972 Hwy 64W Davie County Health Department
40N8 I� E Environmental Health Section ,
C E 1 V E P.O. Box 848
.S„ 210 Hospital Street !
�' JUL 2011 1911
O� �'t Courier# : 09-40-06 •,
BY: ocksville, NC 27028
Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFICATION Fax:(336)-753-1680
(Check One) Replacement Remodeling Reconnection
Name: 70f rer(r Phone Number 336-90 9- 7 O (Home)
Mailing Address: 0-�X V N W (Work)
'70 I-g Email Address:
Detailed Directions To Site: l ��^i �� t.,•e o a'r— ya 14V Y-d 11, rqn 1`�•
Property Address: / 7 .1- V S M,, �� (,✓
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: S Type Of Facility: <5
Date System Installed(Month/Date/Year): /�C�S1�N� I N k—Number Of Bedrooms:__3_Number Of People: 3
Is The Facility Currently Vacant? Yes e If Yes,For How Long?
Any Known Problems? Yes 0 . If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: S•te'N2 e. a , Cl tll� Number Of Bedrooms: lJ Number of People
Pool Size: Garage Size: Other: f� v-f-f
Requested By: t✓ Date Requested: =p ZU11 '10 it
AEg tore)
For Environmental Health Office Use Only
Approved isapproved ,
Comments:
Environmental Health Specialist01jDate:
*The signing of this form by the Environmental Health QJ Itf is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash heck Mone Order
# Amount:$ G •D Date:
Paid By: r( / Received By:_(_ v
Account#: 7/ �j Invoice#: 7 0��
kt-fAlE COUNTY HEALTH DEPARTMENT �7Z us
(Seeptic Tank) Improvements Permit and Certificate of Completion
(Ground'Abiorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION {^` w ,� u ,� '` . rt ch C ' ' �ItJi, N� 1200
"" 't' k�yc, �u r.�.
-.—`rp'.(+ r [ (` S.R. NO.
,_SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
^ House Trailer 800 Gal 400 Sq. Ft.
NO. BEDROOMS e?► NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gala 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK 00 gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY Cha INSTALLED BY
CERTIFICATE OF COMPLETION By Date L�la��7L
(8/16/73) *Construction must c ply with all other applicable State and local regulations
LOT AREA SO QCs C S
w
3
J
u.
arcel#: I400000055 Page 1 of 1
o,Yt�
Davie County, NC - Basic Estate Search �w �
Davie County Web Site
Basic Search Real Estate Search Tax Bill Search Sales Search Q
View Prooerty Record for this Parcel View Map for this Parcel View Tax Bill Information
Parcel#:I400000055 Account#:35620000
Owner Information Tax Codes
ICKS JUNE M ESTATE ADVLTAX-COUNTY T
/o LYNN H BYERLY FIREADVLTAX-FIRE TAX
OCKSVILLE NC 27028
Property Information Township
nd(Units/Type): 41.060 AC MOCKSVILLE
ddress: 972 W US HWY 64
Deed Information Local tonin
Pate: 09/1963 Book: 00066 Page: 0627
Plat Book: 0003 Page: 019
Le al Description PIN
50.76 AC HWY 64 5738086362
Property Values
uildin 350L,46
BXF• 12 81
Land: 322,96
Market: 686 23
ssessed: 392 38
eferred: 293,85CI
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00066 0627 09 1963 WD Unqualified improved 0
View Property Record for this Parcel View Mao for this Parcel View Tax BIII Information
«Return to Basic Search
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=1470275 7/5/2016