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AUTHORIZATION.NO: ifADAVIE COUNTY;HEALTH DEPARTMENT'
Environmental Health Section " PROPERTY INFORMATION
" .Permihee sr P.O.Box 848
-Name: L•Vlr� ECCI.�� Mocksville,NC 27028 Subdivision Name:
u N� .�. Phone# 36-751-8760
ctionsto property:. S�om.'
Section: ' Lot:
- AUTHORIZATION FOR
r WASTEWATER • G+
T1� c�aJe ' " SYSTEM CONSTRUCTION , . Tax Office PIN:#7.991 ' .oS3d,ao�
QrJ Road N ,.-y t�1�� <1 s� Zip:
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Envtronmental 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.
(In compliance with Article 11 of 53.S.Chapter 130A;Wastewater Systems,'Section.1900 Sewage Treatment and Disposal Systems)
' y f
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR PERIOD OF FIVE YEARS.`
NVIRONKIiNTAtALTH SPECT LIS DATE ISSUE
"'4.+:.i-i.� � � f = • i 5v `w..i k. +b'y^i_'t r�F{ ti 'in • .S.y�.Tyr Y-. 't+e'. v'n. -.i'-o b..�V� �F/..r.-..,.- -:- • r �(�.._. /�...-_ - .-,
I ADAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Name:' IY�� LV1rA -ECC tx;< Subdivision Name:
y
ll G 2•-
a151recdons to property: I I ( I�•• �I: Section: =s� G Lot:
r IMPROVEMENT
PERMIT. Tax Office PIN:# II - 16// ,QS�U.d0
C:IJ i.t�: ��, Road Nab` {' t s1� -� Zip:
**NOTE**This Improvement Permit DOES NOT authorizethe 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
constructiorAmstallation of a system or the issuance of a building permit.
(In compliance with Article 11 ofP.S..Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS PERMIT IS SUBJECTTO REVOCATION IF SITE
^ PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
` '"'ENVIRONME HEALTH SPECI LIST}" DATE ISSUE SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE 1403 25�#BEDROOMS Z #BATHS�_#OCCUPANTS GARBAGE DISPOSAL:Yes bio
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPI-yrn ' I DESIGN WASTEWATER FLOW(GPD �`7 .NEW SITE REPAIWSITE li"'
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH 361 ROCK DEPTH �_ LINEAR FT.
OTHER-1-
REQUIRED
THER REQUIRED SITE MODIFICATIONS/CONDITIONS: I��l nLI. t?� y ►` K-(1�:1" 0� Drt= r L •��
IMPxovEmENTPERMrrLAYOUT*APPROVED EFFLUEIIT FILTER& *RISER(S) IF fi'• DELZV FIIIIStIED GRADE}
, D
rOL,"rJcs
T7,
s�aMt'
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECT3IMSYSTEM
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE 483UKWSUU.60
-
OPERATION PERMIT
SYSTEM INSTALLED BY:
4eo'
PP
51,
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: 5
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS DESCRIBED AB HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 SATISFACTORII.Y FOR ANY GIVEN PERIOD OF TIME:
DCHD 05/96(Revised)
�' ti��,7+CW�C•8ktt +l•.w/'`�•i���"T��' ..c}'8,7-vt'�Yr�t{4•tX.�G � -.r'3..vi {i .�� t .. Si'•l. .ih f ._�, -:+ n'i, f-.-f r^ii °v.d°i- - - •!'.'v.
G" D�'r�'°i.3•'7"yc-�r,f..•VJ .r.•"t_,1 p4 r`4"`'1^t•E'�•`#x_viwscYm t' rxLk.�, w. w r�`�
s-,r �_ p• i.,• ��
F 0 3 7 DAVIE COUNTY HEALTH DEPARTMENT --
;.. IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Per nitt�e's
Name: Subdivision Name:
.�
;;'birections to property: lit'J Y I ,-- Section: -'r1' Lot:
' ;"• � . r !-'R � ,�'.r'r�t, � PERMIT IMPROVEMENT �' /
i' "� �'�^'1 � , , �_�• Tax Office PIN:#('X99 _ E / 1JS�d,M-4c
R tt
Road Name C' x�'tl �+ � Zip:
**NOTE**This Improvement Permit DOES NOT authorize the constriction 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)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIl2014MENTAL HEALTH SPECIALISTDATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE-n 01 BEDROOMS_ #BATHS�_#OCCUPANTS—:7— GARBAGE DISPOSAL:Yes q No>
COMMERCIAL SPECIFICATION: FACILITY TYPE l� #PEOPLE #PEOPLF/SHIF F (� #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPP'L /DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE L--
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH-t�' LINEAR FT.
OTHER-1- ST IC-I►J 1�T�U� .%I S}• 4'p 2
REQUIRED SITE MODIFICATIONS/CONDITIONS: Ll_ ,"i Gt,�To II`` CO, 'S e%1• L x.-16
IMP$OVEMENTPERMITLAYOUT*API'I DVF-D CMUE11T FILTER& *R11S1 R(S) IP r,,- BE=
67
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPEC1fSSYSTEM
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE Go
• t
OPERATION PERMIT
1 �
SYSTEM INSTALLED BY:
Feu'•-�" �'�S-�'Onl��i:�� .
L X51
ib
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: S . c'
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS DESCRIBED AB 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.
w
DCHD 05/96(Revised)
_>r
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
r APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME �V1N'L✓�N CGGL�S PHONE NUMBER � g�
ADDRESS SUBDIVISION NAME
` n rJ
LOT #
DIRECTIONS TO SITE ,a YAS-L � Q-A CSC lop
DATE SYSTEM INSTALLED QS�'NAME SYSTEM INSTALLED UNDER Gc570- �"(),O A J7
ti
TYPE FACILITY OV S NUMBER BEDROOMS NUMBER PEOPLE SERVED Z
TYPE WATER SUPPLY � SPECIFY PROBLEM OCCURRING "L✓ ''��
DATE REQUESTED44�__
INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am re ible formil charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGEN
Rev.1/93 (.1P^" s
so
�-
Parcel#: E700000006 Page 1 of 1
oA f�
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Parcel#:E700000006 Account#:8300173
Owner Information Tax Codes
ERINE REBECCA R&THOMPSON RUTH M ADVLTAX-COUNTY TA
230 HIGHWAY 158 READVLTAX-FIRE TAX
DVANCE NC 27006
Property Information Township
nd(Units/Type): 0.290 AC FARMINGTON
ddress:4230 US HWY 158
Deed Information Local tonin
Date: 03/2011 Book: 00854 Page: 0134
Plat Book: 0003 Page: 078
Legal Description PIN
312 AC HWY 158 5861262855
Property Values
Building: 46,4001
BXF• 2,1801
Land: 13 0
Market: 61 5
ssessed: 61591
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00423 0213 05 2002 WD Unqualified Improved 40,000
00598 0704 03 2005 WD Unqualified Improved 0
00778 0174 12 2008 TD Unqualified Improved 70,000
00792 0787 05 2009 WD Unqualified Improved 42,500
2007E 0260 09 2007 WL Unqualified Improved 0
15 00854 0134 03 2011 WD Qualified Improved 63,000
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/itsnet/View.aspx?prid=1465057 6/14/2016