267 Cana Rd HEALTH DEPARTMENT RELEASE (' For Office Use Only
` *CDP File Number 121853-1
Davie County Health Department
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210 Hospital Street County ID Number.
P.O. Box 848 Evaluated Far. HDR/VIIWC
Mocksville NC 27028
Phone:336-753-6780 Fax:336-753-1680 PERMIT VALID 0 6 ! 1 1 / 2 0 1 8
UNTIL:
Applicant: Charles and Evelyn folds ::::�j Property Owner: Charles and Evelyn folds
Address: 267 Cana Road Address: 267 Cana Road
City: Mocksville City: Mocksville
State2ip: NC 27028 State2ip: NC 27028
Phone 4: (704)883-6148 Phone : (704)883-6148
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Property Location&Site Information
Subdivision: Phase: Lot
sville NC 27028NGLE FAMILYTownship:
Directions
#of Bedrooms: #of People: Hwy 601 North right on Cana right,lot 1st on right
*Water Supply: NIA
Type of Business:
Basement: �Yes❑No ,
Total sq.Footage: No.Of Employees:
*Proposed Improvement:
Mobile Home Replaced
Release Conditions
It is the responsibility of the owner to maintain a 5'minimum setback between the 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 required 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 requirements at the time it was installed.
This release in no way expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site will continue to function for any period of time.
Applicant/Legal Reps.Signature Required? Oyes ONO
Applicant/Legal Reps.Signature, *Date:
*Issued By: 2244-Daywalt,Andrew *Date of Issue: 0 6' / 1 1 1 2 0 1 3
Authorized State Agent: 0014A41DW AD
**Site P I n/Drawing attached.* Total Time:(HH:MM)
0 1 Hours 0 0 Minutes
U Hand Drawing O ImportDrawing
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Davie County Health Department
4o1836 r� Environmental Health Section
4 P.O. Box 848 + -1
CEIM 210 Hospital Street
O 'S Courier# : 09-40-06
• 2 -` Mocksville, NC 27028
Phone:(336)-753-6780 Fax:(336)-751-8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Name: FRIL 1140/ttoloti HO MD Phone Number 704 -693_Q � (Home)
Mailing Address: 1230 CJUoLt iL Ot Up (Work)
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Detailed Directions To Site: jobj jdLjj,'q VS �.M�KINIJI L(1' el(�Ht 6)J (�)�¢ �0 1yj (S c o am-(T
Z ' 5;P&LWPL 614 V1
Property Address:
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Type Of Facility: Sw��K
Date System Installed(Month/Date/Year):—Al 93 Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? -Yes If Yes,For How Long?
Any.Known Problems? YesNo If Yes,Explain:
Please Fill In The Following Inf 'tion About T e NEW Facility:
Type Of Facility: 6q�1 �(,(llre 4)111 •e Number Of Bedrooms: Number of People
" equested By: Date Requested:
(Signature) -'^
For Environmental Health Office Use Only
Approved. Disapproved
Comments:
.a
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
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check oney Order # 2 Amount:$ f 0 0 i0 Date
Paid By: Received By-
Account#: 0 Invoice#: z5b-7
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All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied OUVIk warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the County of
Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to or arising out of
j the use or Inability to use the GIS data provided by this website. P rI n ted.May 28, 2013
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Appraisal Card Page 1 of 1
DAVIE COUNTY NC - 5/31/2013 9:46:06 AM
OLDS CHARLES E FOLDS EVELYN A Return/Appeal Notes: G4-080-AO-011
67 CANA RD UNIQ ID 10659
5692000ID NO:5820821716
COUNTY TAX(100),FIRE TAX(100) CARD N0.1 of 1 -
eval Year:2013 Tax Year:2013 LOTS 35-37 CANA RD 0.350 AC SRC-Inspection
Appraised by 19 on 0710 2008 06003 WOODWARD TW-06 C- EX-AT- LAST ACTION 20110712 pT
CONSTRUCTION MARKET VALUE DEPRECIATION CORRELATION OF VALUE +•`
DETAIL O
TOTAL POINT VALUE Eff. BASE
BUILDING USE MOD Area IQUALI RATE RCN EYBAYB REDENCE TO
ADJUSTMENTS 971 00 1 1 %GOOD EPR.BUILDING VALUE-CARD
TOTAL ADJUSTMENT TYPE:Vacant EPR.OB/XF VALUE-CARD 4,50
ACTOR 4ARKET LAND VALUE-CARD 13,00
TOTAL QUALITY INDEX STORIES: rOTAL MARKET VALUE-CARD 17,50 m
TOTAL APPRAISED VALUE-CARD 17,50
TOTAL APPRAISED VALUE-PARCEL 17,50(
TOTAL PRESENT USE VALUE-PARCEL
TOTAL VALUE DEFERRED-PARCEL
TOTAL TAXABLE VALUE-PARCEL 17,50
PRIOR
UILDING VALUE
BXF VALUE 4,50
.AND VALUE 13,00
RESENT USE VALUE
EFERRED VALUE
TOTAL VALUE 17,500
PERMIT
CODE I DATE NOTE I NUMBER AMOUNT
OUT:WTRSHD:
SALES DATA
FF.
ECORD ATE DEED INDICATE SALES
OOK AGE R TYPE PRICE
0118 548 121198A WD X V
HEATED AREA
NOTES n
16X25 CP
SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPR .F
GS RPL ODE ESCRIPTIO T NIT PRICE COND LDGA B AYB EYB RATE V GOND VALUEo
TYPE AREA CS DS H SITE 1 4 500.0 10 L 199 199 S 10 450 c
[ND
PLACE OTAL OB XF VALUE 4,500
b
REA
LS
DING DIMENSIONS
INFORMATION
EST THERADJUSTMENTS TOTAL
BEST USE LOCAL FRON DEPT"/ LND COND ND NOTES 11 OA LAND UNIT LAND UNT TOTAL ADJUSTED LAND LAND
CODE ZONING TAGE E SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES
0100 75 0 1.0000 0 1.0000 PW 13 000. 1.00 LT 1.00 13 000.0 1300L MARKET LAND DATA 13,000
L PRESENT USE DATA
1
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=G408OA0011 5/31/2013