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Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRICTION
(Issued in compliance with Article 11 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.***
DATE %��9��5 AUT}ORIZATION NUI 3
NAME ER
N2 008
NAME ON IMPROVEMENT ��PjjERMIT 11f different than above)
SITE LOCATION i+l �l '�� /Z -!r 11,W1,L
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
*#*NOTICE*** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
4
DAVIE COUNTY HEALTH DEPARTMENT
Y' IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**MOTE** 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)
NAME PROPERTY ADDRESS DATE
LOCATION z5IV
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS _Q2_ # BATHS # OCCUPANTS � GARBAGE DISPOSAL: Yes
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY_ DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
/d0
SYSTEM SPECIFICATIONS: TANK SIZE,&& GAL, PUMP TANK GAL. TRENCH WIDTH,, 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 MAST
SEE; THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BY
�d
**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
SYSTEM INSTALLED BY
la u"
/(
AUTHORIZATION N0. ' OPERATION PERMIT BY Aal 1 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
GRANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FORANYGIVEN PERIOD OF TIME.
DCHD 10/95
DAVIE COUNTY HEALTH DEPARTMENT G
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 ,tisystem_or the issuance of a building permit.
(In compliance with Article 11 of G.S. Ch4ter=130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAMEjfJJ,,f r',¢�P�*/ PROPERTY ADDRESS DATE
LOCATIONtv
,:'� ';/ S '�;�fv ��✓.
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE %t , # BEDROOMS y # BATHS [_ # OCCUPANTS GARBAGE DISPOSAL: YesITo,
COMMERCIAL. SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) 02.1 FEW SITE REPAIR 5ITE(/'
/00
SYSTEM SPECIFICATIONS: TANK SIZE ,2 /i GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ,r/ LINEAR FT.
OTHER
REOUIRED SITE MODIFICATIONS/CONDITIONS:
4` *"THIS PERMIT IS SUB
SEE THIS PERMIT BE
i
+j.
IMPROVEMENT 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 10-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
1
OPERATION PERMIT SYSTEM INSTALLED BY
l
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 430A, SECTION .1900 'SEWS:?REATMENT 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.
DC
SID 10/95-:-,,`,-
u
`A
i
+j.
IMPROVEMENT 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 10-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
1
OPERATION PERMIT SYSTEM INSTALLED BY
l
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 430A, SECTION .1900 'SEWS:?REATMENT 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.
DC
SID 10/95-:-,,`,-
Parcel #: G500000117
Davie County, NC - Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search 0
View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: G500000117 Account #: 8305328
Owner Information
Building:
Tax Codes
BXF•
LONG LEAH FAITH & LONG BRADLEY ALAN
Land:
ADVLTAX - COUNTY T
Market:
234 NC HWY 158
ssessed:
READVLTAX - FIRE TAX
Deferred:
MOCKSVILLE NC 27028
Property Information
Townshi
Land (Units/Type): 7.440 AC
MOCKSVILLE
ddress: 2234 US HWY 158
Deed Information
Local Zoning
Date: 07/2015 Book: 00996 Page: 0737
Plat Book: Page:
Le al Description
PIN
7.43 AC HWY 158
5840305340
Property Values
Building:
32 25
BXF•
Land:
90,16C
Market:
122,41(
ssessed:
122,41C
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 2007E 0296 11 2007 WL Unqualified Improved 0
Z 2013E 0340 10 2013 EF Unqualified Improved 0
3 00996 0737 07 2015 WD Qualified Improved 140,000
View Property Record for this Parcel View Map 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,
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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/itsnetlView.aspx?prid=1455710 6/8/2016