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?AUTMi3RIZAT1ON NO: Irl Q 44 DAVIE COUNTY HEALTH DEPARTMENT
....
Environmental Health Section - P OPERTY INFORMATION
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% P.O. Boz 848
Permittee's94!p
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Name: ° tj //(�Mocksville, NC 27028, Subdivision Name:
"' �r°n`►' �� ') Phone # 336-751=8760 J
Directions to propertyz" l� Section Lot:
/ AUTHORIZATION FOR
WASTEWATER -,-
Tax Office PIN:#'
SYSTEM CONSTRUCTION -
1 gGr1/ Road Name Zip; -'
** ** y ISSUED by the County Envirnntnental Hal
NOTE This Authorization for Wastewater S stem Construction MUST BE , ealth Section nor.
-
to issuance of an Buildin Pennits. This Fonn/Authonzation Number should be resented to the Davie CountyBuilding pec
y Ins tions
Office when applying for Building Permits.
(In compliance with Article 1 I of G.S. Chapter,130A,-,Wastewater Systems Section .1900 Sewage Treatment and Disposal Systems)
'
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1 f ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
1
_ IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
f�h"�C... `4 Y.� �..'�L�wly�v"I.,t,.Y... ,i `w<'" e n .1'.�riv �"^Y'l•'P, r.,'� y:�.�-_, r.v _„v.. {- , ' rt.,`'v� yt. �".•, .� i v• "v, vi.. n'xl y . ti
O 4d DAVIE COUNTY HEALTH DEPARTMENT
„
IMPROVEMENT AND OPERATION PERMITS P OPERTY INFORMATION
f`
;Name .L� :,r� '»� ;� Subdivision Name:,
n.Directions to popert}+' 4/4Section. Lot:'
1 dIMPROVEMENT
PERMIT
`✓ Tax Office PIN:# - -
�-�-
Road Name: Zip:
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
ao `
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCITON,must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
with
(In compliance Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
('Q
' **.*NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
`
/Xf ✓ - „, r ;� ,/,::.:, t;' % PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
` NTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TILS PERMIT BEFORE,
'ENVIRONMENTAL
`
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS# BATHS _� # OCC
,.� UPANTS GARBAGE DISPOSAL Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes orNo .
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE !�
SYSTEM SPECIFICATIONS: TANK SIZE GAL. ", PUMP TANK GAL. TRENCH WIDTH) 6 ROCK DEPTH LINEAR 1�-
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT.FOR FINAL INSPE5WIT1
YSTEM ,
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M."ON THE DAY OF INSTALLATION. TELEPHONE # fi0
s`
"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 NOWAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
Davie County, NC
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Tax Parcel Report
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Thursday, September 8, 2016
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164 +l:'1► 115
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815
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WARNING: THIS IS
NOT A SURVEY
Parcel Information
Parcel Number: 0700000029 Township: Farmington
NCPIN Number: 5862371357 Municipality:
Account Number: 59012000 Census Tract: 37059-802
Listed Owner 1: QUALITY OIL COMPANY LLC Voting Precinct: SMITH GROVE
Mailing Address 1: PO BOX 2736 Planning Jurisdiction: Davie County
City: WINSTON SALEM Zoning Class: DAVIE COUNTY H -B
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27127-2736 Voluntary Ag. District: No
Legal Description: 0.64 AC HWY 801 & REDLAND Fire Response District: SMITH GROVE
Assessed Acreage: 0.56 Elementary School Zone: PINEBROOK
Deed Date: 6/2001 Middle School Zone: NORTH DAVIE
Deed Book / Page: 003760349 Soil Types: GnB2
Plat Book: Flood Zone: X
Plat Page: Watershed Overlay: - ,WS -IV -P
Building Value: 122120.00
Outbuilding & Extra 20340.00
Freatures Value:
Land Value: 31040.00
Total Market Value: 173500.00
Total Assessed Value: 173500.00
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
Davie County, NC
harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all daims or
°c aS causes of action due to or arising out of the use or inability to use the GIS data provided by this website.