�.., '"j � IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
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-� .�� . ., .,, � � , DAVIE COUNTY HEALTH DEPARTMENT - _ . ^�� •- -'� �
--: -- "'''� .. " �' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
� _ Peimittee's�
Name: 4 , . �
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-. Directiobs to property: � `° � -
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IMPROVEMENT
PERNIIT
Subdivision'Name:
Section: Lot:
Tax Office PIN:#
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Road Name � � . � � Zip: � �, r ; �:,,
�
**NOTE** This Improvement Pernut DOFS NOT authorize the constcuction or installation of a septic tanlc system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
conshuction/installation 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)
'� ***NOTTCE*** THLS PERNIIT LS SUBJECT TO REVOCATION 1F SITE
' �. , ,�� �' �" ,'� _.,. � r`� . *.;,'� . i •'t PLANS OR TI-� INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMTI' BEFORE
_ INSTALLING Tf� SYSTEM.
s�,�,�',� ^. ,�.
RESIDENTIAL SPECIFICAT'ION: BUILDING TYPE �� # BEDROOMS � # BATHS �"' # OCCUPANTS � GARBAGE DISPOSAL: Yes br 9
�
COMMERCIAL SPECIFICATION: FACILIT'Y TYPE # PEOPLE # PEOPLEJSHIFI' # SEATS INDUSTRIAL WASTE: Yes or No
i
LOT SIZE ��''�'� TYPE WATER SUPPLY "' DESIGN WASTEWATER FLOW (GPD) ��� NEW SITE REPAIR SITE �
SYSTEM SPECIFICATIONS: TANK SIZE ��� GAL. PUMP TANK GAL. TRENCH WIDTH
REQUIRED SITE MODIFICATIONS/CONDITIONS:
� �
IMPROVEMENTPERMITLAYOUT
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d'
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� ROCK DEPTH ' � LINEAR FT. e{ ��
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
I OPERATION PERMIT
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_�ll �� N ��
�SYSTEM INSTALLED BY: � � �%�
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10-2.,\-`�
AUTHORIZATION NO.�� OPERATION PERMIT BY: DATE:
**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 WII.L FUNCI'fON SATISFACTORILY FOR ANY GNEN PERIOD OF TIME.
DCHD OS/96 (Revised)
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4 � � � �� DAVIE COUNTY HEALTH DEPARTMENT � � ` � �
` -»3 �' `"`' ' • � ' � � IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
-»- _
Pe'rmittee's `
_ �� Name: � � � _
- ', Directi6ns to property: � ��
; _ .
IlbIPROVEMENT
PERNIIT
Subdivision Name:
Section: Lot:
Tax Office PIN:#
R �ad Name• ` Zip: " ' `
**NOTE** This Improvement Pernut DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AIJTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
. constmction/installation 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)
***NOTICE*** THIS PERMIT 15 SUBJECT TU REVUCATIUN lN' S1TE
," �=r ', i� g~; PLANS OR TI� IN'I'ENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
, INSTALLING THE SYSTEM.
-�, ,..�
RESIDENTIAL SPECIFICATION: BUILDING TYPE J�`�*�� # BEDROOMS /� # BATHS �"� # OCCUPANTS � GARBAGE DISPOSAL: Yes oi No
l ��
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFI' # SEATS INDUSTRIAL WASTE: Yes or No
� C�,� ::.s i�J .; (, D i1
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) - NEW SITE REPAIR SITE
� ^' �
SYSTEM SPECIFICATIONS: TANK SIZE / r, t� GAL. PUMP TANK GAL. TRENCH WIDTH 'a ROCK DEPTH 1�� LINEAR FT. �i ��'�
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT �
C`. � . `'�•=w,,,,�,,,�� M.�
....�.,,;,�; � • �.�,
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 830 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT
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k� �$YSTEM INSTALLED BY: �� � �''�r: - �-����
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AUTHORIZATION NO. � OPERATION PERMIT BY: �u='=-�--`� �''�-�-�"�'� DATE: �
**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 OS/96 (Revised) �-
,
9 •. 5a
. • DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME 1_� �_ SL��-�'�' PHONE NUMBER ��� T��� 7
ADDRESS �u-�b
SUBDIVISION NAME
,N -c � �-.� �0�
� �,v 'P N e' , LOT #
DIRECTIONS TO S
t�1_� i�.� � `�
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DATE SYSTEM INSTALLED ��� NAME SYSTEM INSTALLED UNDER �'� �`�'�
TYPE FACILITY o�s� NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED �
TYPE WATER SUPPLY ���..��.�. SPECIFY PROBLEM OCCURRING ���.,►.��,.�-�,,
�c�--�'�'"'�-. _
�a� "� .,
DATE REQUESTED I � - �� � �, INFORMATION TAKEN BY \ �_�.�o� ���rS�.-S�.
This is to certify that the information provided is Forrect 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 AGENT����f���...���
Rev. 1/B3