2271 Hwy 601Sk 2-7y `� 3
Permittee's DAVIE COUNTY HEALTH DEPARTMENT
. `7 � L. ' .r Environmental Health,Section ROPERTY INFORMATION
' .
P.O. Box 848`; ''�. `
D�ectionP
s to roperty.' Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
ZAII �;; ..7/t tr rJ Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
AUTHORIZATION NO:. A Road Name: 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 compliance with Article 11 of G& Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE**.* THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION `
IS VALID FOR A. PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
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 �1S DESIGN WASTEWATER FLOW (GPD NEW SITE REPAIR SITE
�V
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL TRENCH WIDTH �G/ 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 (336)751-8760.
DMD 02/02 (Revised \
LT�D,COUNTY ENVIRONMENTAL HEALTH SECTION \J
• APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAMPHONE NUMBER
OU
ADDRESS �- / lA S �� -s SUBDIVISION NAME_
LOT #
DIRECTIONS TO SITE "d / S 02 E -ss a 471 )"L
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER -7'
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED �Z-
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
-.,L--
DATE REQUESTED
.,L—
DATREQUESTED 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 #: L5 1001300 12
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Parcel #: L5100BOO12
Account #:82513406
Owner Information
BXF:
Tax Codes
Land:
CMANUS JOHN E& MCMANUS CHARLOTTE L
Market:
ADVLTAX - COUNTY TA
ssessed•
271 US HIGHWAY 601 SOUTH
Deferred:
FIREADVLTAX - FIRE TAX
Qualified
MOCKSVILLE NC 27028
104,000
Property Information
Township
Land (Units/Type): 2.780 AC
JERUSALEM
ddress: 2271 S US HWY 601
Deed Information
Local tonin
Date: 12/1999 Book: 00321 Page: 0082
lat Book: 0001 Page: 059
Le al Description
PIN
LOTS 4-5 + P O 3 GRANT
5746248511
Property Values
Bulldin :
93,57
BXF:
1,20
Land:
28 O1
Market:
122 78
ssessed•
122,78
Deferred:
3 00321 0082 12 1999 WD
Sales Information
No. Book Page Month Year Instrument
Qual/UnQual
Improved
Price
L 00126 0107 03 1985 WD
Qualified
Improved
42,500
i 00159 0568 06 1991 WD
Qualified
Improved
70,000
3 00321 0082 12 1999 WD
Qualified
Improved
104,000
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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/itsnet/View.aspx?prid=1479894 8/3/2016