373 Cherry Hill Rd (2) Se
Davie.County,NC Tax Parcel Report �Q���,5{� Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Pare
e Intormation .. , _.. . .. _....,. . ._ ._ .
Parcel Number: M60000004401 Township: Jerusalem
NCPIN Number: 5756617539 Municipality:
Account Number: 11826000 Census Tract: 37059-807
Listed Owner 1: BURTON TERRY R Voting Precinct: JERUSALEM
Mailing Address 1: 373 CHERRYHILL ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 30.276 AC CHERRY HILL RD Fire Response District: JERUSALEM
Assessed Acreage: 30.30 Elementary School Zone: COOLEEMEE
Deed Date: 1/1900 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 001240420 Soil Types: PaD,PcB2,PcC2,RnD,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 389480.00 Outbuilding&Extra 42020.00
Freatures Value:
Land Value: 214530.00 Total Market Value: 646030.00
Total Assessed Value: 488290.00
i v All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davis,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this webalte.
�Permittoes� fir, dca
f /G DAVIE COUNTY HEALTH DEPARTMENT
Name. Environmental Health Section PROPERTY INFORMATION
/ P.O. Box 848
Difections to property: �f Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
Section: _ Lot:
J! AU WAS EWA ER ZATION OR 7�1 (r I '7
ax 5
i" ffic IN:#
- - 3
SYSTEM CONSTRUCTION �75
C( -P vY`
AUTHORIZATION NO: Q Q 2 9 2 5 A Road Name: !' zip:P
**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�of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
C� ***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
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE 3 TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) 36,0 NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZER GAL. PUMP TANK GAL. TRENCH WIDTH� ROCK DEPTH, LINEAR FT.✓0 O
OTHER Of
,AS etated in 15A NCAC 18A.19MS)
REQUIRED SITE MODIFICATIONS/COND" us: r > ccoPiod Systems may also ba 1153
IMPROVEMENT PERMIT LAYOUT O U 5�, 1
,
�T ro 117
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT . �s ,A , t SYf Q T IWBY: I t 7 !J
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CUv1�✓GtG�d� � A�'t�.a �8 � BUMP
AUTHORIZATION NO. OPERATION PERMIT BY: / / DATE: /
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 WALL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCIID 02/02(Revised) 44 ?30 7 l 6 tl j
/C DAVIE COUNTY HEALTH DE
Environmental Health Sec M"P PROPERTY INFORMATION
44,
P.O. Box 848
D* C n to P P" Mocksville,NC 27028 Subdivision Name:
xl"'.- Phone#:336-751-8760
AUTHORIZATION FOR Section: Lot:
All WASTEWATER
SYSTEM CONSTRUCTION -Ta4,qf f icePIN:
AUTHORIZATION NO: 002925 A Road Name:
**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 C,applying for Building Permits.
I
(In compliance withArticleyl 'of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
H C, ***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 1 GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY #PEOPLE— #PEOPLE/SHIFT #SEATS_ INDUSTRIAL WASTE:Yes or No
LOT SIZE )0 TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) 36-oQ NEW SITE REPAIR SITE ✓
r
SYSTEM SPECIFICATIONS: TANK SIZE-GAL. PUMP TANK A4GAL. TRENCH WIDTH ? ROCK DEPTH R/M LINEAR Fr.
OTHER
REQUIRED SITE MODIFICATIONS/CONDN
IMPROVEMENT PERMIT LAYOUT
-A
(ol-T
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT ;,-I".I/,-,-q 5�,,f/C?
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AUTHORIZATION 7—or-
NO. OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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 02102(Revised)
'77
�rtsu. r
S?/ il�c.► :�, bv:taL A6r !_o DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
ar f.1. j epn tf w a..e e ►...y APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
w_.. hj�! pl✓.
NAME_%.+-i ZwrTaw- PHONE NUMBER 536-44'�'
ADDRESS._ 7,3 C/Icrry At///2/ SUBDIVISION NAME
/1'Ia,CJ v ll! /?C ZTd Z F LOT #
DIRECTIONS TO SITE Goll'- T.4�c �/ G'rC.�y ��u- O Z.lrtr�ls. f: C��n► �?/l�
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY_ /Y NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED J-
TYPE WATER SUPPLY ayd_ TY SPECIFY PROBLEM OCCURRING s«.& A
DATE REQUESTED_, l_.yu_oq INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1/93 e 61`6e Y s d'Or 1-0-Q 4-5 . W11� Of(A l Q t o
DAVIE COUNTY HEALTH DEPARTMENT
-- `- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name ,%C r �lli�sa►�' Date
r
Location 469&- 6� AM/��' �J'i T•�,� Air
Subdivision Name Lot No. Sec. or Block No.
Lot Size c sp House Mobile Home _ Business Speculation
No. Bedrooms — c�? No. Baths -Z 1 No. in Family_1_
Garbage Disposal YES fl NO ❑.- - Specifications for System:
Auto Dish Washer YES p NO ❑ ��
Auto Wash Machine YES 0 NO p c GDI�l3 f2 X004 � .�
Type Water Supply _
*This permit Void if sewage syste described below is not installed within 36 months from date of issue.
Improvements permit by
*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 day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by
lye
J J?v
3�
C rtificate of Completion ' ' � "-' ' Date
*The s' ning of this c rtificate shall i dicaI3 that the system described above has been installed in compliance with
the s ndar s set for in the above gulat on, but shall in NO way be taken as a guarantee that the system will function
satis ctor'y for any iven period of t e.
DAVIE COUNTY HEALTH DEPARTMENT
w. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name ;44 J!T:on / Date
Location 4/1 zU `
Subdivision Name Lot No. Sec. or Block No.
Lot Size cL House Mobile Home _ Business Speculation
No. Bedrooms —.t2 No. Baths .2,!I–,No. in Family_4_.
Garbage Disposal YES p NO Specifications for System:
Auto Dish Washer YES [] NO ❑ ���X.3�j2�� �ODe����
Auto Wash Machine YES NO p
Type Water Supply !! _—
`This permit Void if sewage syste ' described below is not installed within 36 months from date of issue.
Improvements permit by
*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 day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by
L7 '(11
l
C rtificate of Completion I"-W-00 Date ,zo :,
"The s' ning of this c rtificate shall i dica that the system described above has been installed in compliance with
\ the s ndar s set for in the above gulat on, but shall in NO way be taken as a guarantee that the system will function
satis ctor' y for any iven period of t e.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
' Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone 28 1 2�-
1. Permit Reauested B Business Phone 6-:1, - (75904
kl�f2. Address (- —
3. Property Owner if Different than Above
Address
4. Permit To: a) Install ''Alter Repair
b) Privy Conventional 'Other Type
Ground Absorption
c) Sub-DivisionSec. Lot No.
5. System used to serve what type facility: House Mobile ome Business
IndustryOther
b) Number of people
6. a) If house or mobile home, statXpw
e of home and number of rooms.
House Dimensions � Z 2-0 K 3
Bed Rooms s Bath Rooms 2 Den w4ehmet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water-using fixtures:
commodes urinals garbage disposal
lavatory showers Ca washing machine
dishwasher sinks 1
8. a) Type water supply: Public Private Community
b) Has the water supply system beeVmp ro ? Yes r/ No
9. a) Property Dimensions--SIR AC., ` r,
b) Land area designated to buildin site �—
c) Sewage Disposal Contractor E►fit
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is correct to the best of my nowied e.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
Y
2Cb
DCHD(6-82)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date
Address Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S S S
PS PS PS
U U U
2) Soil Texture (12-36 in.) Sandy, S S S
Loamy, Clayey, (note 2:1 Clay) S) PS PS PS
U U U
3) Soil Structure (12-36 in.) S S S S
Clayey Soils PS PS PS
U U U
4) Soil Depth (inches) S S S
PS PS PS
U U U U
5) Soil Drainage: Internal S S S
PS PS PS
U U U U
External SS S S
PS PS PS
U U U U
6) Restrictive Horizons
7) Available Space S S. S S
PS PS PS PS
U U U U
8) Other (Specify) S S S S
PS PS PS PS
U U U U
9) Site Classification 7- e
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments:
Described by e"n�� Title ��� Date
SITE DIAGRAM
DCHD(6-82)