6425 Hwy 801S17
a w;
P:rmittee s _ DAVIE COUNTY HEALTH DEPARTMENT
Narfe' ' �y% �!'f r'.rr so Environmental Health' Section PROPERTY INFORMATIOW
.,5/�ti �� P.O. Box 848
Directions to property: + + NCocksville, NC 27028 Subdivision Name:
+,: �'c3d,=v ;' ' /� S f,,t. �'. Phone #: 336-751-8760
1 Section: Lot:
/AUTHORIZATION FOR
j'ff '� WASTEWATER' Tax Office PIN:# -
SYSTEM CONSTRUCTION
AUTHORIZATION NO: 2367 .. 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 Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section :1900 Sewage Treatment and Disposal Systems).
,,J.. ✓' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS # BATHS,, # OCCUPANTS � GARBAGE DISPOSAL: Yes or No
r
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) STQ NEW SITE REPAIR SITE
A
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH `�� ROCK DEPTH / LINEAR F . ` O
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 (336)751-8760.
DCHD 02M (Revised)
1
�7
C., S75
• DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
f3y -1-
1 9 r
1 -
19r e 10._� JJ
ADDRESS (_r ` ;)' S
PHONE NUMBER
-77S- a7�o
IVISION NAME
h__\_0 cCS '/ I (l -e-, LOT #,
DIRECTIONS TO SITE I a4G sem- ° I jzgo
L--4--4- n .. , 4— C J'4' _�
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER LL,� T::-- S'4,-\.
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SE V -ED ' 7
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKE
This Is to certify, that the information provided is correct to the best of my knowledge, and that
SIOWA)TURE OF OW ER OR AUTHORIZED AGENT s
Rev. 1193
> l I V
F'
I understand I am responsible for all charges ied from this application.
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View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: L600000010 Account #:75116000
Owner Information
Building:
Tax Codes
BXF:
ENABLE MAX W& VENABLE FRANCES M
nd•
ADVLTAX - COUNTY
Market:
579 NC HIGHWAY 801 SOUTH
ssessed:
READVLTAX - FIRE TAX
TT
Deferred:
OCKSVILLE NC 27028
Unqualified
Vacant
Property Information
2
Township
nd (Units/Type): 3.130 AC
03
JERUSALEM
ddress: 6425 S NC HWY 801
Vacant
0
Deed Information
00166
Local tonin
Pate: 10/1999 Book: 00317 Page: 0142
1992 WD
Unqualified
Plat Book: Page:
0
4
Le al Description
0327
PIN
23 AC HWY 801
Unqualified
5756240549
Property Values
Building:
64,96
BXF:
5201
nd•
33 41
Market:
98 89
ssessed:
98 89
Deferred:
1992 WD
Sales Information
No.
Book
Page
Month
Year Instrument
Qual/UnQual
Improved
Price
1
00116
0131
11
1992 WD
Unqualified
Vacant
0
2
00116
0327
03
1996 WD
Unqualified
Vacant
0
3
00166
0131
11
1992 WD
Unqualified
Vacant
0
4
00186
0327
03
1996 WD
Unqualified
Vacant
0
5
00317
0142
10
1999 WD
Qualified
Improved
65,000
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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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=1466607 8/31/2016