1773 Hwy 601S,�',.:' "f i ;� w'i�"A,�i ki +.r , k � .. -^^., ..:,.;-v : ..w•.' �: F. �� � s - _.: n. .. ...: ��w,:'6:: -...v ti� : �;;�
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� AUTHbRIZATION NO ' j � � �� DAVIE COUNTY HEALTH DEPARTMENT; .� . '�'� ,...,,. '
• Y � '• - PROPERTY-I OR ION'�
, ` Environmenfal Health Section �...-_-��
� , - Perm�ttee' � ` n i� � ;,,.� � , , P.O.>Box 848 , •
" Name: .' ��� �Y W�Z ��`���-. ,_#� Mocksville, NC 27028 Subdivision Name:
` : . ` . � ` ' . .Phone # , 336-751-8760 '
Directions to property: � �-� �.�� �� � ' ' ° ' ' ` ` Section�' LoL•
'�- AUTHORIZATION FOR . �
� � �1��,'j"' , �,.� ir.� rLt�.:�G � � (�. WASTEWATER Tax Office PIN:# _
.
, # (, . , . SYSTEM CONSTRUCTION ,
r
, ; 77� ' i�l�l �� , Road �Na��: N �Y (�t?lS Zi}i:2�c�2: F�
'' **NOTE** This,Aufhorization for Wastewater.System Construction MUST BEISSCTED by the Davie County Environmental Health Section prior
' x� issuance of any BuildingPecnuts. ThisFomi/Aufhorization Number should be presented to the Davie Counry.Building Inspectioris`
Office when applying for Building Permits. .: � " '•
�' (In complianc�e, w� � ide'11 G.S. Chapter 130A, Wastewater Systems,�Section .1900 Sewage Treatment and Disposal Systems)
�'"�: � ,, • ***NOTICE*** THISAUTHORIZATION FOR WASTEWATER CONSTRUCTION
'' �� * i� ,'�,,,� �jy IS VALID FOR A PERIOD OF FIVE YEARS. -
NVI ENT L HEALT SP LIST, :� DATE ISSUED ,
. � , ' . ._ "` . , . .,
DAME COUNTY HEALTH DEPARTMENT
� s , IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
.: Permittey's Y.
Name:`i ~� "' `� I��t 7- Subdivision Name:
r r ' Directions to property:' r tM Section: Lot:
IMPROVEMENT
r, j PERMIT Tax Office PIN:#
177:z�'e;N IL .),qf:t'$ Road Ne: iAtr�'►'l.�i'1'�S Zip:C'�c� ,
**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
constiuction/mstallation of a system or the issuance of a building permit
(In compliance with Article 11 f G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
/ j
,. ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
�• ?;<;, _�,.. t •. •.-" ' 12 ,'�. ? PLANS OR THE INTENDED USE CHANGE. YOUR US WASTEWATER
-� — SYSTEM CONTRACTOR MUST SEE THPERMIT BEFORE
ENVIRONMENJ' t HEALV SPECIALIST DATE ISSUED
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE,.t1USf # BEDROOMS L GARBAGE #BATHS �_ #OCCUPANTS 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 SITEit
✓
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ? 2 ROCK DEPTH _ Z� LINEAR FT. 1190
OTHER ' -T
REQUIRED
La1JT�t�•� �a
REQUIRED SITE MODIFICATIONS/CONDITIONS: (L) 00 PQdp(--ct( o jc V-G -t s' UGC F}thi;
IMPROVEMENT PER MIT LAYOUT *APPROVED EFFLUENT FILTER* •SFR4S F 61 1. BELOW FINISHED GRADE*
SQL` i7
uj
2i��
u3e
�ls�
X la'
l F�"3 T
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
r BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS I3&$ W4M6W
(336)751-8760
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A I
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
ja
.J'kY�-diy ,(z..+v.' rT+v."¢•-i,C"+,,,.".s`i"P%+�c.�rwrr.Y'°a3a.:."nwai.""i Y"t.v`:•ti�;•ti `�:'-:"r{iy +.Rr..+A-� ...:»h � �" � ":i"`, •., x�;:"� t�:.-. -� '� r�`r..•t x s-•�:fv*3 a
ry M
J 6A DAVIE COUNTY HEALTH DEPARTMENT 1 `
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
,• 5
Perm
-Name:
Subdivision Name:
Directions•to property: .t �' f.;.I'1 Section: Lot:
IMPROVEMENT
�:.'-} �_'� s ►, G PERMIT Tax Office PIN:#
f i.7:; P -I IL Road Name: 1 t':' (,}, ;t `4 Zip:�.h `/i_> r
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of aseptic 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 1.1 f G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
M ***NOTICE*** TILS PERMIT IS SUBJECT TO REVOCATION IF SITE
G-'��' , , I ��s j j PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRpIVMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
j INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE u(3SG#BEDROOMS-25'_ #BATHS �_ #OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
`,IAT SIZE TYPE WATER SUPPLY o Y DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ._X n ROCK DEPTH LINEAR FT. �$U
s
OTHER 4 l5- CA 4a l%T 10,j 12�, o yL
REQUIRED SITEMODIFICATIONS/CONDITIONS: Kur—t` ' �f� t oPurty o,3 �LG�C �� 4,44al 0,E t..
