111 Veach LnDavie Countv, NC
Tax ParrPl RPr►nrt
Tuesdav, October 11, 2016
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Parcel Information
Parcel Number: L5100A0007 Township:
NCPIN Number: 5746242194 Municipality:
Account Number: 75084000 Census Trect:
Listed Owner 1: VEACH JOHN RAY Voting Precinct:
Mailing Address 1: 111 VEACH LANE Planning Jurisdiction:
City: MOCKSVILLE
State:
Zoning Class:
NC Zoning Overiay:
Zip Code: 2702&0000 Voluntary Ag. District:
Legal Description: 1 LOT HWY 601 Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
9" °'F Davie County,
`'��N�� NC
0.91 Elementary School Zone:
11/1972 Middle School Zone:
000880513 Soil Types:
Flood Zone:
Watershed Overlay:
122900.00 Outbuilding & Extra
Freatures Value:
10290.00 Total Market Value:
133190.00
Jerusalem
37059-807
COOLEEMEE
Davie County
DAVIE COUNTY R-20
DAVIE COUNTY CZOD
JERUSALEM
COOLEEMEE
SOUTH DAVIE
CeB2
DAVIE COUNTY
133190.00
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All dah Is provfded as is without warrarrty or guarantee of any kind either expreased or implied tncludtng but not ItmRed to the
implied warraMles of inerchaMabliity orifMeas Tor a particular use. All users of Davie CouM�s GIS webske ahall hold harmless the
CouMy of Davie, North Grolina, Its agerrts, consukarrts, contractors or employees from any and aq claims or causea of actlon due ta
o►aridng ou[ of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME�o � .J ✓Gs�.
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PHONE NUMBER 2'�`�� �- S� �%
ADDRESS I/ � V'�-�-�-� L-Q-..�- "i -
SUBDIVISION NAME
l�` .� �" �-S ✓ 6 ���. LOT #
DIRECTIONS TO SITE � � � S ( A'"�� �--�- � �'+^tis • ) /l-�- ss L,�l3..r1-y C..�c��
G�% �-�' c-�. S t.. e�.. ��C/ ��' t t� lC.. � o n /9 c7 ca.�C t_
DATE SYSTEM INSTALLED �� NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED 2-
TYPE WATER SUPPLY SPECIFY,PROBLEM OCCURRING S e-�-- �-� See,y,�,/.S
DATE REQUESTE
NFORMATION TAKEN BY�
This ia to certity that the information provided is correct to the best of my knowledge, and that I understand I a respo i le for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT 1./ r���6�i�—�
Rev. 1/93
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AUTHORIZATIOjV NO. i'� ��.�t DAVIE COUNTY HEALTH DEPARTMENT
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�� � � ( Environmental Health Section PROPERTY INF(�RMA"FION" -� ��
� N mettee's �\���,� 1 f�!���1-� P.O. Box 848
�� , Mocksville, NC 27028 Subdivision Name:
I�1 t� 4� Phone # 336-751-8760
Directions to property: �.9 Section: Lot:
` ( I `-� "� AUTHORIZATION FOR
V�;..��'..�-1 l.� � �.. ���.,r� � , p; WASTEWATER
�� �'7 `� t��' SYSTF.M CONSTRUCTION Tax Office PIN:# - -
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Road Name: V L:-��...�i �,......1 Zip: f' ii ��.`_�`
**NOTE** T'his Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Env'uonmental Health Section prior
ro issuance of any Building �ermits. This Form/Authorization Number shoold be presented to the Davie Counry Building Inspections
Offic whyn applying,�'or Building Permits.
(lq complian�e �t�Article 11 o�'G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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EfFWR�UNME�`V7AL HEALTH SP�
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DAT� 1SSU�D
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***NOTICE*** THlS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
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' -- t�� ���� DAVIE COUNTY HEALTH DEPARTMENT
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' : ' ' ��°r - TMPROVEMENT AND OPERAI31ON PERMITS
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Permittee's � i J� � ' } _ �
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PROPERTY INFORMATION " �
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Name: '' - ���`'� � � �- r�"� -- ``� Subdivision Name:
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Directions to property: i� `�--= �� Section: Lot: �'"
� . ; .. k ' `.� IlVIPROVEMENT
\.ri �;,. �� � t t . _� ; � ,;,' •� � },,'T 1 ; . PERMTT Tax Office PIN:#
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Road Name: '� , ` , � ;-- - _ � Zip;
**NOTE** This Improvement Pemut DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AU'THORIZATTON FOR WASTEWAT'ER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building pernut.
(In compliance �'ith Article 11 of G.S. Chapter 1}OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
�_-�—r' J" ;:.-� ***NOTICE*** THLS PERNIIT IS SUBJECT TO REVOCATION IF SITE
r f` �' j��. .. �✓"' ,,,r''' ''�'. d"%'�.: �';� PLANS OR TI-IE INT'ENDED USE CHANGE. YOUR WASTEWATER
EDFVIRONMENTAL` HEALTH SPECIALIST DA ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE �,,� # BEDROOMS '� # BATHS 2 # OCCUPANTS 2 GARBAGE DISPOSAL: Yes n�
COMMERCIAL SPECIFTCATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIF'T # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE `� �� TYPE WATER SUPPLY ��"�� DESIGN WASTEWATER FLOW (GPD)1�_l CO � NEW SITE REPAIR STfE ✓
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK � GAL. TRENCH WIDTH -�'�' ROCK DEPTH �� I LINEAR Ff. ��-� �
nTHFR Z "'" 'cS) �l-� �J�TI Q+.� �JC7�C.ls�
REQUIRED SITE MODIFICATIONS/CONDITIONS: `e��''! A (�l, 0", �'U "��J � � � f.-i::r � � , ��`� �U�r �-� ""� �
IMPROVEMENT PERMIT LAYOUT .���i�,,��t��U EFFLI��.F�!T FILTER$- �-�IS�R (S) Y� 6' s i3EL��r . FIPJIS;�=D G::�L��•
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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 (7fr4j 8347&�6(kt )t
(335Z751-8760
I OPERATION PERMIT
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SYSTEM INSTALLED BY:
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AUTHORIZATION NO. ��O'`� 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 THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96 (Revised)
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_, �'13Al�IE C UNTY HEALT DEPARTI�9ENT SEPTIC TANK PER1�tIT Date d?o7 /�Q3
' Jwner/Occupant To :��� � � � � �,
Address F � �� ��.�
Address
Building Contractor Address j �'y�
Cal . �� �_ Manufa urer's Name �,..� ,� � j , �i' Address
No. of Iines _�_ Width �/��in. Total length o?o?S� ft. No. sq. ft. de
Type o£ filter material ��o Total tons used 3 0—��
P9inimum REquirements: tiouse Trailer Tank cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 90d °00
No one shall install a septic tank in Davie County without a permit from the f?ealth Offic
or his agent.
Date of Final Approval Si.gned:
Sanitarian
I hereby certify that the above septic tank has been installed according to specificatior
Signed: � ��r�
Septic T'ank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028. _
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