2296 Hwy 601SDAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
REPAIR OPERATION PERMIT
Account #: 990001818
Billed To: Frederick Grant
Reference Name: REPAIR PERMIT
Proposed Facility: Residential Repair
ATC Number: 5926
Tax PIN/EH #: L510OA0005
Subdivision Info: ,
LocationiAddress: 2296 US Highway 601 S-27028
Ptoperty Size: 0.39 Acre
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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.
System Type: S.T. Manufacturer 2 Yl Tank Date Tank Size
Pump Tank Size Bedrooms
System Installed By: Ci tvInspector#: Dates6�L%Z.
GPS Coordinate:
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Environmental Health Specialist: Date:
DCHD 11/06 (Revised)
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DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990001818 Tax P]N,EH #: L510OA0005
Billed To: Frederick Grant SttfSdivisitin<lrifo: '
Reference Name: REPAIR PERMIT LocatiOniAddress 2296 US Highway 601 S-27028
Proposed Facility: Residential Repair-C]a1r,pair ❑Expansion
QI eerTh%N orization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
eat ection prior to.issuance of any building permit(s), (incompliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms_ # Bathrooms # People 2 Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size Type of Water Supply: bounty/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow (GPD) ,t1Q Tank Size^ L. Pump Tank GAL.
Trench Width _?fr�L Max. Trench Depth 3cn Rock Depth Linear Ft. 060'C?S%
Site Modifications/Conditions/Other: Lt ( ry
Contact the Davie County Environmental HeAlth Section for final inspection of this system between
8:30 — 9:30a.m. on the day of installation. Tel hone_# (336)751-8760
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' DAVIE OUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST
' /%
APPLICATION IP/ATC OSWW REPAIR
el
Name-a&drA S-�.�N<<P�' /'A Telephone Number
Address iD SUS (( &0/ S 470�
Mailing Address (if different from above)
Email Address:
Subdivision Name Lot #
Directions
Date System Installed Name System Installed Under
Type Facility Number Bedrooms Number People Served
Type Water Supply Specific Problem Occurring
Date Requested Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE, AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
Signature of owner or Authorized Agent
Initial Fee Date REHS
Revisit Charge Date Reason
Revised 2-2011
:# /m/
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y moo': DAVIEOLINTY ENVIRONMENTAL HEALTH SERVICE REQUEST
' APPLICATION IP/ATC OSWW REPAIR
Name, .1r4__ 'l l V A)kj,y &M4 Telephone Number
Address y�fta
Mailing Address (if different from above)
Email Address:
.Su`i`division NameLot #
Directions t y
Date System Installed Name System Installed Under-----
Type Facility Number Bedrooms Number.People Served
Type Water Supply Specific Problem Occurring
Date Requested Info Taken By
THIS IS TO CERTIFY THAT THE'INFORMATION PROVIDEIIIS CORRECT TO THE BEST OF MY
KNOWLEDGE, AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
' r
Signature of owne .or Authorized Agent
Initial Fee Date REHS'
Revisit Charge Date r Reason
Revised 2-2011
GoMAPS - Davie County NC Public Access
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WATERSHED STRUCTURES
WATER_BODIES
71 COUNTY_ BOUNDARY
ADDRESS
/ DRIVES
STREETS
RAILROAD -CENTERLINE
�. PARCELS
CiTY_LIMRS
BERMUDA RUN
F1COOLEEMEE
EJDAVIE COUNTY
MOCKSVILLE
nccountles
DAVIE
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***WARNING: THIS IS NOT A SURVEY!*** I
Monday, May 7 201
This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded
deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public
primary information sources should be consulted for verification of the information contained on this map. The
County and mapping company assume no legal responsibility for the information contained on this map.
O
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Isk
Parcel #: L510OA0005
Davie County, NC - Basic Estate Search
• Basic Search Real Estate Search Tax Bill Search Sales Search 0
View Property Record for this Parcel View Map
R
Parcel #: L510OA0005
Owner Information
REDMON STEPHANIE GRANT
296 S US HWY 601
MOCKSVILLE NC 27028
for this Parcel View Tax Bill Information
Account #:8304464
Tax Codes
ADVLTAX - COUNTY TA
FIREADVLTAX - FIRE TAX
33,04 0011
BXF•
4,50
Property Information
917
Township
nd (Units/Type): 0.400 AC
ddress: 2296 S US HWY 601
ssessed:
JERUSALEM
Deferred:
Unqualified
Improved
0
Deed Information
0609 12 2014 WD
Local Zoning
Date: 12/2014 Book: 00975 Page: 0609
Plat Book: age:
0
Legal Description
PIN
1 LOT HWY 601
5746235859
Property Values
uildin
33,04 0011
BXF•
4,50
nd•
917
Market:
4671
ssessed:
4671
Deferred:
Unqualified
Sales Information
No. Book
Page Month Year Instrument
Qual/UnQual
Improved
Price
L 00143
0505 01 1900 WD
Unqualified
Vacant
0
>_ 00193
0523 03 1997 WD
Unqualified
Improved
0
3 00975
0609 12 2014 WD
Unqualified
Improved
0
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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OPeViefc�'
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=1476160 7/21/2016