1580 Cherry Hill Rd)
Davie Count,v, NC Tax Parcel Report Tuesday, October 11, 2016
WARNING: THIS IS NOT A SURVEY
_ _ _ _
Parcel Information
Parcel Number: N600000071 A Township:
NCPIN Number: 5754384356 Municipality:
Jerusalem
Account Number: 82525617 Census Tract: 37059-807
Listed Owner 1: SPILLMAN STACIE DENISE Voting Precinct: JERUSALEM
Mailing Address 1: PO BOX 738 Planning Jurisdiction: Davie County
City: COOLEEMEE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: 1.170 AC CHERRY HILL RD Fire Response District:
Assessed Acreage: 1.13 Elementary School Zone:
Deed Date: 4/1998 Middle School Zone:
Deed Book / Page: 002020016 Soil Types:
Plat Book: Flood Zone:
Plat Page: Watershed Overlay:
Building Value:
Land Value:
Total Assessed Value:
°�°°'F Davie County,
�a�;N�i NC
0.00 Outbuilding & Extra
Freatures Value:
12150.00 Total Market Value:
16650.00
_
JERUSALEM
COOLEEMEE
SOUTH DAVIE
PaD,Pc62
DAVIE COUNTY
4500.00
16650.00
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' `' rIZATION,NO: ' °� � (� `� DAVIE COUNTY HEALTH DEPARTMENT
�� �"��` Environmental Health Section PROPERTY INFORMATION
'Perm ttee's " � /^� � P.O. Box 848
Name: 'Cl�:.£�. 1�"��1L�_�,t� Mocksville, NC 27028 Subdivision Name:
Directions to property: �.= � � � �' � c.� �'.t j�_t::C � Phone #: 704-634-8760 Section: -I,-ot��
` AUTHORIZATION FOR Z
�� 11LL i�� �`= �:{`�� � �>� ���.; f I�`.,��>�.i WASTEWAT'ER Tax Office PIN:# �''i �� ..:?� _� J� c�
SYSTEM CONSTRUCTTON
��jC?�t �h�7)n ( .,f � ��% C� �ZDh��x Road Name: r�+�i.��'� ��t It� �Zip: ��%v2��
**NOT'E** This Authorization for Wastewater System Construcdon MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pernuts. This Forrn/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Arti�le 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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' �' ,;�'"" � �,.._ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�--. �—��'�1.�� �i,�,j,,� . lri.,.� _: � � l�r�^ � IS VALm FOR A PERIOD OF FIVE YEARS.
ENVIT�ONA%fENT L HE ��SPECIALIST DATE ISSUED
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�Y � �� �' " �'- ' "� � j(� � DAVIE COUNTY HEALTH DEPARTMENT /
�'r '„ " ' , ,
�� ".��''" `���; IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perrnitt� � � ,Y�/�}
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ar�e; R s�.� � �':i�.. �(�!� t_}`f� � � Subdivision Name: .
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� Dire'ctions io ro rt : ' '.' � �:' '� �_:> ►1� �-` , � #
p pe y� i Section: -L.et^
' ' IlVIPROVEMENT .�
7 , . +' 't= "" ,'t. �;.�, ' � :i� ~ .-,
1 �i i L t �. � ' '��i � f , �.,� f.. C, �- . � j��,-.. i � �:c PERNIIT Tax Office PIN:# , r'� _ _.� � _ � . � � �_a
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i;� d e�, r,(? ,i l�l? �C '��'�t► h� Road Name: _� t�i:t.%'� }-� t:.� ���Zip: �: %�s?�
**NOT'E** This Improvement Pernut DOES NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained frc�m this Department prior to the
construction/installation of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
' r" �%� � f �° 1i ***NOTICE*** TIIIS PERMIT IS SUBJECT TO REVOCATION IF SITE
..�-._,_..._..,�
� j, .%: ./; �.... .. �/1l ;,: j�'' PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER
Y ENVIROY�TME�� LTH,'3PECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE Tf�S PERNII'I' BEFORE
C.:..-� INSTALLING Tf� SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE rn FI # BEDROOMS �# BATHS �# OCCUPANTS � GARBAGE DISPOSAL: Yes o No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WAS1'E: Yes or No
LOT SIZE � L<� TYPE WATER SUPPLY� DESIGN WASTEWATER FLOW (GPD) _ t�7 [Y_/ NEW SITE � REPAIR SITE
'l 1� ��
SYSTEM SPECIFICATIONS: TANK SIZE ��-GAL. PUMP TANK GAL. TRENCH WIDTH �� ROCK DEPTH � LINEAR FT. �
OTHER � ���T��F��) � ro.� rJ!?3C1�5
l� 1
REQUIRED SITE MODIFICATIONS/CONDITIONS: F-�-� P J'� O�i i� • J'•� lim t. ����k_ � ) p!�C� ��qPe,Q T y C, �� �, I��Tn L�-
� Cc�J1dJi
IMPROVEMENT PERMIT LAYOUT
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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 (704) 634-8760.
