2329 Hwy 601N* NOTE
Name
Locati
j
DAVIE COUNTY HEALTH DEPARTMENT J
IMPROVEMENTS PERMIT AND CERTIFICATE OF, COMPLETION i
Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
J %�i Date'' .. 4
Subdivision Name
Lot No. - Sec. or Block No.
Lot Size
House
Mobile Home — Business �''"� Speculation
No. Bedrooms No.
Baths _ _ No. in Family� s�'-
Garbage Disposal
YES
❑ NO1
.Specifications for System:
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES
YES
p NO ❑
t NO ❑
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements 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 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed by
Certificate of Completion ��� Date
*The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department v Q
Environmental Health Section O N�
P. O. Box 665
Mocksville, N.C. 27028 R
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN IISGSUED. C�
l Home Phone C/ (�� I'll,5� `
1. Permit Requeste y �' r Business Phone Skmf_
2. Address
3. Property Owner if Different than Above
Address
4. Permit To: a) Install %/ Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub -Division Sec. Lot No.
5. System used to serve what type facility: House Mobile Home Business
Industry Other
b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms Bath Rooms Den w/Closet
b) If Business, Industry or Other, State): umber persons served
What type business, etc. Kt- opl, ,
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes �� urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Public Private C mmunity
b) Has the water supply system been approved? YesV No
9. a) Property Dimensions �b� X�'� i f
b) Land area designated to building site • cl�0 A & J
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? _
10
What type?
This is to certify that the information is correct to e b t of my knowledg
3o --?7
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
w'I
mob -.A
'01WAIRIk oj_�j
3("� K;klp,
(2P.opuJy GJL'Y'vo
DCHD (6-82)
RL 5 NIA
9 VhL -
Wd GcJ — /✓oT 79k /'17�_
Name—
Address
FArTf)R.R
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
P. O. Box 665
Mocksville, N.C. 27028
y� SOIL/SITE EVALUATION
Date
Lot Size w
AREA 1 AREA 2 AREA 3 ARFA 4
I) Topography/ Landscape Position
9)
y
S
S
S
(p�
PS
PS
PS
`IT
U
U
U
') Soil Texture (12-36 in.) Sandy,
S
S
S
Loamy, Clayey, (note 2:1 Clay)
PS
PS
PS
U
U
U
1) Soil Structure (12-36 in.)
S
S
S
Clayey Soils
PS
PS
PS
U
U
U
�) Soil Depth (inches)
S
S
S
PS
PS
PS
U
U
U
i) Soil Drainage: Internal
S
S
S
p
PS
PS
PS
U
U
U
U
External
S
S
S
PS
PS
PS
J
U
U
U
Restrictive Horizons
Available Space
S
S
S
S
PS
PS
PS
7
U
U
U
i) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
Site Classification
,
U—UNSUITABLE
Recommendations/ Comments:
Described by _
SITE DIAGRAM
Fl.
DCHD (6-82)
S—SUITABLE PS—Provisionally Suitable
Title ��i� Date
Davie Corrrrty Neakii Department
n Norrre Nealt � A err
and 9 q
210 HOSPITAL STREET / P.O. BOX 665
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-5985
December 3, 1987
Stephen Pacitto
Rt. 6, Box 321A
Mocksville, NC 27028
Re: Site Evaluation
Mr. Pacitto:
On December 1, 1987, this office evaluated a .94 acre tract of land at
your request to determine the suitability of installing a septic tank
system.
The soil on said site is provisionally.suitable for the proposed
project.
Sincerely,
Rr-
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd
Enclosure
Parcel #: G30000003701
Davie County, NC - Basic Estate Search
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Parcel #: G30000003701
Account #:55052000
Owner Information
Tax Codes
ACITTO STEPHEN P & PACITTO THERESA F
ADVLTAX - COUNTY T
329 US HIGHWAY 601 NORTH
FIREADVLTAX - FIRE TAX
MOCKSVILLE NC 27028
Property Information
Township
Land (Units/Type): 1.170 AC
CLARKSVILLE
ddress:
Deed Information
[- Local Zoning
Date: 02/1988 Book: 00141 Page: 0866 .
Plat Book: Page:
Legal Description
PIN
1.17 AC OFF HWY 601
5820534192
Pro a Values
Buildin
BXF•
Land: 15,74
Market: 15 74
ssessed: 15 74
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00141 0866 02 1988 WD Unqualified Vacant 8,50b
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,
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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.daviecountyne.gov/itsneWiew.aspx?prid=1431429 8/23/2016