IMPROVEMENT PERMITLAYOUT*APPROVED EFFLLENT F IL
r
F 6" BELOW FINI%ED Gitl
�Iu�S�'
to
"CONTACT A REPRESENTATIVE OF THE DAVB3,COUNTY HEALTH DEPARTMENTFOR 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 6945 75"A `t
(336)751-8760
SYSTEM INSTALLED BY: � � uL Q 2
xx
(V
Ao
SIr
i -0J5(5-
�/
AUTHORIZATION NO. `� OPERATION PERM Y:
THE ISSUANCE OF THIS OPERATION PERMIT SHAL INDICATE THAT TH S TM DEP;CRIBEI) ABOVE HAS ITcINSTALLED iN COMPLIANCE
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENTANI D �PbSAL SYSTEMS", BUT SHALIi IN NO WAY BE TAKEN ASA
GiJA7FA TE THAT THE SYSTEM WELL FUNCTION SATISFACTORILY FOR ANY G., N PPRIOD OF TIME.
DCHD 05/96 (Revised)
2
a
,
3t
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
WORKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT
NAMPHONE NUMBER ���—J�✓�
ADDRESS SUBDIVISION NAME
.2 20.0
SUBDIVISION LOT # ,D
DIRECTIONS TO SITE // �vG/-r ; �`/ /r1/l� /`OaSl- /�� / X4
--2 12-1 //,"
DATE SYSTEM INSTALLED
NAME SYSTEM INSTALLED UNDER 9 //
SPECIFY PROBLEMS OCCURRING �� /i &Ipw � ► 7'<91��'
DATE REQUESTED �2'�9-� INFORMATION TAKEN BY%'/� -
Parcel #: K5150A0009
Davie County, NC - Basic Estate Search
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View Prooertv Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: K51SOA0009
Account #:47600000
Owner Information
Tax Codes I
60,71
MARTINEZ JOSE HERNAN& MARTINEZ MARIA A
ADVLTAX - COUNTY TAX
Land:
1773 HIGHWAY 601 SOUTH
READVLTAX - FIRE TAX
75,710
MOCKSVILLE NC 27028
75,710
Property Information
3 00208 0134 12 1998 WD
Township
nd (Units/Type): 0.700 AC
Vddress:
66,000
JERUSALEM
1773 S US HWY 601
Deed Information
Local Zonin
ate: 12/1998 Book: 00208 Page: 0134
lat Book: 0001 Page: 097
Le al Description
PIN
OTS 33-34 R P ANDERSON
5747100491
Property Values
Building:
60,71
BXF:
2,000
Land:
13,000
Market:
75,710
ssessed•
75,710
[Deferred:
3 00208 0134 12 1998 WD
Sales Information
No. Book Page Month Year Instrument
Qual/UnQual
Improved
Price
1 00141 0275 12 1987 WD
Unqualified
Improved
18,000
2 00154 0018 04 1990 WD
Qualified
Improved
18,000
3 00208 0134 12 1998 WD
Qualified
Improved
66,000
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/itsnet/View.aspx?prid=1471648 8/3/2016