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4629 Hwy 601Na:'}, AUTHORF.ATION NO: 0653 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permitte_ e's P.O. Box 848 Name:" '. illl t'r % �' Mocksville, NG 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property:' 4. Section: Lot:' AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION - W �f7/�� Zip: 270At, ,-Ro **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/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. - (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) t , ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. '. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUE15 �' H" Y;_'1 - P JG #_+ : _a_. '•lJ i'"'fi•s"q tro..r..R tYx.:-, cw ��i.? V� uu i 19 '•f4�t t` t ti'^. i, "R �+wt�-r r..•^ as r-, ^,i �vv'xlr..{`«w..i ✓.a''. .. �..dt'�'4.v.'A 4''B�v,)2'nj .� .g'.';=r R`� e `"� ' n. ✓'r�`y+ r r 't., X3'3 5it �" DAVIE COUNTY HEALTH DEPARTMENT _+ IMPROVEMENT AND OPERATION PERMITS . PROPERTY INFORMATION P - �' Subdivision Name: Direcrtions to property: �` % ,vim %�. " -. r"L+i-� Section: Lot: IMPROVEMENT ► .,� PERMIT Tax Office PIN:# - - 411 Road W.- o / zap: **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. (II 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 ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED .. SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE . INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE /V # BEDROOMS # 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) C;/;lO NEW SITE - REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ,ROCK DEPTH LINEAR FT. 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 (704) 6348760. OPERATION PERMIT SYSTEM INSTALLED BY: jF] Y rc' l AUTHORIZATION NO. v OPERATION PERMIT BY: it DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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 05/96 (Revised) � a•'NT+tc 4y, -S �.`-ifs.`%^-,-. ,xi.��} ti:ti... g .•.i¢. r �„�47, s. <,..,a .,. <5. ,}.t+ �-i ,, �^�u:. ,� tl"i�+1s.-Y'rt .�,:�. ... •r. -.r e'r-....i...w __v < -s<4�, -r: �:y.� �' t �` T DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION 4 Subdivision Name: Directions to property: Section: Lot: EWPROVEMENT PERMIT Tax Office PIN:# Road-70 ha 6: 100 !y • Zip: 0 0 9Y **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*** 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 16� # BEDROOMS 7 # BATHS I # OCCUPANTS --/—GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE �_ # PEOPLE # PEOPLE/SHIFT .���, ��jj��,# SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK (/ GAL. TRENCH WIDTH, ROCK DEPTH. LINEAR FT. X r, a i�• } V,�,� •..t: '"� "i,ii.. :'. ,� ick,: OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: P • "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. OPERATION PERMIT SYSTEM INSTALLED BY: Y AUTHORIZATION NO. 645 3 OPERATION PERMIT BY: 1/f`ti! / DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. mmij u3/96 (Kevised) 7 �,z NAME ADDRESS " G DIRECTIONS TO ® //Yr DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) i PHONE NUMBER /�� DIVISION NAME LOT # DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY NUMBER BEDROOMS .2 NUMBER PEOPLE SERVED TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING DATE REQUESTED INFORMATION TAKEN BY -.40 This is to certify that the information provided is correct to the best of my knowledge, and thpt I understand I am SIGNATURE OF OWNER OR AUTHORIZED AGENT, Rev. 1193 for all charges Incurred from this application. Parcel #: C300000049 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search \\Iew Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: C300000049 Account #:38199940 Owner Information Tax Codes ADVLTAX - COUNTY 7 FIREADVLTAX - FIRE TAX HUDDLE WILLIAM D 629 US HIGHWAY 601 NORTH OCKSVILLE NC 27028 BXF• Property Information Township Land (Units/Type): 1.090 Address: 4629 N US HWY 601 CLARKSVILLE 53,86( ssessed: 53,86( Deed Information Local Zoning Date: 03/2016 Book: 01014 Page: 0112 Plat Book: Page: Le al Description PIN HWY 601 38199940 Property Values Building: 36,65( BXF• 8 Land: 17,13( Market: 53,86( ssessed: 53,86( Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00178 0128 01 1995 WD Qualified Improved 40,000 2 01014 0112 03 2016 WD Qualified Improved 50,000 View Prooerty Record for this Parcel View Mao for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 O�eVsatct' riotA. 4: 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.claviecountync.gov/itsnet/View.aspx?prid=1460037 8/10/2016