1245 Underpass Rd (2) t . �
HEALTH DEPARTMENT RELEASE Foroffoeuseontv
� . *CDP File Number 121208- 1
� ,.�,�,F� Davie County Health Department
�,.° �y�, F8�0000140
,. •,� � 210 Hospital Street Counry ID Number:
4, . 7
r ' HDRNUWC
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,�F' P.O. Box 848 Evaluated For:
'`���'` Mocksville NC 27028
:. _._..__.
Phone: 336-753-6780 Fax:336-753-1680 �EftMI n i��" � 4 l�l��l,�, 0 1 �
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Applicant: Richard Hendrix Pra.e`�i Owner: Linda H. Berrier/Kathy�Holt ��-� �
Address: 738 Riverview Rd s4ddress: 1245 Under ass Rd
P
C��Y: Advancd C��Y: Advance
r
StatefLip: NC 27006 State2ip: NC 270Q6�
(336)650-4320 --�`��
Phone#: one#:
..._.....__.___._.._...
Property Location 8 Site Information
Addr �245 Underpass Road Subdivision: Phase: Lot
Ro Advance NC 27006
GLE FAMILY Township:
'StruCture: Dlrectlons
#of Bedrooms: 3 #of People: I-40 East exit Hwy 801 going South,left onto Underpass Road,on right
White House,in curve.
�Water Supply: PUBLIC •
Type of 8usiness:
Basement: �Yes❑No
Total sq.Footage: No.Of Employees:
`Proaosed Improvement:
Pool
`Release Conditions
It is the responsibility of the owner to maintain a 5'minimum setback between ihe wastewater system and any part of the structure
foundation,including porches,decks,and any other appurtenances. If you are unsure as to the exact location of the septic system,please
have a licensed installer or inspector locate the septic system for you. The local county health department in no way implies that the
proposed construction meets the�equired setbacks from the septic system unless otherwise noted. This release only shows that this
property has an approved wastewater system that appears to have met the permitting requiremenis at the time it was installed.
This release in no way expresses or implies that the existing subsurFace sewage treatment and disposal
system senring the site will continue to function for any period of time.
ApplicanULegal Reps.Signature Required? QYes �No
ApplicantlLegal Reps. Signature: ����.�1 *Date: � � �a � -LO � �
*ISSUed By: 2244-Daywalt,Andrew *Date of Issue: 0 4 / 1 9 / a 0 1 3
Authorized State Agent:
��S ite P la /Drawing attached.** Total Time:(HH:
0 1 urs Minute
�Hand Drawing C7lmport Drawing
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Davie County Health Department
�Ps j� ,:�;����' tal Health Section ,,� ,
# '�.,
�a 1.0. Box 848
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� �� ,''�� �"�, ���i'� � 5 2��1� 2 �:x�ospit�ll Street
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O 't � 'er# : 09-40-06 " 1911
U � �3YI. jocksville, NC 27028 �
Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFICATION Fax:(336)—753-1G80
(Check One) Replacement Remodeling Reconnection
� `
Name: ��� 6 ^!i✓� PhoneNumber 3 S�j����,� �d (Home)
Mailing Address: 7 3� �v�o r[I� �PC� l�r'� (Work)
N.vI[� «�. � o �� 2�D�(7 Email Address:
Deta'led Directions To S'te: a� a-S l� ' �`T"�� �'�S� '" �+��
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; � � 1 �� ,�ti��'� .� l�Vl t��- �z�.��
Property Address: `�` �r
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: /Yu✓��Gc� Type Of Facility: �1 !]' G�5 �
, Date System Installed(Month/Date/Year): �Cj S�, Number Of Bedrooms:,�Number Of People:
Is The Facility Cunently Vacant? Yes 10 If Yes,For How Long?
Any Known Problems? Yes � If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: pOv � Number Of Bedrooms: Number of People
Pool Size: c�, Garage Size: Other:
Requested By: i Date Requested:
(Signa re)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee
ed or limited)that the on-site wastewater system will function properly for any given period of time.
