1463 Hwy 801Ny
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Permittees f t DAVIE COUNTY HEALTH DEPARTMENT P
Name; ;,.S t'� f ' t �1�° Environmental Health Section PROPERTY INFORMATION Da
• 4f% P.O. Box 848
Directions to property. -r, 664. Mocksville, NC 27028 Subdivision Name:
P r' Phone #: 336-751-8760
v J� J:. "i c� Y1 '' Section: Lot:
"" AUTHORIZATION FOR
.c 1 r �t �� WASTEWATER Tax Office PIN:#
C:r C' `r� 41STEM CONSTRUCTION
AUTHORIZATION NO: r A Road Name: Zip:
**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 Forrn/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compincTith Article 11 of G.S. Chapter 130A; Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
`��* /' ✓ Ir �ir IS VALID FOR A PERIOD OF FIVE YEARS.
r;
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS -✓ # BATHS # OCCUPANTS Z GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPES # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE ' ` ` 'TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) X16 NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE'iAoo GAL. PUMP TANKGAL. TRENCH WIDTH ROCK DEPTH (/ LINEAR FT. 10
As stated in 16A Wggi8Am(,k '
pis�d SrtltQlna may 0 41
` `
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT f a G f O
d i G tsl
(
C``.G0
Ltd '
5 tr51 e v'" or, �j dG
I
C". S�L/,:
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M..ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
1 OPERAT
O
f PERMIT
I-a z., �
SYSTEM INSTALLED BY:
o
AUTHORIZATION NO. OPERATION PERMIT BY: f DATE: O
"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 02/02 (Revised)
Permittees • { DAVIE COUNTY HEALTH DEPARTMENT
Namccr i "` Environmental Health Section PROPERTY INFORMATION
':. : � 41(s F , i .:��.� P.O. Box 848 .
�1
Dlrectlons to property: ` Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
_. .
'Section: Lot:
,N AUTHORIZATION FOR
i : c:,; .7 (.. �1 (, ;i �� �: % t WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
r --•r ..,,• „- tit .,..
�> "kXrNbk ZATION NO: 002880 "'A Road Name: Zip:
**NOTE** This Authorization dor Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Forrri/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(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
b`' f�f ✓k�'" t`�
lei I IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED �J
RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS _,..! # BATHS � # OCCUPANTS � GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE' # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes oT?
LOT SIZE r " TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) / NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: WANK SIZE `� C GALT PUMP TANK�GAL. TRENCH WIDTH 1 �` ROCK DEPTH r LINEAR FT.
A rf. "'i V • ! h l_..1 �� t �. �'1 � / \� 1. ea
REQUIRED SITE MODIFICATIONS/CONDITIONS: _
IMPROVEMENT PERMIT�TrAYOUT
,Ir Pi
Tc
1
�` ,r�G,� �U� 1 ��t �Gy1 P11�'�ia►Zc�.
ev,, or
r
SISI^. "
40 -
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT `/�
k � r SYSTEM INSTALLED BY:
q.
i
__--7
1
AUTHORIZATION NO. OPERATION PERMIT BY, DATE,
**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 A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 02/7 (Revised)
oto°
DAVIE COUNTY ENVIRO MENTAL HEALTH SECTIO 1,011111
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) C Al
ON NUMB
,t/(/-�7 ,
BDIVISION NAME
n
LOT
TO
#
TO SITE Vi'1 /Jii KLA - �r SSS 4/��/ '�Gl
6AI Pow
DATE SYSTEM INSl`ALLED y _NAME SYSTEM INSTALLED UNDER AM
TYPE FACILITY NUMBER BEDROOMS v NUMBER PEOPLE SERVED
TYPE WATER SUPPLY.. SPECIFY PROBLEM OCCURRINGA6Z—) �
h,Ii/ Z11..o j..A I n//// `Aw._11 AIA I,/l/,/ %./ I A'z, nww��+../Y.� .. �
DATE REQUESTED %-ff QX 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
Pay. 1193 ct c l � I. �- ?-t1WVJ � n e.A� —1K wyu � �
GoMAPS - Davie County NC Public Access Page 1 of 1
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Parcel #: C600000067
Davie County, NC - Basic Estate Search
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t
View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: C600000067
Account #:51038000
Owner Information
uildin
Tax Codes
BXF•
ILLER POLLY J& MILLER HARVEY A
nd:
ADVLTAX - COUNTY T
arket:
1463 NC HIGHWAY 801 NORTH
ssessed•
READVLTAX - FIRE TAX
[Deferred:
DVANCE NC 27006
Property Information
Township
FLand (Units/Type): 1.220
FARMINGTON
dress: 1463 N NC HWY 801
Deed Information
Local Zoning
Pate: 01/1900 Book: Page:
Plat Book: Page:
Legal Description
PIN
1.24 acHWY 801
51038000
• Pro ger Values
uildin
126,720
BXF•
nd:
27,75
arket:
154,47
ssessed•
154,4701
[Deferred:
Sales Information
No Sales Data found.
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/itsnet/View.aspx?prid=1478859 9/14/2016