2185 Hwy 601SU
Penriittee's DAVIE COUNTY HEALTH DEPARTMENT
Name: Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions to property: Mocksville, NC 27028 Subdivision Name:
AUTHORIZATION NO:
Phone #: 336-751-8760
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION -
002570 A
Road Name:-" 1r� %1'=1'r �"C'l C Zip:
**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.
Gln compl ance with ArticleJl Lsf 6A-<hapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE AY) �G' # BEDROOMS 3 # BATHS -- # OCCUPANTS 7 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE -��PE WATER SUPPLY cfti%DESIGN WASTEWATER FLOW (GPD) 3 (c0 NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL PUMP TANK GAL. TRENCH WIDTH' ROCK DEPTH N LINEAR FT.
OTHER l�`l_�ll �-n1 n i � � (, 3 L.uv� ��L11t:,� 1 t T C , (-"L)-( 10 J -Mk'
REQUIRED SITE MODIFICATIONS/CONDITIONS: V -C `1 `� "� F F `r ` L ' .3 i ` S G 1* (= E "�o J��= , Vtf /6' Fi10w..
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IMPROVEMENT PERMIT LAYOUT
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11 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. 1
OPERATION PERMIT
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iYSTEM INSTALL�3Y:
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AUTHORIZATION NO. OPERATION PERMIT BY- D DATE: C' Q�
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THA H Y RIBE A E HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATME ND 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 oast (Revisaa)
r errtlttee's }l1 1 E ; i
DAVIE COUNTY HEALTH DEPARTMENT
lNarrse '• ? "' ` '' `° Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions=to.property: (I Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
" + Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION - -
``AUTHORIZATION NO: 002570 A Road Name:"-/ ~' ,+j' -' " / J� Zip: �
**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 cgrpplianc/with Articlq l l.of-G-S-Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r"
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIROWEN—TALC—HEALTH SPECIALIST DATE ISSUED—
, W
RESIDENTIAL SPECIFICATION: BUILDING TYPE f ( c # BEDROOMS 5 # BATHS # OCCUPANTS 1 GARBAGE DISPOSAL: Yes or1No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
,
LOT SIZE �7 �• IPE WATER SUPPLY 1 `vrti7� DESIGN WASTEWATER FLOW (GPD) % NEW SITE REPAIR SITE ✓
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH - ROCK DEPTH N C LINEAR FT
OTHER f`L
REQUIRED SITE MODIFICATIONS/CONDITIONS: ` `' `"� f i i `� ` r L "t
IMPROVEMENT PERMIT LAYOUT
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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 PERMITGSXS EM II S ALLF,RBY:
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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 PERMITGSXS EM II S ALLF,RBY:
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AUTHORIZATION NO. 2:5, 3ON OPERATION PERMIT BY DATE: q O7
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THA H Y RIB A E HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATME D DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. s
DCHD 02_!02 (Revised)
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AUTHORIZATION NO. 2:5, 3ON OPERATION PERMIT BY DATE: q O7
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THA H Y RIB A E HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATME D DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. s
DCHD 02_!02 (Revised)
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IMPROVEMENTS PERMIT 'AND .CERTIFICATE OF COMPLETION
.' *NOTJ=-:Issued in Compliance With Article II of G.S. Chapter'130a
f` Sanitary Sewage Systems
Per
Name r�, �' `c�. .. •
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Locatio
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Subdivision Name
Lot No.
Sec. or Block No.
Lot Size ') �'� X �- "° House Mobile Home:•— Business Speculatio
N0.?Bedrooms r No. Baths No. in Family 4 _ Vation
Garba� a D•is ! osal YES. ❑ NO [B"
'
g pSpecifications for System: tly
Adio Dish`•Washer YES p' NO ❑ !U
Auto,Wash Ma phine - YES V NO ❑
....Type Water Supply
*,This permit Void if sewage,sy stem described below is not installed within 5 years from dale of issue.
This permit Fis subject to revocation if site pl ns or the intended use change.
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`I-mproverlierits permit by`
'Contact arepresentative 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 day of completion. Telephone Number 704-634-5985.
Final Installation Diagram System System Installed by
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�. Certificate of Completion Date
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u ;»The signing of this certificate shall indicate'thatthe system described above has been. installed..in,compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
3tisfactorily for any given period of •time.
A4-4, &,,i „„l <O B,G (jA aw
rJfry --,—
y DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
• APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
S�, L
PHONE NUMBER
ADDRESS G S 10 %e01 S SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER "U—q H, --``.2,S
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLYTY SPECIFY PROBLEM OCCURRING
9p V
� A-8DATE REQUESTED INFORMATION TAKEN BY
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 #: L5100B000101
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
.I
Parcel #:L5100B000101 Account #:8302813
Owner Information
uildin :
Tax Codes
BXF•
ILLARD LISA WALLER
Land:
ADVLTAX - COUNTY T
arket:
185 US HIGHWAY 601 SOUTH
ssessed:
FIREADVLTAX -FIRE TAX
Deferred:
MOCKSVILLE NC 27028
0
1 00698 0490 01
Property Information
Qualified
Township
Land (Units/Type): 0.490 AC
1 00944 0869 11
JERUSALEM
ddress: 2185 S US HWY 601
Improved
140,000
Deed Information
Local Zoning
Date: 12/2013 Book: 00947 Page: 0773
Plat Book: Page:
Le al Description
PIN
1.48 AC HWY 601
5746158166
Property Values
uildin :
95,64 01
BXF•
12 13
Land:
19,80
arket:
127,57
ssessed:
127,57
Deferred:
Vacant
Sales Information
No. Book Paye Month Year Instrument
Quai/UnQual
Improved
Price
. 00164 0913 08
1992 WD
Unqualified
Vacant
6,000
! 00947 0773 12
2013 NW
Unqualified
Vacant
0
1 00698 0490 01
2007 WD
Qualified
improved
133,000
1 00944 0869 11
2013 WD
Qualified
Improved
140,000
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Page 1 of 1
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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=1470807 7/29/2016
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