Payme : Cash Check Money Order # Amount:$ . Date: �' ��
Paid By: �� Received By: � (�L
Account#: a Invoice#: �
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. Da�ie County Health Department ,
��►8 I� Environmental Health 'Section � _ ,
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, � �� :.� '"� . P.o. BoX g4s . : .
� ,��„ . ' 210.Hospital Street �
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� � ���� Courier# : 09-40-06 :.�, 1911
Mocksville, NC 27028 �
Phone:(336)-753=67$0 ON-SITE WASTEWATER CERTIFICATION Fax:(336)-753-1680
, ; ;
(Check One) Replacement .� Remodeling Reconnection
. }� 4 , ,
Name: /\i t�i,��.� /���-��, G�✓/�C Phone Number .� .�l /�S f3�� .3' a d (Home)
Mailing Address: 7 3� y�u,� /��i �o�� l�rl � � � (Work)
i y�- . -
� N.�t� U �.-. � r-� � ? `�pU(7 Email Address: ,
__-._ _�- _ .
� Detailed Directions To S'te: aZ � � 7 c.S �� " �`7"V L'��1 S� " �i�f'
: V�- � �� �6 /5� � .��� � sS G � ��� d.� �-
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, � '� . . ( 1 � !v G1�f��/ •' ��l�E -��I/�-� .
Property Address: '7.� J / � ��S � .
/
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: /Y�✓�"`'��r-► Type Of Facility: � (> !�-�� f�
�
Date System Installed(Month/Date/Year): /Cf��7 Number Of Bedrooms:_�Number Of People:
Is The Facility Currently Vacant? Yes �Ng� If Yes,For How Long? . .
:�,Any Known Problems? Yes � If Yes,Explain: 1
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: �dv ' Number Of Bedrooms: � Number of People �
,
Pool Size: � Garage Size: Other: �
Requested By: �''`� i� ..i Date Requested:
(Sign�ttfre) ,
For Environmental Health Office Use Only '
Approved Disapproved
Comments: '
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee
�(.ext ed or limited)that the on-site wastewater system will function properly for any given period of time. '
Payme .t: Cash Check Money Order # ' � _�Amount:$ , (1 Date: � �
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�..�. ; � �..{�:�-�,,, � \,;i.�;..��;"� i�,, /
Paid By: ' r � Received By: � :1
Account#: . � �r Invoice#: � -
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All data Is provided as is without warranty or guarantee of any kind either ezpressed or implied including but not limited to the implfed O v'l I
'��� " `r warnnties of inerchanUbility or fitness for a partitular usa.All usera of Davie County'a GIS website shall hold harmless the County of U N .
Davie,North Carolina,its agents,connultants,eontncton or employees from any and all claime or causes of action due to or arisi�g out of {
ti the use or inability to use the GIS data provided by this website. P�I I�IEd.Ap� �5, 2013
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• ; Qp�raisal Card Page 1 of 1
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DAVIE COUNTY NC 4 35 2013 4:14:11 PM
BERRIER LINDA H BERRIER ROBY G Retum/AppealNotes: FS-000-00-140
1245 UNDERPA55 RD UNIQ ID 9804 � '
572000 � � D412-P7 ID N0:5881218205
COUNTY TAX(100),FIRE TAX(100) CARD N0.1 of 1 -
Reval Year:2013 Tax Year:2013 1.00 AC UNDERPASS RD LOT 3 HARTMAN 1.000 AC SRC=Inspedion ^
raised b 19 on 10 14/2008 07002 MOGKS GHURGH TW-07 C- EX-AT- LAST ACT[ON 20110712
CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE
oundation-3 Standard 0.6100 ;�
ontinuous Footin 5.0 Eff. BASE r,
ub Floor System-4 US MO Area UA RATE RCN EY8 AYB � REDENCE TO MARKET �;
r
I ood 8,0 Ol 01 2 650 116 81.20 220579 195 1891 %GOOD 39.0 DEPR.BUILDING VALUE-CARD 86 03
Merior Walls-10 TYPE:Single Family Resldentlal Sin91e Family Residential DEPR.OB/XF VALUE-GRD 12,54 ^�
luminum/Vin I Sidin 29.0 MARKET LAND VALUE-CARD 26,98 �
ooMg SWcture-03 STORIES:3-2.0 Stories OTAL MARKET VALUE-CARD 125,55 �`
able 8.0
ooflnq Cover-03
halt or Com sition Shin le 3.0 OTAL AVPRAISED VALUE-GRD 125,55
n[erior Wall Cons[ruction-3 OTAL APPRA25ED VAIUE-PARCEL 125,55
lastered 20.0 �
' nterlor Floor Cover-09
ine or SoR Woods 10.0 OTAL PRESENT USE VALUE-PARCEL
eating Fuel-03 OTAI VALUE DEFERRED-PARCEL .
