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. :AUTHORIZATION NO. � �� � � �� DAVIE COUNTY HEALTH,DEPARTMENT �" . � � . .
`; y�' '� � � Environmental Health Section : PROPERTY INFORMATION .
`Perm�ttee's % / .�{ , � P.O. Box 848
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`Name. t�� ��,rj? .: , 4;.. Mocksville, NC 27028 Subdivision Name:
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; � � �� � ) ' Phone # :336-751-8760
Direcfions to property:.' -� '�!a a /L' •: Section: ' Lot:
AUTHORIZATION FOR
. / . WASTEWATER' , .
� � ' ""��'�'� �' _ ''� � ' ` SYSTF,M CONSTRUCTION::: " Tax Office PIN:# -
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� ' Road Name: Zip:
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**NOTE** This Authorization for.Wastewate� System Construction MUST BE'ISSUED by the Davie Counry Environmental Health Section prior
.'� °',', to issuance of any Building Perrnits. This Forn�/Authorization Number should be presented to the Davie Counry_Building Inspections
' Office when applying for Building Permits:
`(ln comp�iance with Article 11 of G.S. Chapter 130A;,Wastewater Systems, Section ] 900 Sewage Treatment and Disposal Systems)
//' � ' % ' � ***NOTICE*** TH1S AUTHORIZATION FOR WASTEWATER CONSTRUCTION
y 1� a� ,,/: . �� ., —.J�'-�I , '`' ,` � IS VALm FOR A PERIOD OF. FIVE YEARS.
`ENVIRONMENTAL' EALTH SP ALIST, :, DATE ISSUED
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�.8 6DAVIE COUNTY HEALTH DEPARTMENT
' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's,
Subdivision Name:
Directions to property:- d=1 i,�r s,'if�«1' Section: Lot:
_j
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name:Zip:
**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
constriictionlinstallation of a system or the issuance of a building permit
(In compliance with Article 11 of G.S. Chapter 130A; Wastewater Systems,ection .1900 Sewage Treatment and Disposal Systems)
S '
Jl { s ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM. .
RESIDENTIAL SPECIFICATION: BUILDING TYPE /7' # BEDROOMS Z # BATHS _ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY. TYPE # PEOPLE # PEOPLE/SHIFT „ # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE Y
SYSTEM SPECIFICATIONS:. TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH Al LINEAR FT.137
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"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 (702M41$ LXX
(336) 751-8760
DCHD 05/96 (Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) (1�
NAME PHONE NUMBERy
ADDRESS SUBDIVISION NAME D
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED ��y1s NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY Ca ewc-.•�`� �[ SPECIFY PROBLEM OCCURRING
DATE REQUESTED 3 Z-z1�-/, 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 responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1193
Parcel #: G30000005001
Davie County, NC - Basic Estate Search
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Vlew Property Record for this Parcel. ViewMapfor this Parcel View Tax Bill Information
Parcel #: G30000005001
Account #:82527640
Owner Information
Tax Codes
ADVLTAX - COUNTY T
FIREADVLTAX - FIRE TAX
LATHAM KEITH H & LATHAM LINDA L
509 US HIGHWAY 601 NORTH
MOCKSVILLE NC 27028
BXF•
Property Information
Township
nd (Units/Type): 0.810 AC
ddress: 2521 N US HWY 601
CLARKSVILLE
75 78
ssessed:
75,78
Deed Information
Local Zoning
Date: 03/2007 Book: 00702 Page: 0258
Plat Book: 0009 Pa e: 076
Legal Description
PIN
RACT 1 KEITH LATHAM S D
5820441995
Property Values
Buildin :
5617
BXF•
3,61
Land:
16,00
Market:
75 78
ssessed:
75,78
Deferred:
Sales Information
No. Book Page Month Year Instrument Quai/UnQual Improved Price
1 00186 0616 04 1996 WD Unqualified Improved 0
2 00702 0258 03 2007 WD Unqualified Improved 0
3 00170 0158 09 1993 WD Qualified Improved 55,000
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,
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=1462092 8/23/2016