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Permittee's DAVIE COUNTY HEALTH DEPARTMENT
Name: - 7 Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
,,s rte,.; f';.'J,..
Directions to property: �r.s Mocksville, NC 27028 Subdivision Name:
Phone #:336-751-8760
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
« SYSTEM CONSTRUCTION �s � W �/ (oO�S
AUTHORIZATION NO: 002682 A MoaDame: Zip:2,?y2-e
**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)
l ✓ r ! ! ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
-')` IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DARE
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 06 DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL TRENCH WIDTH ROCK DEPTH � LINEAR FT.3
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
II FOR FINAL INSPECTION OF THIS SYSTEM PLE jcff ALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. tl
t'k`r t II
OPERATION PERMIT 15 17- j�Afi)t?
SYSTEM INSTALLED BY
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AUTHORIZATION NO. ,G[ D� OPERATION PERMIT BY: D �� Y
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOV AS 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) 1-0 jlogy JkVVji�.51j 7 0�/
A;-0
P DAVIE COUNTY HEAL DEPARTMENT
Environmental,He PROPERTY INFORMATI N
P.O. Box 48
Direiqfio �o Mocksville, N 27028
fis _property:
Phone #: 336-701-8760
AUTHORIZATION FOR
WASTEWATER
t. SYSTEM CONSTRUCTION
AUTHORIZATION NO: 002682 A
Subdi.vi.s,ioq_Name:.
Section:
Lot:
Tax Office PIN:#
- '2 2,
Moa LUe:s11" &()"S Z2 -M
**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 I I of G.S. Chapter 130A, Wastewater Systems, Sectioq. 1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
'
00 16, IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DAfE ISSLJfD
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS. # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE" #PEOPLE/SHIFT_ #SEAT&" INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)�eb NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ____—GAL. PUMP TANK ,GAL :`TRENCH )WI'DTH ROCK DEPTH ,0k LINEAR FT
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
V
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE# IS (336) 751-8760.
OPERATION PERMIT
CS
ZS
AUTHORIZATION NO. OPERATION LUIN rr_XUv11 I BY:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THATT14E SYSTEM DESCRIBE �BO AS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I OF G.S. CHAPTER 130A, SECTION. 1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
THE SYSTEM WILL
GUARANTEE THAT FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 02102 (Revised) IN?
Z -q
SYSTEM INSTALLED BY Av-"
I LLQ
IV
Parcel #: L5010B0011
Davie County, NC - Basic Estate Search
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Parcel #:L5010B0011
owner Information
MITH PAUL DAVID & SMITH PAMELA T
1898 US HIGHWAY 601 SOUTH
MOCKSVILLE NC 27028
Property Information
Land (Units/Type): 0.590 AC
ddress: 1898 S US HWY 601
Account #: 67995630
Tax Codes
ADVLTAX - COUNTY TA
FIREADVLTAX - FIRE TAX
Township
JERUSALEM
Deed Information Local Zoning
Date: 08/1996 Book: 00188 Page: 0853
Plat Book: 0001 Page: 005
Le al Description PIN
OTS 27-30 DANIELS PARK 5746087751
Property Values
Building:
73,62CI
BXF:
Cl
Land:
1184
Market:
85 46
Assessed:
8546
eferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00188 0853 07 1996 WD Qualified Improved 65,000
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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=1467085 7/29/2016