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AUTH�RIZ;ATION NO: VBG
1719;5
DAME OUNTY,HEALTHDEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee'c, w11,, P.O.Box 848
Name: Vie' .Mocksville NC 27028 Subdivision Name:
�1r Phone# 336-751-8760 ,v-3o�rJ
Directions to property: 6J y I S S C WOO S ctio : Lot:
AUTHORIZATION FOR �p�f CC Lf�j�J�j- '0,�f.� BCtQ�.
a nJli S , A(:�U��, F QUM: (r�?4+L" WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION
At t t•1. (2�4y2C C�: f-6'q9 W 8'� Road Nam : 410405 W 16$zip: Z'702
**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 Pen-nits
(In compliance with Article l l of G.S.Chapter I30A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
./� ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FTVE•YEARS. ..
ENVIRON" At HEALTH SPEqMNST DAA ISSUED
s,:.r,� r'y„�� 3.<.trt '�-s .,:.'IY vtjrti.t'.•.S�s°" /['-'+ �w.lwcF'ri�2i M1Ay},r yy F'Er°,r� '�"•dY•..."u1i"T
DAVIE.COUNTY HEALTH DEPARTMENT ,
IMPROEMENT' AND.OPERATION PERMITS' , PROPERTY INFORMATION
Permittee.s,
_ ^ ti Subdivision Name
N!/
yDlrections'to property: :. Section. Lot: V 3
11vIPROVEMEN /1 p/,fCc v- �T,S'�r�.Cfal—ot;,:V'f
A" ,Aq PERMIT "f; t Tax Office PIN:# -
/ Riad N- �r� Zip:
**NOTE"This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or anywastewater system.An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department priorto the
constriction/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)
*""NOTICE***THIS PERMIT IS SUBJICI'TO REVOCATION IF SITE
^''i t .r ; • 0�' M'-"`` 1 PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
�- SYSTEM CONTRACTOR MUST SEE PERMIT BEFORE s.
ENV,IRO NT HEAL SPE IALIST: DATE ISS ED S
a '' INSTALLING THE SYSTEM. r
RESIDENTIAL SPECIFICATION:BUILDING TYPE BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes r No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS" INDUSTRIAL WASTE:Yes orr No
LOT SIZES l�iC�[t TYPE WATER SUPPLY YDESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE AL. PUMP TANK GAL. TRENCH WIDTH -�tl ROCK DEPTH LINEAR FT. <C70 /
OTHER 2 2L n oA UXu�
REQUIRED.SITEMODIF7CATIONS/CONDITIONS: Ir TAtl U� o02 . ICu=�p O�� 1 jy j � � PLO MA t ►idle WA
1C,.545 Gni_
•IMPROVEMENT PERMIT LAYOU , /
'' -COQA.t�G 'i' 7L- �► 11�r a17
/ SYSTJ *
Xlz o 25
Z ;
IFS-
.F
E
**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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: 04=M4
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 WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised)
20,
a�*-xr:'t'h/2L•!q SSy j``+ ifi:�h>{i.r �vsS.l ri*r•.. �iwr+P i . �,:�.�: .,..��y,, �.,?Ci .a:�.:.�., � �"
DAVIE C OUNTY HEALTH DEPARTMENT
TMPRO EMEk AND OPERATION PERMITS PROPERTYAN ORMATION
Peat ittee°s
' game fav 1 )C � I Subdivision Name `
,dDlrections to property: ? , r' a ' - . Section: Lot: `V
IMPROVEMENT' ff'/�f�CC7¢a `�` f,'� �' 1-5W
t�t`� t �: E i :, •;. •;,t PERMIT �` Tax Office PIN;#
df 1 j`ir. �t ,►. <l CG ' 1-6'y� R _� / fl,� " ', ttl lSg Zip'
Road Name:
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation of a 4eptic tank system or any wastewater system An',
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained f-om this Department prior to the
i
construction/installation of a system or the issuance of a building permit.
F (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
.`' �"' PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPEIALIST DATE ISSL9ED
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE i= '
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE lkosC.#BEDROOMS #BATHS #OCCUPANTS " ' GARBAGE DISPOSAL:Yes r No
COMMERCIAL SPECIFICATION: FACILITY TYPPE/3 #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes
�or NNo
LOT SIZE Irl�t'•TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE 1AL. PUMP TANK GAL. TRENCH NEA
-'� ROCK DEPTH tZ LIR FT.
�
OTHER 1�1 C�l t1 T).,.� 1�-•)CI: i
REQUIREDSCIEMODIFICATIONS/CONDIT14NS$1�'1AL1. t)J e-VJ-)0L)d'_ �,(.L p rrl� IIJtr'Gc'/ /'ct1,v��
IMPROVEMENT PERMIT LAYOUT
_ _ _. • � Ott—� wn`r'�Q {Cu;r.�
_ S
Few
`
**CONTACT)k 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 (336)751-8760. '
OPERATION PERMIT
SYSTEM INSTALLED BY:
/
i
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 1 I OF G.S.CHAPTER 130A,SECTION.19W"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)
,
Parcel#: H500000217 Page 1 of 1
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Parcel#: H500000217 Account#:82522972
Owner Information Tax Codes
DOWTIN ROBIN I IC ADVLTAX-COUNTY T
25 ROANOKE AVE UNIT 803 FIREADVLTAX-FIRE TAX
OANOKE RAPIDS NC 27870
Property Information Township
nd(Units/Type): 1.410 AC MOCKSVILLE
ddress: 2005 US HWY 158
Deed Information Local tonin
ate: 02/2016 Book: 01012 Page: 0638
fat Book: Pa e:
Legal Description PIN
1.411 AC US HWY 158 5749270227
Property Values
Building: 64,97
BXF: 1,4801
Land: 17,90
Market: 84 35
ssessed: 84,354
Deferred: cl
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00407 0957 02 2002 WD Unqualified Improved 39,500
00492 0881 06 2003 WD Unqualifled Improved 16,500
00557 0963 06 2004 WD Unqualified Improved 30,000
01012 0638 02 2016 WD Unqualified Improved 28,000
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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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/itsnettView.aspx?prid=1473649 6/14/2016