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' AUTHORIZATION NO: � 1 67 DAVIE COUNTY
HEALTH DEPARTMENT
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Environmental Health Section
:PROPERTY INFORMATION
Permit_fee`s :
f
P.O. Box 848
"
Name ; �.1altl
Mocksville, NC 27028
Subdivision Name:,
_.. _
Directions to property:`•�!�a�.�/�
Phone #: 704-63.4-8760. "
Section:
Lot:
AUTHORIZATION FOR
WASTEWATER
r`flLr�"cam`"r t'
Tax Office PIN:#%
- -
SYSTEM CONSTRUCTION
Road Name: bo N•
Zip: .4 710A F
**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/AuthorizationNumber should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 1 l .of G.S.- Chapter 130A, Wastewatery g Disposal Systems)
S stems, Section .1900 Sewage Treatment and Dis sal S s
LOW
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF. FIVE YEARS:.: `
ENVIRONMEN AL HEAL SPECIALIST:, , DATE ISSUED
DCHD 05/96 (Re%ised�
ate"" 9 �[� �✓� _
DAVIE COUNTY HEALTH DE ARTMENT s.
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Penluttee
Name",.��1 Subdivision Name:
t Directions to property:
Section: Lot:
IMPROVEMENT
4/ �. ' F+ PERMIT Tax Office PIN:# - -
'""1 8r7
�+ Road Name• 6 / 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
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*** TIIIS PERMIT IS SUBJECT TO REVOCATION IF SITE
,e.1 r` PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEAT SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE W # BEDROOMS V-# BATHS ,_ # OCCUPANTS GARBAGE DISPOSAl1: 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) 2&61) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZEGAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTHC� LINEAR FTl--3 �� 1
OTHER A49
)
REQUIRED SITE MODIFICATIONS/CONDITIONS:
r
,! ' ! d ..` •ani r•,.... *..,.
IMPROVEMENT PERMIT LAYOUT `� r
.17 . .
*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. .
SYSTEM INSTALLED BY: �
H LYl,+• n, �UnU.� '
a..
100
0
0 01
1T QDI Lo -Djf
._ r
AUTHORIZATION NO. ��� OPERATION PERMIT BY: t v
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEE STALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BETAKEN ASA r
ti GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANYGTVEN PERIOD OF TIME. r
z�{ DCHD 05/96 (Rev�sedZ
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME We l PHONE NUMBER *q - � 0
ADDRESS 3 u 5 4W X 6 0 �' SUBDIVISION NAME
Cj
70;? LOT #
DIRECTIONS TO SITE �o () %�• Z6 atAOF OAC, , �'''� i' • sem^- e-` / h t.AA 4-p—
r J. ►f be -,&h n Cil '-Ka _
U -r�► o d -q -d- w-- C-1 T
DATE SYSTEM INSTALLED ► SNA E SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED �-
TYPE WATER SUPPLY CBw►—�i'��. SPECIFY PROBLEM OCCURRING
DATE REQUESTED % % INFORMATION TAKEN BY L7�
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. 1/93
ijvx
Parcel #: F300000054
Davie County, NC - Basic Estate Search
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Parcel #: F300000054 Account #:37884000
Owner Information Tax Codes
HOWELL INA MAE ADVLTAX - COUNTY T
187 US HIGHWAY 601 NORTH FIREADVLTAX - FIRE TAX
MOCKSVILLE NC 27028
Property Information
Township
75,47
nd (Units/Type): 1.650 AC
CLARKSVILLE
Land•
ddress: 3187 N US HWY 601
Market:
Deed Information
Local Zoning
102,35
Pate: 10/1954 Book: 00056 Page: 0160
Plat Book: Page:
Le al Description
PIN
1.7AC HWY 601
5811926690
Property Values
Buildin
75,47
BXF•
3,03
Land•
23,85
Market:
102 35
ssessed:
102,35
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00056 0160 10 1954 WD Unqualified Improved 0
View Property Record for this Parcel View Mao 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/itsnetfView.aspx?prid=1463415 8/18/2016