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1967 Hwy 64E T�-t r t . x�. '.X:, .Y•"'�,-`-� •::�t I � -.-. �4�,o ��" J .. � .. � . ,. _ 7 ` .��, , �.,.. ,��,4r,t�, �. ..�.-k f 51 ,�.+�a': i,� .r . ,� ��.� .� :..- L✓�pi �..�..« ..�.,.�•. � .�r, . - ,'�'^ �1 ., :�j��� . ��� , ^ � ���DAV�r yCOUNTY HEALTH DEP T1�IE�1T ,, -�- .� - � (,�. � i. -s� a°�� � �°�'" ROVEMENT AND OPERATION P ITS PROPERTY INFORMATION � r�,-P�t����"' .��r�����w�� : �- , «- ' ?IaTam'e ;-�:.��/"!✓'f,�'��r..frl� � Subdivision Name: � � . . � , . , �-� ' . " — � ,.....- _ � �Dnect�oris to property ��„���ft� t'�'i:`.�"" _ . �'Sechon:� � Lot: . "", ��— - _:�VVIPROVEII�NT , .� � - . _. _ IP .. _-____. . , __--.-•- � - �`'.�,'i�y:; �. •'`v` .,',f w r �' /'� ' PERNIIT.�;i Tax Office PIN:# - - . '. � Road Name: Zip: # , , . . " **NOTE**This Improvement Permit DOES NOT authorize the construction or�installation of a sep6c tank system or any wastewater system:An ALTI'HORI7,ATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the " ; construction/installation of a system or the issuance of a building pernut. - (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems): � '�/,',� ,, ,..,�: �,�^ , ***NOTICE***THIS PERNIIT IS SUBJECT-TO REVOCATION IF SITE , � � ,��%��i''�r :�' `� .�").;-�"�`%� ;'�r•" S�/,�! PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER:. ENVIRONMEAITAL HEALTH SPECIALIST DATE ISSUED SYSTEM COIy_T�A,CTOR MUST SEE THIS PERNIIT BEFORE; - `INSTALLING Tf�SYSTEM. ' �'�; ,.,., '� , ;, „ ;:. ; ;, . ,. . . . � , RESIDENTIAL SPECIFICATION:BUILDING TYPE H #BEDROOMS�_#BATHS 2-- #OCCUPANTS � � GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLFJSHIFT #SEATS INDUSTRIAL WAS1'E:Yes or No '-LOT SIZE TYPE WATER SUPPLY �b DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE . �( " SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. :TRENCH WIDTH�C� ROCK DEPTH� LINEAR FI'. l�l� -0THER REQUIRED SITE MODIFICATIONS%CONDITIONS: nvtpxovEMErrrrEx�rrLAYotrr �pPPRQVED EFFLU ILTER� �RISERtS) IF 6t, �lELO�I FINIS3-�D CRAB��� � � ' ��1 ; - . ; : _ . � ` �. .i � **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FIlVAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON TH�DAY OF INSTALLAT'ION.TELEPHONE#IS(704)63$�bFSXX}fXX � � (336�751-876 , OPERATION PERMIT S M INSTALL�1�BY: - . � �e� ����/ _ � ��°�' _ _ . . � � . . , , _ � /�f� � � / � : AUTHORIZATION NO.�OPERATION PERMIT BY:�� � DATE: ���� �/ *'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SXSTEM DESCRIBED ABOVE HAS BE ALLED IN COMPLIANCE ' WITH AR'17CLE 11 OF G.S.CHAPTER 130A;SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT ALL NO WAY BE.TAKEN AS A GUARANfEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. , \ , , . ; •DCHD OS/96(Revised) i� • �' j ".,�� ,l� ... � :-�,, �:`. `c �— ��' . _. �. �:: ,L .�.�h.,.' .lt �f .�.,�:;i .,' ��.'ar,��.:F.' s,-.-.�.� ,t�.'=�"* r -1 ..y,,;,,::��.. .'p"{ 1�4� .�-1�.`, v :j. �r,�,..z,,y,t�.,a,ay.,,��+�,'u:� ..F,.�..:iV'-a°!�1ir.,i.��.+11,r"�7'f NyTr.����f�" '��0. _ � . ,� .:��_ .. . + � .. . ; � .. _. . ... . . - r., ���� �, l AUTHORi'zATiorr rro: '� � � O�DAVIE-COUNTY HEALTH DEPARTMENT �� �r'�� wO� ... Environmental Health Section PROPERTY.INFORMATION Permittee,s,,/'),,, . PA.Box 848 ` Name: 1�.lG1/"/"r°�� �.+'�Qr'r'(� � •k .�; Mocksville,NC 27028 Subdivision Name: , .- Phone# 336-751-8760 Directions to propeRy:����"'� ` ' � Section: Lot: � '. � AUTHORIZATION FOR : : ,,��i�`''�Y i��' ��/' - ` WASTEWATER Tax Office PIN:# = - SYSTF.M CONSTRUCTIOTI� — . °Road Name: Zip: � **NOT'E**This Auth�nzation for Wastewa'ter System Construction MUST BE ISSCJED by the Davie County�nvironmental Health Section prior , ,'." ' to issuance of any Building-Permi��.This Eomi/Authorization Number should be presented to the Davie Counry Building Inspections ' O�ce when applying for Building Permits. ` ` p th Article 11`of G.S.,Chapter 130A,Wastewater,Systems Section.1900 Sewage Treatment and Disposal Systems) ,. , (ln com liance wi ' � �,, . . ,. _ s*� *** � f y j NOTICE THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION � ,1��,:�5," '`; � ._� IS VALID FOR A PERIOD OF FIVE YEARS. 'ENVIRONMENTAL.HEALTH SPECIALIST . . DATE ISSUED ' 00P &�y e, 0 ADDRES DIRECTIONS TO Ile DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) �C PHONE NUMBER, SUBDIVISION NA LOT # OCT g 12000 DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY____6 SPECIFY PROBLEM OCCURRING DATE REQUESTED%ls-/l-c06 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 M Parcel #: J600000078 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 for this Parcel View Tax Bill Information Parcel #: 3600000078 Account #:80632000 Owner Information Tax Codes OOD IVAN DARRELL EMOCKSVILLE ADVLTAX - COUNTY TA 1967 US HIGHWAY 64 EAST FIREADVLTAX - FIRE TAX NC 27028 Market Property Information Township - Land (Units/Type): 9.420 AC FULTON ddress: 1967 E US HWY 64 00539 0087 03 2004 WD Deed Information �— Local Zoning Pate: 03/2004 Book: 00539 Page: 0087 lat Book: 0002 Page: 053 Le al Description PIN 19.363 AC HWY 64 5757695453 Property Values Buildin • 40,32 0011 BXF• 42,07 nd: 8936 Market 171 75 ssessed: 17175 Deferred: 3 Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00121 0806 02 1984 WD Unqualifled Vacant 0 2 00460 0506 01 2003 WD Unqualified Vacant 30,000 3 00539 0087 03 2004 WD Unqualified Vacant 0 View Property Record for this Parcel View Mao for this Parcel View Tax BIII Information « Return to Basic Search Page 1 of 1 oN.V riot 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.daviecountyne.gov/itsnet/View.aspx?prid=1467428 6/30/2016