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117 Forest Drive Lot 48Dav >.016 [all All dm Is provided as iswhhou twine rty orguanunee ofany kind tlNersaine sed or hoplied Including but not gmbed to the Davie County, Impgedwaran esafnrershantablllty orflNess for a particular use Au users of Davie County's GIS webstie shall hold harmless the County of Davi% NorthCarolina, b agents, consultants, contractors oremployees Fran anyandagdaimsorcausessfactiondueto NC - or arising out of the use or inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: C714000016 Township: Farmington NCPIN Number: 5862865416 Municipality: Account Number. 2570000 Census Tract: 37059-802 Listed Owner 1: ARNOLD WILLIAM O Voting Precinct: SMITH GROVE Mailing Address 1: 117 FOREST DRIVE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAME COUNTY R-20 State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27006-0000 Voluntary Ag. District: . No Legal Description: LOT 48 CREEKWOOD ESTATES Fire Response District: SMITH GROVE Assessed Acreage: 0.47 Elementary School Zone: PINEBROOK Deed Date: 8/1989 Middle School Zone: NORTH DAVIE Deed Book/Page: 001500132 Soil Types: GnB2 Plat Book: 0004 Flood Zone: Plat Page: 171 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: [all All dm Is provided as iswhhou twine rty orguanunee ofany kind tlNersaine sed or hoplied Including but not gmbed to the Davie County, Impgedwaran esafnrershantablllty orflNess for a particular use Au users of Davie County's GIS webstie shall hold harmless the County of Davi% NorthCarolina, b agents, consultants, contractors oremployees Fran anyandagdaimsorcausessfactiondueto NC - or arising out of the use or inability to use the GIS data provided by this website. V/ X6 DAVIE COUNTY HEALTH DEPARTMENT .`, IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **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 I1 of B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME C, �rno�// PROPERTY ADDRESS /'eS�AI ,�/Q{�QyJCC'. DATE &-4°-9vS" LOCATION SUBDIVISION NAME ��{ �e /w t70� '/ LOT NUMBER �_ SEC. /BLOCK NUMBER Z� RESIDENTAL SPECIFICATION: BUILDING TYPE /YBltrt .t BEDROOMS R BATHSt OCCUPANTS GARBAGE DISPOSAL: Yes" COMMERCIAL -SPECIFICATION: FACILITY TYPE D PEOPL& M OPLE/SHIFT SEAS INDUSTRIAL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY/.d/•/—/^�F`i0,GN WAST •R F-LOIS�tG@D EW,9iTE _ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE �Q GAL. PUMP TAM(I/tloo GAL. TRENCH WIDTH , i K ROCK DEPTH LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. D IMPROVEMENT PERMIT BYQ/�� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN B:30-9:30 A.M. OR 1:U-1:30 P.M. ON WDAY OF INSTALLATION. TELEPHONE t IS (704) 634-0760. t `OPERATION PERMIT -L�' RIs CRs 15U � Oyu �ec� SYSTEM INSTALLER BY Fr Po�s� 03e'3: Naea'3y "--° 03e%3 AUTHORIZATION NO. OO 10 OPERATION PERMIT BY DATE **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE i1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAPiE TREATMENT AND DISPOSAL SYSTEMS", BUT SHRLL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 REQUIRED SITE MODIFICATIONS/CDM ***THIS PERMIT IS SUBJECT TO SEE THIS PERMIT BEFORE IM •an ,,-y c'.r,i DAVIE COUNTY HEALTH DEPARTMENT • r� IMPROVEMENT PERMIT,And OPERATION PERMIT_ tiJ . t IMPROVEMENT PiRMIT } *+NOTE** This toproyement permit DOES NOT authorize the construction ,or installation of a septic tank system or any wastewater,., system. AN AUTHORIZATION FOR WASTEWATEq SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a sy-- ar the issuance of a building permit. / iln compliance with Article 11 of S.S. Chaptev(30A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)c NAME