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AUTHORWATION NO: 0869 DAVIE COUNTY HEALTH DEPARTMENT ;pa
y.. Environmental Health Section PROPERTY INFORMATION
Permiftee's . ` P.O., Box 848
Name: ^Sc�rc.t 3 �� C'� `a-�� Mocksville, NC 27028 Subdivision Name:
_: .�� Grp Phone #: 704-634-8760
Directions t"o property: 3 t� �� Section: Lot:
AUTHORIZATION FOR
WASTEWATER .
Tax Office PIN:# -
SYSTEM CONSTRUCTION , ,
Road Name: 2O 1 to 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 Form/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)
q ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
r� �`4h�. �' �. �N'j1 I�W+• .� v '�'�ti 1,. /� f .� .' : k .., �."r '.`riti : �it Ns^ YP a
,• �t� � ,"�'�$f7i-' rry,,. .,arz.a�fi /fits 1's•�'� ry � +sdt��`'ti.;s :�ri.,,:l i r},>xi L4y,. � r �;.;-. �
X6
' DAVIE COUNTY HEALTH DEPARTMENT'
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
.Pertruttee's
Subdivision Name:
q =Dite`ctions toproperty: '1'- ,- a 4 Section: Lot:
E\1PROVE3W.NT
PERMIT Tax Office PIN:#7-1
- -
Road Name + �' Zip; * .
e-
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. 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)
V I t ; . ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
"y^S { PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS I # BATHS �_ # OCCUPANTS GARBAGE DISPOSAL Yes ,ZN�
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE"� C41 --b TYPE WATER SUPPLY . DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR Fr.
OTHER
REQUIRED SITE MODIFICATIONS/CONDMONS:
IMPROVEMENT PERMIT LAYOUT
o�d ,
1NQ
�YQvS�
**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 (704) 6348760.
AUTHORIZATION NO.� a� 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
GUARANTEE THAT THIS SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
i
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r
**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 (704) 6348760.
AUTHORIZATION NO.� a� 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
GUARANTEE THAT THIS SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
l�yz � '?{'e'xi e f„i j:2TF7�1�r .t .r-tq µ•emir.; arKt, ..a •✓�a t fft"n.,.,u."T `^t y..-�1'u.a -. 'sem; ik'� s��.-; :tsti s -,� � .� � _ - --
DAVIE COUNTY HEALTH DEPARTMENT
'`'
IMPROVEMENT AND."OPERATION PERMITS PROPERTY INFORMATION
P.ernllttees
f ame
1131f�ections to property:
`K + IMPROVEMENT
t - '• PERMIT
Subdivision Name: "
Section: Lot:
Tax Office PIN:# -
Road Name. , zip:., t r,
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. 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)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.,
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS_ # BATHS �_ # OCCUPANTS GARBAGE DISPOSAL: Yes
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT [� # SEATS INDUSTRIAL WASTE: Yes or No
OT SIzi-Vii—
LT NEW SITE REPAIR SITE
TYPE WATER SUPPLY Lam) a_ ;`s� DESIGN WASTEWATER FLOW (GPD) �._ �
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"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 (704) 6348760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
w.
AUTHORIZATION NO. v b ` OPERATION PERMIT BY:' ; p DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL; INDICATE THAT THE $YSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENTAND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARAFEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD. OF TIME.
DCHD 05/96 (Revised)
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A .00
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
yur,t a!/ale-,7 7s ;-- APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME Zo h >7 P I A e -R. PHONE NUMBER 99k - 3 / / I
ADDRESS /4.5-7 >ywV gd//✓ 1270Cj'sv;1& VpAt SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE/Sd' - % • l:iT `W,111 ?5 ,0- AA.' — ?•,Rl ^ R o/ -q,o%L . 2 r?7;1eA'
DATE SYSTEM INSTALLED / 9S-� NAME SYSTEM INSTALLED UNDER TYPE FACILITY #Atto-- NUMBER BEDROOMS Z NUMBER PEOPLE SERVED Z
TYPE WATER SUPPLY W // SPECIFY PROBLEM OCCURRING -an" ➢l /41 Z:t�
DATE REQUESTED 7 — 97 INFORMATION TAKEN BY,
This Is to certify that the Information provided is correct to the best of my knowledge, and
SIGNATURE OF OWNER OR AUTHORIZED AGENT.
Rev. 1193
[am responsible for all charges i urred from this application.
Parcel #: C600000020
Davie County, NC - Basic Estate Search
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View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: C600000020
Account #:56972000
Owner Information
uildin :
Tax Codes
BXF•
ILCHER JOHN W JR& C/O SARA PILCHER
nd•
ADVLTAX - COUNTY T
Market:
1657 NC HIGHWAY 801 NORTH
essed:
READVLTAX - FIRE TAX
eferred
OCKSVILLE NC 27028
Property Information
Township
nd (Units/Type): 3.630 AC
FARMINGTON
AA dress: 1657 N NC HWY 801
Deed Information
Local Zoning
Date: 10/1984 Book: 00124 Page: 0635
Plat Book: Page:
Legal Description
PIN
AC HWY 801
5852581550
Property Values
uildin :
68,95
BXF•
7,98
nd•
50f59
Market:
127 52
essed:
127f 52
eferred
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00124 0635 10 1984 WD Unqualified Improved 0
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=1479078 9/22/2016