3021 Hwy 64E**CONTACT A REPRESENTATIVE OF THkAVIE 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.
SYSTEM INSTALLED BY 1�
OPERATION PERMIT
AUTHORIZATION N0. 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 I
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD-10/95
- DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
A111bod
IMPROVEMENT PERMIT
**NOTE** This improvement permit DOES NOT authorize the construction or installation
of a septic tank system or any wastewater
`o')�'t�{�
systema 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)
NAME 4 l S Sy Wr. PROPERTY ADD SS DATE o �
LOCATION l 0 " `�ysi
Nb
SUBDIVISION NAME LOT NUMBER
SEC./BLACK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE vAoIoSe # BEDROOMS 3 # BATHS
# OCCUPANTS -L GARBAGE DISPOSAL: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFf�`
`i'SEATS INDUSTRIAL. WASTE: Yes/No
LOT SIZE 2 asnw- TYPE WATER SUPPLY DESIGJ WASTEWATE14LOW`(GPD)
NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TAW GAL. TRENCH WIDTH
ROCK, DEPTH �...%� LINEAR FT.
OTHER , N' °'` ✓
REQUIRED SITE MODIFICATIONS/CONDITIONS:.-�;DAA16g al -4 -tr CK., 64 RLGSk
5'1 n-)
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR',T}E INTENDED USE CHANGE.
YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
,; -
To
IMPROVEMENT PERMIT BY_��
,
**CONTACT A REPRESENTATIVE OF THkAVIE 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.
SYSTEM INSTALLED BY 1�
OPERATION PERMIT
AUTHORIZATION N0. 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 I
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD-10/95
x_. ,.. I/X0
7 Y DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
w s All,
^M0TGERMIT —PI
Th I is;iaprovesent permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater
-system. AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTIONmust be obtained from this Department prior to the
t 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)
NAME C, S ca tt" PROPERTY ADD SS 3 U (a T= .- DATE `
LOCATION (0
SUBDIVISION NAME �`Y: " LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE raga ? # BEDROOMS 3 # BATHS N OCCUPANTS -4. GARBAGE DISPOSAL: Yes/No
E i
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT``'' 'O,SEATS "' INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY Q, DESIGN"W'ASTEWATEA FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM ,SPECIFICATIONS: TANK SIIE GAL. PUMA TA; \ GAL. TRENCH WIDTH ROCK DEPTH .J-) LINEAR FT. 4
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:.w( 'Co `L - :t.0 i
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PIANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
' • ..�� oto .' �-- ,,"�, �
4'
IMPROVEMENT PERMIT BY not'
}
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION SOF THIS SYSTEM BETWtEN
8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704)'634f60.
OPERATION PERMIT SYSTEM INSTALLED BY
N
�-
., pW1V
AUTHORIZATION NO. b-7 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 "SERE TREATMENT AND DISPOSAL SYSTEMS", BUT SHAH IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
a:
„PCHD+-1:0%95 _
1 ".. Y ,. i0 ` r•e a' i R,;... ): � .y „� f cd� �.1, 1h . 1/ ;�-.: .x,�+ B :_ ,
Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.D. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR W 61 WRTER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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.***
AUTHORIZATION.NUMBER. �.
N2 J167
NAME �Z� `—�-�P� 1 s so 1`t� DATE
MALE ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME aG+41 Gr. SSo1nn PHONE NUMBER Rqg- 4q 4
ADDRESS -3b,21 }A -h L `i E Y "6'LV- 276Z r SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE (E " 2-"L' �) (Mu v>ti 44 QpST V1 Corte,
DATE SYSTEM INSTALLED Z0}1)rt• NAME SYSTEM INSTALLED UNDER
TYPE FACILITY fl MSP- NUMBER BEDROOMS ..3 NUMBER PEOPLE SERVED -7-
TYPE WATER SUPPLY opnT SPECIFY PROBLEM OCCURRING Du..-ya
?1_do/►n Ly
t nn
DATE REQUESTED of -A (0'i 4- 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 #: J700000083
Davie County, NC - Basic Estate Search
4 -Basic Search Real Estate Search Tax Bill Search Sales Search
View Property Record for this Parcel View Man for this Parcel View Tax Bill Information
Parcel #:3700000083
Account #:8305766
Owner Information
"ding:
Tax Codes
•
HN SOUTHARD INC
L,OS
Improved
ADVLTAX - COUNTYT30
et:
LULUNGTON
sed:
FIREADVLTAX - FIRE TAXNSTON
Unqualified
SALEM NC 27103
125,000
00830
Information
06
Township
EressProperty
(Units/Type): 1.810 AC
Improved
FULTON
:3021 E US HWY 64
0509
09
Deed Information
Unqualified
Local Zoning
Pate: 11/2015 Book: 01006 Page: 0037
01006
0037
Plat Book: Page:
2015 WD
Unqualified
Legal Description
62,500
PIN
1.823 AC HWY 64
02
5777092014
Property Values
"ding:
105,17(1
•
2,2901
Improved
28,19
et:
135 65
sed:
135,65
Unqualified
Improved
Sales Information
No. Book
Page
Month
Year Instrument
Qual/UnQual
Improved
Price
00824
0196
04
2010 TD
Unqualified
Improved
125,000
00830
0012
06
2010 WD
Unqualified
Improved
83,000
01000
0509
09
2015 TD
Unqualified
Improved
76,000
01006
0037
11
2015 WD
Unqualified
Improved
62,500
2003E
0046
02
2003 WL
Unqualified
Improved
0
00140
0584
10
1987 WD
Qualified
Improved
75,000
00573
0014
09
2004 WD
Qualified
Improved
135,000
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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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/itsnetfView.aspx?prid=1484618 6/22/2016