C�/l A /w PROPERTY ADDRESS �I / ro /�� s��Ii� d{�QW e . DATE &-01 LOCATION J%`/Sl�S r, F dil r C. / SUBDIVISION NAME LOT NUMBER SECT/BLOCK NUMBER e RESIDENTAL SPECIFICATION: BUILDING TYPE r e : t BEDROOMS # BATHS .,�2. # OCCUPANTS GARBAGE DISPOSAL: Yes o CRCIAL-SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT I M SE 1`S _ INDUSTRIAL WASTE: :Yes/No' DESIGN LOT SIZE //?)XQM TYPE WATER SUPPLY 6? WASTE TEA FLOW`i6f )a EW'SITE _ REPAIR SITE _&,f& 11000 1411 SYSTEM SPECIFICATIONS: TANK SIZEAL4a 6AL. PUMP TZ M. TRENCH WIDTH Fe' ROCK DEPTH LINE�FT. 1 OTHER REQUIRED SITE MODIFICATIONS/CDM ***THIS PERMIT IS SUBJECT TO SEE THIS PERMIT BEFORE IM **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 THE DAY OF INSTALLATION. TELEPHONE # IS (704)-634-8760. OPERATION PERMIT r F r - M 't N�^ g ,a9 AUTHORIZATION NO.' OO -r0 OPERATION PERMIT BY s.�o ` DATE Jb -iq-g5 - . /- **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE'tlr,&'G:S. CHAPTER A1OA, 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 I O / 95 .. .t. - t **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 THE DAY OF INSTALLATION. TELEPHONE # IS (704)-634-8760. OPERATION PERMIT r F r - M 't N�^ g ,a9 AUTHORIZATION NO.' OO -r0 OPERATION PERMIT BY s.�o ` DATE Jb -iq-g5 - . /- **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE'tlr,&'G:S. CHAPTER A1OA, 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 I O / 95 .. .t. - DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) NAME 6. �! A�lwo id PHONE NUMBER ADDRESS SUBDIVISION NAME I %�✓wy e l LOT # //;7 4 DIRECTIONS TO SITE DC'fr®y /O!Q{/Pili %a %Sy'®�✓/Pf DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY--.64ffe- NUMBER BEDROOMS NUMBER PEOPLE SERVED O1 TYPE WATER SUPPLY Grrl// SPECIFY PROBLEM OCCURRING DATE TAKEN BY Ila This is to certify that the Information provided Is correct to the best of my knowledge, mid that I undeAld I am responsible 1 charloga Incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED Rev. 1193 DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion _ .. (Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR C r -a n F:11 Cclt S.T On fr,10A DATE /0- '/Z-, PERMIT _:LQCATION ..QOI �nr.•�-:,rvY'P� i1Cr`n�.>:. Cfo•-.. T_ 7^ N° �'i'+res `t'�n]T 775 "�'aPce liuu=e+ S.R. NO. ` SUBDIVISION NAME CpccV3 wd" E%4a}E5 LOT NO. f SECTION OR BLOCK NO. HOUSE ® MOBILE HOME t3 BUSINESS ❑ House Trailer 800 Gal. 400 Sq. Ft. NO. BEDROOMS NO. BATHROOMS Two Bedroom House -800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO ❑ ` Three Bedroom House 900 Gal. '900 Sq. Ft. AUTO. DISHWASHER YES ❑ ,. NO .❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO. , WASH. MACHINE,,, YES ❑ NO ❑ 1 �� SITE SUITABLE YES_❑ NO Eltrt� ,` Ro1C ` ��Q �. , SIZE OF TANK gal. -a a 3op Rsv^>• NITRIFICATION FIELD '0 sq. ft. DEPTH OF STONE IN ;LINES: WATER SUPPLY: Individual Public ❑ IMPROVEMENTS PERMIT BY -Te. y/�j INSTALLED BY (' - CERTIFICATE OF COMPLETION.:' , - . By. '(�l'Lf'_ Date (8/16/73) *Construction'`must < LOT AREA (/With all other applicable State and_local'regulations g'�,L,nest 200400/a"/e• $�Skem. „� tock. iWD 1%S•°GrNesK 3�j�G Lf'�f� �y- c 'T� f"1 w�''�� co TC. Cv 66'.4.0, Davie County Health Department A ENVIRONMENTAL HEALTH SECTION i, P.O. Boa 665 ;:. _ :.... Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRIXTION (Issued in compliance with Article It of G.S. Chapter 130A, Wastewater Systems) ***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.*** 0 ANO ` ' / �JIWO nRIZATIDN N1PKR NAME � j!` CJ DATE �fi��'9S� N2:.) ii � Q NATE ON IMPROVEMENT PERMIT (If different than above) J- SITE SITE LOCATION !i°L w�0 ZZ COMMENTS/CONDITIONS TBI WINGRIZATION TO'CONSTRUCT WASTEWATER SYSTEM