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� � IMPROVEMENTS PERMIT. AND CERTIFICATE OF COMPLETION� �
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' NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a ,,�
Sanitary Sewage Systems P8f1111t NU�t'1b81'
Name 1= c�� 1 e ����t AtmS � �� �' a�Date �--.� �-�� 0
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Location ��1.1_�—aC6� - i �d��� � � ►i1.� , �.0 `��o�� �. �
Sub�3iv s on Name Lot No. Sec. or Block No.
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Lot Size ��-�`�S s� House� �� ��''� M�bils, Home —_.._ Bus�neSs Industry 4
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No. Bedrooms �_�,No. �aths '�` 1 . No. in Family �_ Pub�ic Ass�inbly ' Other
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Garba e Dis osa YES.,�] , NO p S ecifications for S stem: y��_3�
9 P �:; f c� � �� P Y 1
Auto Dish Washer � YES ❑" NO ❑ .°'•�` `�
% 1'�h� � y � �� / ��.''�� � �,. ��
Auto Wash Ma ;hine YES [y! NO ❑ � � d 0� � 3 � c �» �``..y
Type Water Supply � <' ° ,,k C p � � . w. ' - — ,. �,,. x: , �
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'This permit Void if sewage system described below is not installed'w.ithin 5 years from d�te of issue.
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This permit is subject to revocation if sit�e�pllanss:-or�the intended use hange. ..
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�"Contact a representative of the Davie Counry Health Department for final insp�ction of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Tele�hone Number: 704-634-5985. '
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Final Installation Diagram: `""`� System Installed by —�'""�'�—S `` \���
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Certificate of Com letion � ��N�_ Date
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'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be:taken as a guarantee that the system will function
satisfactorily for any given period of time.
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� ���� � �:z, ° IMPROVEMENTS PERMIT'ANDS CERTIFICATE OF COMPLETION.+� ,
��_ �,� "NOTE: Issued in Compliance With Article II of G.S. Chapter 130a �
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�. v Sanitary Sewage Systems
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M Name ``i°Date - 7 513
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Subdiv�sion Name Lot Na Sec. or Block Na
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No. Bedrooms �_.No. Baths � No. in Family '�� _ PublicAss�mbly Other '�� Y�' ``
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. ' Garbage Disposal ,= : YES :p NO ❑ ' . . .'; f f: -�
Specifications for System: p _�� �
Auto Dish Washer � ` YES ❑ NO ❑, '�,; �' ' `° '
Auto Wash Ma^hine YES [� NO ❑ t t� . �� �" ' ` . ;
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'This permit Void if sewage system described below is not installed within 5 years from date of issue. c
' This permit is subject to revocation if site plansf or the intended use change. -
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^ Improvements permit by �—h���� ' ���
"Contact a representative of the Davie County Health Department for final inspection of this system between 8:30•9:30 A.M.;
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985. '
�:.
Final Installation Diagram: • System Installed by __���'"� ���
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Certificate of Completion ���^�"�_ Date
'The signing of this certificate shall indicate that the system described above has been installed in compliance with 4
the standards set forth in the above regulation, but shaU in N0 way be,taken as a guarantee that the syst� will tunction
, satisfacforily for any given period of t�me. '-;' '� •� •�':
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.; DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IM�OVEMENT PERMIT (REPAIR)
NAME �= � �- � `� � ����'a� 3 @�� PHONE NUMBER 7 6 � '�� � " tI � 13
ADDRESS �� `� � � �-�� I SUBDIVISION NAME
� o c.�� 5 v \1 �� � � , �, LOT # .
DIRECTIONS TO SITE �' � � � r � .� ��
DATE SYSTEM INSTALLED ��� NAME SYSTEM INSTALLED UNDER ��`e
TYPE FACILITY ��� NUMBER BEDROOMS � NUMBER PEOPLE SERVED �
TYPE WATER SUPPLY C--���"� SPECIFY PROBLEM OCCURRING 1�� ��.n-�
DATE REQUESTED L�' `� `� LI INFORMATION TAKEN BY \ 5�,���� �-���
This is to certify that the information provided is correct to the best of my knowled e, and that I underotand I am reaponaible for all charges incurted from thla epplicaUon.
SIGNATURE OF OWNER OR AUTHORIZED AGENT \\�
Rev. 1/93
■M■■MEME■■■■N■
■■MEMEN■■MENN■
■NOMMEMEMEMME■
■■■■■EM■■■MEE■
■NNOMEME■■■EM■
■■EM■ME■■■EME■
■O■MEM■NOMMEM■
■EMEMEMEME■M■■
■NOMMENNE■■■N■
■
■
Parcel #: M503OA000202
Davie County, NC Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search
View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: M5030A000202
Account #:23774000
Owner Information
Tax Codes
BXF•
DWARDS ROBERT DEAN & EDWARDS KATHY GAIL
ADVLTAX - COUNTY T
66,70
O BOX 472
READVLTAX - FIRE TAX
ssessed:
MOCKSVILLE NC 27028
Deferred:
Information
Vacant
Township
EressProperty
(Units/Type): 0.490 AC
00166
JERUSALEM
:2576 S US HWY 601
1993 WD
Deed Information
Vacant
Local toning
ate: 07/2010 Book: 00832 Page: 0649
00513
0468
Plat Book: Page:
2003 WD
Legal Description
Improved
PIN
1.524 AC HWY 601 & 801
00515
5746510153
09
Property Values
Book
Building:
120,29
BXF•
8301
Land:
66,70
Market:
187 82
ssessed:
187,8201
Deferred:
Unqualified
Sales Information
No.
Book
Page
Month
Year Instrument
Qual/UnQual
Improved
Price
L
00165
0230
09
1992 WD
Unqualified
Vacant
23,000
Z
00166
0875
01
1993 WD
Unqualified
Vacant
0
3
00513
0468
09
2003 WD
Unqualified
Improved
0
t
00515
0207
09
2003 WD
Unqualified
Improved
112,500
5
00832
0649
07
2010 WD
Unqualified
Improved
203,200
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Page 1 of 1
g
0A -01J11 -S
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=1479699 7/21/2016