as 1.0 OTAL TAXABLE VALUE-PARCEL 125,55
eating Type-10 VRIOR
eat Pum 4.0 UILDING VALUE 99,62
ir Conditioning Type-03 BXF VALUE 16,04
� entral <.0 LAND VALUE 26,98
drooms/Bathrooms/Half-Ba[hrooms RESENT USE VALUE
/1/1 11.00 , EFERRED VALUE
Bedrooms OTAL VALUE 142 84
AS-3FU5-OLL-O +-36--+-8-+
throoms I B A 5 I F E P I
AS-1FU5-OLL-O I I I .
I I 2
alt-Bathrooms I 2 0
AS-1 FUS-0 LL-0 I 8 I PERMIT
� fFlce I I I CODE DATE NOTE NUMBER AMOUNT m
4 I +-16--+ +--16--+ —
OTAL POINT VALUE 103.00 8 I 8 I F U S I G
I +---2 4----++ I I ROUT:WTRSHD: '
BUILDING ADJUSTMENTS . '�
ualf 4 ABAVG 1.200 I I I ; SALES DATA �' �
ha e Desi 4 FACTOR 4 1.050 I 1 I 0 FF' INDICATE v
I g I I RECORD DATE DEED SALES o
ize 3 Size 0.900 I I 4 I BOOK PAGE M R TYPE / / PRICE
OTAI ADJUSTMENT FACTOR 1.13 +1 0-+--2 O---+-3 2-+ 8 I 004E 166 4 00 W L E I c
OTALQUALITYINDEX 11 SFOP 8 I +---26----+
+--20---+ I I
I I
I 1
I g HEATED AREA 2,824
I I
. +-------42-------+ NOTES
SUBAREA UNIT ORIG% ANN DEV % OB/XF DEPR
TYPE � GS AREA % RPL CS ODE DESCRICTIO LTH H NIT PRICE COND LDG#L B AYB EYB RATE V COND VALU
AS 1 23 10 30036 z5 ARN 3 5 1 9 I5.0 10 L 192 199 S 4 1253
EP 352 07 1997 OTAL OB XF VALUE 12 53
OP 16 035 454
US 1 23 09 9029 .
IREPLACE 5-Two or 5,40
more
UBAREA 2.98 20.57
OTALS
UILDING DIMENSIONS FEP=W16N20W8BA5=N2W16548EIOFOP=58E20NBW20EE32N18W26N28q528E24N8 pTR=E15 FU5=E16530E26518W42N48SW15=.
ND 2NFORMATION
IGHEST THER AD7USTMENTS LAND TOTAL
ND BEST USE LOGL FRON DEPTH/ LND COND ND NOTES ROA UNIT LAND UNT TOTAL AD7USTED LAND LAND
SE CODE ZONING TAGE DEPT SIZE MOD FACT RF AC LC TO OT TYPE VRICE UNITS TVG AD75T UNIT PRICE VALUE NOTES
URALAC 0120 50 0 2.5000 4� 1.0900 01+10+00+00+00 VW 9 900.0 1.00 AC 2.72 26 977.5 2697
OTAL MARKET LAND DATA 1.00 26,98 ,
� OTAL VRESENT USE DATA ' .
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parce1=F800000140 4/15/2013