OPERATION PERMIT
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SYSTEM INSTALLED BY: 1`� " � � ��
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N� ,1-1�^�,�
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AUTHORIZATION NO. ��� OPERATION PERMIT BY: DATE: 7 L q�
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE STEM DESCRIBE ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECI'ION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WII.L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96 (Revised)
� APPLICATION FOR SITE EVALUATION/IMPROVEMENT
..
' Davie County Health Department
• �,3"�g Environmental Health Section
�� P.O. Box 848
� -�
n� p
, U�� Mocksville, NC 27028
"�"
�,, � � (704) 634-8760
a c���a�t�
MAR 2 3 1998
�'�'�*IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
Name to be Billed Contact Person � ��5��
Mailing Address P� �X;� t� Home Phone �-g 4'— �� �i'�
City/State/Zip (_.f)d ���Y✓l� � Business Phone �0 `i' � a'� I
2. Name on PermidATC if Different than Above
Mailing Address City/State/Zip
3. Application For: [] Site Evaluatio [] Improvement Permit & ATC [ Both
4. System to Serve: [] House [�obile Home [] Business [] Industry [] Other
5. If Residence: # People �1 `# Bedrooms�y"# Bathrooms z ['y�ishwasher [] Garbage Disposal
[�j'�Vashing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: [�ounty/City [] Well [] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes [�►�iVo
If yes, what type?
EZ THER tl PL�tT OR S Z TE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT **'�'PL�T OF THE PROPERTY MUST BE
SUBMITTED WITH TffiS APPLICATION.
Property Dimensions: �• 1�1 ��' � WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: #y��5� - 3 8 -� ; C�o I S-� C�ie 1��'i ��/{/c 1�
Property Address: Road 1'�Tame l,-�� Y f�1,� 4d1 �� K� • �
City/Zip
1Vlo('�c.sUt l,[v �.�70�-� ; ►
If in Subdivision provide information, as follows: �
�
Name: �" �
�
�
Section: � � �' / �
�
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter aze
subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or
changed.� I; also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized
Representative of the� Davie County Health Department to enter upon above described property located in Davie County and owned
by .�i� ���iVl�"� to duct all testin oce res as essary to determine the site suitability.
��%.,���5 SIGNATURE !
DATE �
Revised DCHD (06-96)
THIS AREA MAJ $E USEb �Olt b1�llVINC� (jOUR SITE 1'Lt1N:
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�', DAVIE COUNTY HEALTH DEPARTMENT r� ��JQ. I
. Environmental Health Section SECTION .�er�
SoiUSite Evaluation
APPLICANT'S NAME f''�'�` ""'�„`"� DATE EVALUATED ���31�0
PROPOSED FACILITY M'�OML PROPERTY SIZE ^' I 1� G11c:�
SUBDIVISION
ROAD NAME CI `i�-�pQY }.� )L-�- �O
Water Supply: On-Site Well Community Public '�
Evaluation By: Auger Boring ✓ Pit Cut
HORIZON I DEPTH
Texture group
('nncictanrr�
SITE CLASSIFICATION: PS EVALUATION BY: �'` �A�-��`�'"��
LONG-TERM ACCEPTANCE RATE: �� � OTHER(S) PRESENT: L.lt�"` �Q"�
REMARKS: �Y� Gt-� . I� I. ���1 %E �t Tt 1-IAS �^} L-' JT flO��; N 3�
LEGEND
Landscape Position �
R- Ridge S- Shoulder L- Linear slope FS - Foot slope N- Nose slope
CC - Concave slope CV - Convex slope T- Terrace FP - Flood plain H- Head slope
Texture
S- Sand LS - Loamy sand SL - Sandy loam L- Loam SI - Silt
SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C- Clay
CONSISTENCE
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wet
NS - Non sticky SS - Slightly sticky S- Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P- Plastic VP - Very plastic
Structure
SC - Single grain M- Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineralogv
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface [o free water or inches from land surface to soil colors with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gaUday/ft2
DCHD (01-90)
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