1339 Hwy 801N (2)fav
WARNING: THIS IS NOT A SURVEY
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 harmless the
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Parcel Information
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
Parcel Number:
C60000007602
Township:
Farmington
NCPIN Number:
5852983345
Municipality:
Account Number:
82514806
Census Tract:
37059-802
Listed Owner 1:
KAPP JERRY W
Voting Precinct:
FARMINGTON
Mailing Address 1:
1620 FARMINGTON RD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
DAVIE COUNTY QD
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
TRACT B 1.7504 AC HWY 801
Fire Response District:
FARMINGTON
Assessed Acreage:
1.78
Elementary School Zone:
PINEBROOK
Deed Date:
8/2009
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
008040193
Soil Types:
EnB,ChA
Plat Book:
0010
Flood Zone:
Plat Page:
103
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding 8r Extra
16260.00
Freatures Value:
Land Value:
29740.00
Total Market Value:
46000.00
Total Assessed Value:
46000.00
Davie County,
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 harmless the
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NC
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
Permittee's (�' ( Q DAVIE COUNTY HEALTH DEPARTMENT
Name: 3`Il Environmental Health Section PROPERTY INFORMATION
s:.. P.O. Box 848 e x� / % 3' LL
Directions to property: 4 4 ` ' 1 ' ' F Mocksville, NC 27028 Subdivision Name:
i'v r`a J Phone #: 336-751-8760 Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN :# -
AUTHORIZATION NO: ` "`' ` ID A Road Name �* F Zip
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**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 Pen -nits.
(In compliance with Article 11 of G.S. Chapter, 130(1, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r J ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENT¢L-HEALTH SPECIALIST DATE ISS ED
' far :� 4q'j ry
RESIDENTIAL SPECIFICATION: BUILDING TYPE F � �- # 131M9 rr {� OMS - # BATHS _ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE
# PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE -TYPE WATER SUPPLY -�a"1 r°DESIGN WASTEWATER FLOW (GPD) ' "{ NEW SITE REPAIR SITEa(12 to of
?•"
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH 17 LINEAR FT. ---�-Q
OTHER a wT J
REQUIRED SITE MODIFICATIONS/CONDITIONS: 4"'I=I" �� - r f : �'``�� t- `�' l�-�-�-� �'�' t�' �(+'T 7+� ! t- ► �1 �Dt=��
IMPROVEMENT PERMIT LAYOUT
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**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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO.-- OPERATION PERMIT BY:
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0?,t,o-ewOL
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5
DATE: / ') 7
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 01!02 (Revised)
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Perm •a
H ittees DAM
.� E COUNTY HEALTH DEPARTMENT
Name: - Environmental Health Section PROPERTY INFORMATION
i P.O. Box 848 -7 3 Z
Directions to property: I Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
" SYSTEM CONSTRUCTION -
AUTHORIZATION NO: 4-� ' S' `$ A Road Name: t r s Zip:
t
**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 FomVAuthorization Number should be presented to the Davie County Building Inspections,
Office when applying for Building Pennits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r f IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED t
t
RESIDEN-CAL SPECIFICATION: BUILDING TYPE BEDROOMS ') # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE ° r CYPE WATER SUPPLY � DESIGN WASTEWATER FLOW (GPD){'.. NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ;'LINEAR FT. -�—
OTHER —r 17-1 r;
s
REQUIRED SITE MODIFICATIONS/CONDITIONS:- jt_ : I t ' 1 . t . J , ! ! n t " 14 e t) j i - .�'l•
I IMPROVEMENT PERMIT LAYOUT
**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 (336)751-8760.
OPERATION PERMIT
y�
SYSTEM INSTALLED BY: r L��' �f i. / f /
� •S
t1
AUTHORIZATION NO.' OPERATION PERMIT BY: 1't� (� < ' / - DATE: /
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE i
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 01102 (Revised)
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
y PO Box 848/210 Hospital Street
Mocksville, NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑
qc' LAPP
Mailing Address: 1573
�� Phone Number: 1 LIC) - Ll 1 � Q (Home)
WALL lS ! (" Cr -1 2 -3s ) 9 (Work)
Detailed Directions To Site: "Lj `1 %01 ti
Property
S''1 oc- Ato%? %DI
Please Fill In The Following Information About The Existing Dwelling:
�7 �
Name System Installed Under: l C �2 Type Of Dwelling: Hex)5s
Date System Installed(Month/Day/Year): Cbff) Number Of Bedrooms:--3L—Number Of People:
Is The Dwelling Currently Vacant? Yes Er No ❑ If Yes, For How Long?
Any Known Problem's? AYes [/'No ❑ If Yes, Explain:
"
Please Fill In The Following Information About The New Dwelling.
Type Of Dwelling: VAC\. t C a w Number of Bedrooms: Number of People:
Requested By: Date Requested:
(Signature)
For Environmental Health Office Use Only
Approved [IDisapproved ❑ a Wil. 3 f;
Comments: ', S��LZ� `��'1' 11 �C �,.., I ala -IT-) . LL-
Environmental Health
*The signing of this form by the Environmental Health Staff is in no way inte {Od, 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 ❑ Check ❑ Money Order ❑ # Amount: $ Date:
Paid By: �± Received By:
Account #: (l� Invoice #: