295 Cherry Hill Rd (2)Davie Countv. NC
Tax Parcel Report Tuesdav, October 11, 2016
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Parcel Information
Parcel Number: L600000016 A Township: Jerusalem
NCPIN Number: 5756519922 Municipality:
Account Number: 82525224 Census Tract: 37059-807
Listed Owner 1: ALLEN ANN D& JASON G Voting Precinct: JERUSALEM
Mailing Address 1: 295 CHERRY HILL ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-6620 Voluntary Ag. District: No
Legal Description: 11.700 AC CHERRY HILL RD Fire Response District: JERUSALEM
Assessed Acreage: 10.94 Elementary School Zone: COOLEEMEE
Deed Date: 12/1998 Middle School Zone: SOUTH DAVIE
Deed Book / Page: 1999E0010 Soil Types: Pc62,PcC2,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 177070.00 Outbuilding & Extra 2910.00
Freatures Value:
Land Value: 51170.00 Total Market Value: 231150.00
Total Assessed Value: 231150.00
9P�°'F Davie County,
�o��N�i NC
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IPIPROVEI�NT DERMIT
DAVIE CDUNTY NEALTH DEPARTMENT
IMPROVEl�NT PERMIT and OPERATION PERMIT
*+�NOTE�+� This i�prove�ent per�it D�S NOT authorize the construction or installation of a septic tank syste� or any NasteNater
syste�. flN AUTHDRIZATIDN FDR NASTENATER 5Y5TEM CDN5TRlICTIDN �ust be obtained fro� this Depart�ent prior to the
construction/installation of a syste� or the issuance of a building per�it.
(In co�pliance Nith Article il of 6.5. Chapter 130A, NasteMater Syste�s, 5ection .1900.SeNage Treat�ent and Disposal 5yste�s)
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LOCATI����t+',�'/'�'•-t� ,+���� l�l� '
5UBDIVISIDM NAME LOT MA�44BER
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RESIDENTAI SPECIFICATION: BUILUIN6 TYPE %%��"' � BEDROOMS ,,�
SEC./BLOCI( NUMBER
A BATHS „� N OCCt��ANTS � 6ARB(�E DISPOSAL: Yes/�
CDMI�RCIAL SPECIFICATION: F�ILITV TYPE � PEDPLE � PEDE'LE/SHI�T% .. # SERTSf INDU5TRIAL 41A5TE: Ves/No
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LOT SIZE ��'�� TYPE WATER SUPPLY � DESI6N i#15TEWAT�A �FLOW tGPD) �� NEbI SITE REPAIR SITE �%
SY5TEM SPECIFICRTIDNS: TArp( SIZE 6AL. F�1MP TR�6t 6AL. TRENCN WIDTH _?c� �� RDCK DEPTH ��LIt�AR FT. /S�J �
OTHER
REQUIRED SITE MODIFICATIDNS/CONDITION5:
*�*TNIS PERMIT IS SUBJECT TO REUOCATION IF SITE PLANS OR THE INTENDED USE CHF�JGE. YDUR WASTERWATER SYSTEM CONTRACTOR h�1ST
5EE THIS PERMIT BEFORE IN5TALLING THE SYSTEM.
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IMPRDVEMENT PERMI �„V
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�*CONTACT p f�PRE5ENTRTIVE � THE DAVIE COINVTY HEALTH DEPARTI�NT FOA FIt�I INSPECTION DF THIS SYSTEM E�ET4IEEN
8:30-9:30 A.M. OR 1:�-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHOME # I5 (704f 634-9760.
OPERATION PERMIT
SYSTEM INSTALLED BY�� ����-'
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AUTHORIZATION N0. C� ��`?j DF�ERATIDN PEt�IT BY DATE �� �� ��
f�THE ISSUANCE OF THIS �ERATION PERMIT SHALL INDICATE TF��T THE SY5TEM DESCRIBED ABOUE HAS BEEN INSTALLED IN COMPLIANCE WITH
AATICIE il � G.S. CHAPTEA 130A, SECTI0�1 .19� "SE4�E TREATMENT AND DISPOSAL SYSTEMS°, BUT SHALL IN NO I�IY BE TAKEN AS A
6UARANTEE THAT THE S`/STEM WILL FI�TIDN SATISFACTORILY FOR RNY 6IVEN PERIOD � TI1�.
