3567 Hwy 601N2, '.:: ,p ) :'.: .. :' y ... ' i _. •t:.: ..s �._.. .... i.,tt � i., ..,.s r �" _„ _; ♦tea «.a^K s.. L ...N .. „'<
Pr mittce't; ' �� DAVIE, COUNTY HEALTH DEPARTMENT
rl:Name: ' ;� � ' �-t�` �. Environmental Health Section AOPERT INFORM -A110
P.O. Box 848' G
Directions to property: L ` i /1 .T Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
[^� t_..t j 1 v,a.. AV l h, Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM 6NSTRUCTION -
AUTHORIZATION NO: ti p Road®® j1o+)'! �f1%� • Zip:��
,
:4 **NOTE** This Authorization for Wastewater Sy stem 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.
(In compfi wi Article `i 1 of G a�pter 130A, Wastewater Systems, Section'. 1900 Sewage Treatment and Disposal Systems)
f . ***NOTICE***.THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
j' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVI NT HEALTH SPE LIST DA E ISS ED
RESIDENTIAL SPECIFICATION: BUILDING TYPE�J'`t # BEDROOMS \ # BATHS " # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE j� )# PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY "" "' " ` I �% DESIGN WASTEWATER FLOW (GPD) NEW SITE - REPAIR SITE
SYSTEM SPECIFICATIONS:. TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH r! o ROCK DEPTH 12- LINEAR FT.
Ovo
OTHER I '1>'5Tir'16J'fi103
c
REQUIRED SITE MODIFICATIONS/CONDITIONS: �j
� TAIL t?^� - ` "*�* �f-IF'.�%+ 5t/ faor - Wa),
**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 (336)751-8760.
ti
OPERATION PERMIT
T - Mj a.1,tay �Q, SYSTEM INSTALLED BY:
y3y'To7at_ lirtic3to'Xt7,
tWr,' B�iTn F��J ISr+ y co✓
AUTHOA ON NO. SSI004 "OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT T S TEM DESCRIBED Aa 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.
DCHD 02/02 (Revised)
L)` 3
• DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION��
�`^ ((APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME L Ic��1�I .L�11� PHONE NUMBER
ADDRESS ��ln� `�� N SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED S NAME SYSTEM INSTALLED UNDER
TYPE FACILITY r� NUMBER BEDROOMS Z NUMBER PEOPLE SERVED 7
TYPE WATER SUPPLY Cevn)W SPECIFY PROBLEM OCCURRING
DATE REQUESTED 27 INFORMATION TAKEN BYM
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
Parcel #: E30000006501
Davie County, NC - Basic Estate Search
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Parcel #:E30000006501 Account #: 59436000
Owner Information
Building:
Tax Codes
BXF:
RATLEDGE JOHN DAVID
Land:
ADVLTAX - COUNTY T
Market:
182 RALPH RATLEDGE ROAD
ssessed:
FIREADVLTAX - FIRE TAX
Deferred:
MOCKSVILLE NC 27028
Property Information
Township
Land (Units/Type): 1.330 AC
CLARKSVILLE
[Address: 3567 N US HWY 601
Deed Information
Local tonin
Pate: 12/1985 Book: 00129 Page: 0289
Plat Book: Page:
Legal Description
PIN
1.451 AC HWY 601
5821072622
Property Values
Building:
3615
BXF:
Land:
19,70C
Market:
55,85C
ssessed:
55,85C
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
L 00125 0806 02 1985 WD Unqualified Vacant 0
Z 00129 0289 12 1985 WD Unqualified Improved 0
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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/itsnettView.aspx?prid=1462787 8/23/2016