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- , DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Subdivision Name:
Directions to property: 11�. -4, Section: Lot:
I • "ti. "-` ( IlIIPROVEMENT
PERMIT Tax Office PIN:#
N 7.1�
Road Name: CJS• Zip: 70013
**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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
% W ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
/.; r 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 # 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) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK S 2 �ZL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ,,?'V' t LINEAR FI':l.Srd /
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) 634-8760.
x
AUTHORIZATION NO. ,27b�, OPERATION PERMIT BY: _ 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.
DCRD 05/96 (Revised)
s :'r y4 sf*y__.it >� K- A 7;., ...g c �-:. is ti+ s� < - i r = y,'y� .._, ;. _-.. _gi'rt. a . ;yi.t,.:�i'�•., `�.t.> ' „ Vy
A
!
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
. .Penrutt�ce's
Subdivision Name:
�+'�. �►
:`Directiorrs to"property: '.� � F� �F'� r` . Section: Lot:
IMPROVEMENT
"F ` PERMIT Tax Office PIN:#
/g7. o��+
3 Road Name: �.3 % Zin: oC i ry 49A X
**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
::: "".; ; 1, /° , 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 _ # BEDROOMS .2 # BATHS —/— # OCCUPANTS oZ GARBAGE DISPOSAL: Yes or No,
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFIP# SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE.
r
SYSTEM SPECIFICATIONS: TANK 5�AL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR
- 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
f `
SYSTEM INSTALLEDBY:'
4,
X S'x/9 "
AUTHORIZATION NO..O 76 j OPERATION PERMIT BY: 1 � DATE: S/ -2d
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE -1 I 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)
t Q, •�
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
//��
/=�,
WORKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT
NAME oxz,-id PHONE NUMBER
ADDRESS -3 6 L SUBDIVISION NAME
/n
n SUBDIVISION LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED
NAME SYSTEM INSTALLED UNDER
SPECIFY PROBLEMS OCCURRING
DATE REQUESTED�� INFORMATION TAKEN BY
Parcel #: K515OA0016
Davie County, NC - Basic Estate Search
`Basic Search Real Estate Search Tax Bill Search Sales Search
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Parcel #: K51SOA0016
Account #:72164000
Owner Information
Building:
Tax Codes
BXF:
WAIN DAVID HOWARD & SWAIN IVA NELLE
Land:
ADVLTAX - COUNTY TAX
Market:
1875 US HIGHWAY 601 SOUTH
ssessed:
READVLTAX - FIRE TAX
Deferred:
OCKSVILLE NC 27028
PropertV Information::9
Townshi
Land (Units/Type): 8.790 AC
JERUSALEM
ddress: 1875 S US HWY 601
Deed Information
Local Zoning
Date: 05/1968 Book: 00078 Page: 0552
fat Book: 0002 Page: 086
Le al Description
PIN
LOTS 1-18 + 83-91 FOSTER
5746193185
Property Values
Building:
90,90
BXF:
2,49
Land:
83,95
Market:
177 34
ssessed:
177,34
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00078 0552 05 1968 WD Unqualified Improved 0
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
I`< Return to Basic Search
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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=1458929 7/29/2016