DCHD 10/95
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� � � `��= � IMPRUVEM�NT PEAMIT andfOPERATIDN PERMIT
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°`� +��I�TE�f This i�prove�ent per�it DDES NUT authorize the construc#ioq;a� �nstallation of a septic tank syste■ or any NasteNater
syste�. AN RUTHORIZATION FDR {JA5TEWATER SYSTEM CONSTRLICTI�1 �ust be obtained fro� this Depart�ent prior to the
construrtion/inst�allation of a sy,sie• or the.�ssuance of a building per�it. ;.
lIn co�pliance with Article il of 6.5. Chapter 1�A,J�aateNater Syste�s;' Section .1900 Sewage Treat�ent and ,Disposal 5yste�s)
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tJ� �. C� .� =y /'. ✓ � PR�'ERTV R DRES5 C� ' P_ )'Y � � C.L-. , � �a v� � DATE _�/i.r �'r ;�
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SUBDIU15I�1 N�M{E LDT M�IBER SEC. /BLOCK NUMBER
RESIDENTAI SPECIFICATION: BUILDING TYPE %�` �1 BEDR�MS , r� # BATNS _t'`% # OCCLIF�ANTS .� 6ARBf�iE DISPOSAL: � Yes/�
C�RCIRt. SPECIFICflTIOM: fACILITY TYPE # PEDRLE M PEDPLE/5HIFT # SERT5 INDUSTRIAL NASTE: Yes/No�
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LOT SIZE /'' TYPE WATEA Sl1PPLY ,�'r� DESI6N �1STEWATER �FLOW fGPD) : �' ��i � tiEVJ SITE REPAIR SITE d�
5Y5TEM SPECIFICATI�IS: TF�JK SI2E . 6AL. PUMP TANK 6AL. TRENCH WIDTH r'�� �� R�K DEPTH � LII�AR FT. /SG� �
OTHER " �
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REQUIRED 5ITE MDDIFICATIDNS/CONDITIONS: ` y
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*�*THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OA THE INTENDED USE CHANGE. VDUR WASTERWATER SYSTEM CONTRACTOR p�1ST
5EE THIS PERMIT BffORE INSTALLING THE SYSTEM. ,
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IMRRDVEMENT PERMII�
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+�*CONTACT A REPRESENTATIVE � TNE DAVIE CmNJTY HEALTH DEPARTMENT FOR FINAL INSPECTION � THIS SYSTEM AETWEEN
8:30-9:3@ A.M. OR 1:00-1:30 P.M. UN THE DAY OF INST�kLATION. TELEPHONE # IS i704) 634-87E0.
�ERATION PERMIT
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SYSTEM INSTALLED BY�y-��`��� '='—°�`��m-�
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AUTHORIZATION N0. ���`�j " OPERATION PE�IIT BY
\_ �_ .' ,ti3�x. � ;'_5�i�-:�__ DATE 3 "� � _ �
f�THE ISSUANCE OF THIS OPERATION PERPIIT SNALL INDICATE TF�T THE SYSTEM DESCRIBED ABDVE HAS BEEN INSTG�I.ED IN COp�LIANCE 41ITH
ARTICLE 11 OF G.S. CHpPTER 130A, SECTIOM".19� "SEV�E TREATMIENT AND DISpOSAL 5Y5TENS', BUT Sf�All IN NO WAY 9E TAKEN AS A �
6`U�iRAIVTEE THAT THE SYSTEM WILL fUI�TI�I SATI5FACTORILY FOR A�lY 6IVEN PERIOD � TIME. �
DCHD 10/95 .V ��. , :,
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�s ' Davie County Health Depart�ent '
• ENVIROPIMENTRL HEALTH SECTIDN
P.O. Box 66� '
Mocksville, N.C. 27Q�8 j
AUTHORIZNTION FOR WRSTE�WTER SYSTEM tX�ISTRl1CTI�!
ilssued in ro�pliance with Article 11 of I
G.S. Chapter 130R, Wastewater Systems? ;
�+�+�This Ruthorization For Wastewater Syste� Construction �ust be issued by the Davie Cnunty Environ�ental Health 5ection prior to I
issuance of any Building Per�its. This For�/Authorization Nu�ber should be presented to the Davie County Building Inspections
Office when applying for Auilding Ger�its.***
�+ ` ALfiHORIZATIDN F��IBER
NRME � C� �/�� DATE ���� s �.� �� � � `' � '�
h E
NRlE ON I�PROVEIE�IT PERMIT tIf different than above)
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5ITE LOCATIai �' �
COM�ENTS/I�ITIQ�S ON AUTNORIZATIaI TD (X1N5TRUCT WASTEWATER 5Y5TE�1
�MpTICE+� THIS AUTHURIZATIDN A NA5TEWATER SYSTEM CDNSTAUCTIDN I5 VALID FQB A RERIDD OF FIVE (5) YEARS.
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ENVIRONfNTAL IfALTH SPECIRI.IST DATE
DCHD 10/95
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F �t DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
, APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME f� rl ��/�°lf PHONE NUMBER %r%���ys ,�
ADD
DIRECTIONS TO SITE � Ph^� /-��'/� �1 i`�'• ��"
BDIVISION NAME
LOT #
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DATE SYSTEM INSTALLED � NAME SYSTEM INSTALLED UNDER
TYPE FACILITY � NUMBER BEDROOMS � NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING ��L'� "�
DATE REQUESTED INFORMATION TAKEN BY ,�2%'�
This is to certity that the information provided is correct to the best of my knowledge, and that 1 understand I am responsible for all charges incurred irom this application.
9 p,/
SIGNATURE OF OWNER OR AUTHORIZED AGENT �_. _e�l ���r,.�L �
Rev. 1/93
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