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AUTHORIZATION -NO 139
4 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section ' PROPERTY INFORMATION
Pet idttee's . `1 P.O., Box 848
Name: Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760 ,
Directions to property: Section: Lot:
AUTHORIZATION FOR
WASTEWATER
D'o ETax Office PIN:# - -
SYSTEM CONSTRUCTION
Road Name gip:
**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 l of G.S. Chapter 130A,.Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
f ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
EN60.�..�TAHSPECIALIST DATE ISSUED
va
'4- DAVIE COUNTY HEALTH DEPARTMENT
.}� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION `4
• ;; Mame:1' '' Subdivision Name:
Pirections to property: 1 +�=' � Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# -
Road Nam e• S � i
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.,.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE D4TENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE #BEDROOMS # BATHS # OCCUPANTS f l GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE v
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH y ROCK DEPTH NEAR F-rO- �
" F,
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 (704) 634-8760.
OPERATION PERMIT '
SYS M INST LED BY:
A
AUTHORIZATION NO. / J OPERATION PERMIT BY: � � , DATE: ':2
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96 (Revised)
3.
;J—
A 0
DAVIE COUNTY HEALTH DE'PAR'TMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perntlttee S
Subdivision Name:'
4?
Directions toproperty: e- 6; Section: Lot'
IMPROVEMENT
PERMIT Tax Office PI .#
Road Name:` -LVfi,
-A
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section. 1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS\-? # BATHS V # OCCUPANTS � GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE,- # PEOPLEISHIFT # SEATS - INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGNwA`WATER FLOW (GPD) NEW SITE ---�-- REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP DTH ROCK DEPTH LINEAR Flow
AL. TRENCH WI
OTHER -
REQUIRED SITE MODIFICATIONS/CONDITIONS:•
IMPROVEMENT PERMIT LAYOUT
kyl
"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 � DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT
SYS M INST LED B
SYS M VINST L5EDB
r-- W1
Y' 0
/V(
AUTHORIZATION NO./y3'
OPERATION PERMIT BY: DATE:
—
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96 (Revised)
T,
A
"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 � DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT
SYS M INST LED B
SYS M VINST L5EDB
r-- W1
Y' 0
/V(
AUTHORIZATION NO./y3'
OPERATION PERMIT BY: DATE:
—
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96 (Revised)
T,
®ws
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
WORKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT
NAME -fobtA
PHONE NUMBER
ADDRESS SUBDIVISION NAME
1,0 ?SUBDIVISION LOT # J_
DIRECTIONS TO SITE /07✓- c :5Y_('
V G
DATE SYSTEM INSTALLED
DAVIE COUNTY HEALTH DEPARTMENT Wy 2
(Septic Tank) Improvements Permit and Certificate of Completion NaCtiiS(%JIle
(Ground Absorption Sewage Disposal System - G.S. Chapter,130-Article 13C)
OWNER OR CONTRACTOR., -I—t, 4,j (101. P +t r_ c. DATEERMIT
0 613
LOCATION � ', 1 .? c3 r :" • •
S.R. NO.
,SUBDIVISION NAME LOT NO. SECTION OR,BLOCK NO.
7
HOUSE MOBILE HOME BUSINESS ❑
f House Trailer 800 Gal. .400 Sq. Ft.
N0. BEDROOMS __ N0. BATHROOMS _ Two Bedroom House 800 Gal. 600 Sq. Ft..
GARBAGE DISPOSAL UNIT YES ❑ 0 Mk#00 Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES 0 ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES �0 ❑
SITE SUITABLE YES Gj- NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD i3 sq. ft. 4.44 • a QU
DEPTH OF STONE IN LINES: *!
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
Parcel #: J700000015
Davie County, NC - Basic Estate Search
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is
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Parcel #:3700000015
Account #:17820000
Owner Information
BXF:
Tax Codes
Land:
ORNATZER TOBY A & CORNATZER LINDA ANN
Market:
ADVLTAX - COUNTY T
ssessed:
482 US HIGHWAY 64 EAST
Deferred:
READVLTAX - FIRE TAX
MOCKSVILLE NC 27028
Property Information
Townshi
nd (Units/Type): 0.990 AC
FULTON
ddress: 2482 E US HWY 64
Deed Information
Local Zoning
Pate: 10/1975 Book: 00096 Page: 0759
Plat Book: Page:
Legal Description
PIN
1.92 AC HWY 64
5767391352
Property Values
Building:
13018
BXF:
4,79
Land:
20,53
Market:
155 50
ssessed:
155,50
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00096 0759 10 1975 WD Unqualified Improved 0
View Property Record for this Parcel View Map for Ihis Parcel View Tax Bill Information
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UR
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.daviecoun"c,gov/itsnet/View.aspx?prid=1478439 6/23/2016