695 Cana RdDavie County, NC
Tax Parcel Report
Wednesday, October 12, 2016
WARNING: THIS IS NOT A SURV�Y
____ _ _
Parcel Information
Parcel Number: F40000003001 Township:
NCPIN Number: 5820979245 Municipality:
Account Number: 82521552 Census Tract:
Listed Owner 1: IRELAND ANDREA DIANE Voting Precinct:
Mailing Address 1: 695 CANA ROAD Planning Jurisdiction:
City: MOCKSVILLE Zoning Class:
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag. District:
Legal Description: 1.200 AC OFF CANA RD Fire Response District:
Assessed Acreage: 1.14 Elementary School Zone:
Deed Date: 9/2003 Middle School Zone:
Deed Book I Page: 005140666 Soil Types:
Plat Book: Flood Zone:
Plat Page: Watershed Overlay:
Building Value: 99920.00 Outbuilding & Extra
Freatures Value:
Land Value: 13570.00 Total Market Value:
Total Assessed Value: 114860.00
Clarksville
37059-801
CLARKSVILLE
Davie County
DAVIE COUNTY R-A
WILLIAM R. DAVIE
WILLIAM R DAVIE
NORTH DAVIE
En6
DAVIE COUNTY
1370.00
114860.00
Q�,����, . All data is provtded as Is without warranty or guarantee of any kind either expressed or Implied including but not limlted to the
Davie County� Implied warranties of inerchantability or Ttness for a particular use. All users of Davie County's GIS website shall hold harmless thu I
County of Davie, North Carollna, its agents, consultants, contractors or employees from any and all daims or causes of action due to I
npt x,�"i NC or arising out of the use or Inability to use the GIS data provided by thls websitn. ��..
�. .
IMPROVEMENT PERMIT
. . , . ,. . '�Xo
DRVIE CDUNTY HERLTH DEPRRTMENT
IMPROVEM�NT PEAMIT and �ERRTIDN PERMIT
**NOTE+�* This itprove�ent per�it DOES NOT authorize the ronstruction ar installation of a septic tank syste� or any wasteNater
syste�. AN AUTHORI2ATION FOR IJA5TEWATER SYSTEPI CDN5TRUCTI�tJ �ust be o6tained fro� this Depart�ent prior to the
construction/installation of a syste� or the issuance of a building per�it.
tIn co�pliance with Article 11 of 6.5. Chapter 130A, Flastewater Syste�s, 5ection .1900 Sewage Treat�ent and Disposal 5yste�s)
NAM� C �i f;I�,� �. _ PRDRERTV ADDRESS (_� Q� t�-- /��_ �� 7D,,7i � DNTE ,..S�,�l.�
L�:RTION /',/`1,.r/iJ �c�/
SUBDIVI5ION NAME LDT MJMBER SEC./BLDCf( NU�1BER
RESIDENTAL SPECIFICATION: BUIL�ING TYPE ��k BEDR�MS � N BATHS �# OCCUF'ANTS � 6AR84�E DISPOSAL:�/No
CDMMERCI� SPECIFICATION: fACILITY TYPE # PEDRLE # PEOF'LElSHIFT # SEAT5 INDl15TRIAl WASTE: Yes/No
LOT SIZE ��� TYPE WATER SUPPLY / / DESI6M 4�5TE41ATER FLOW lGPD) ,,�� NEN SITE �/�REPAIR SITE
SYSTEM 5PECIFICRTI�IS: TANK 5IZE � 6AL. FNMP TRNK 6AL. TRENCH WIDTH � R�K DEPTH _� LINEAR FT. !v� .� �
OTHER ��l,r.�,���C"r-��� l��ic�,c
REt�JJIRED SITE MDDIFICATIONS/CONDITIONS:
*�*THI5 PERMIT IS SU9JECT TO REVOCATION IF SITE PLANS OR THE INTENDED US'E CHANGE. YDUR WASTERWATER SYSTEM CONTRRCTOA MUST
SEE THIS PERPIIT BEFORE INSTALLIt� THE SYSTEM.
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IMRRDVEMENT PER�fIT BV ,/" Yu'.� //
�*CONTAGT A REPRE5ENTATIVE � THE �AVIE C�ITY NEAI.TH DEPARTMENT FOR FINAI. INSPECTION DF THIS SYSTEM AETWEEtJ
8:30-9:3@ A.M. OR i:�-1:30 P.M. ON THE DAY �F INSTf�LATION. TELEPHONE � I5 f7a4) E34-8760.
OPERATION PERMIT
AUTHORIZATION N0. � � � �
SYSTEM INSTALLED BY �J ���-�1
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ID�1 PERMIT BY ' �
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�*THE ISSURNCE � THIS OPERATION RERPIIT �N9� E THAT TflE�Si`5
ARTICLE 11 � G.S. CNAPTER 13@A, SECTION .� "SE4�GE EA�l4E�
6UAAAPITEE THAT THE 5`lSTEM WILL FLINCTION SATISFACTO�ILY FOR RMY 6I
DCHD 10/95
DATE 4 � I � ! +�
IBED ABOUE HAS BEEN INSTi�.LED IN C�L.IANCE WITH
5AL 5YSTENSB, BUT SHALL IN NO WAY 9E TAKEN R5 A
B-� TII�.
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is,_�,r.-`Yj , ��� • � �:,��.. . � .
� .�� ��, Davie County Health Depart�ent
�� -�- .��=�a H " ENVIRONMENTRL HEALTH SECTION
r,�, ,� _ . .
,� a, , - P.O. 2ox 665
, �r--�� �.� . " - � - Mocksville, N.C. 27028
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; , ^ ;��,, � ,- ..;,: �.
^�',, ° Alli}IDRIZATIDN FOR WASTEWRTER SYSTDI l�F�iTRUCTIa!
.. _ �,. _ .
. � i? � ..
, (Izsued in co�pliance with Article 11 of
• G.S. Chapter 1s0A, Wastewater Syste�s)
+�*+�This Authorization Fnr WasteNater Syste� Construction �ust be issued by the Dav;e County Environ�ental Health 5ection prior to
issuance of any 9uilding Per�its. This For�/Ruthorization Nu�ber should be presented to the Davie County Building Inspectior�s
Dffice when applying for Building Per�its.+�+�
/ AtlTHDRI2RTION I�IJb'.�ER
„ �r�� a! Q n (� `'1
I�IRME � �� P ��C% �'(� /� /1,if_' DATE �.3'„�li .I": �,�.o � �) .1 �
�
NRME ON IIPRUVEMENT PERMIT (If different than abovel
SITE LOCATIp�I /" ",��r l-� c�
COlIfNTS/(X11�ITIQrS ON RUTHDRIIATIp�I TO CONSTRLICT WR5TEI�ATER 5Y5TEM
�fNU'TICE� THIS AUTHORIZATIDN FO WA5TE41ATER SYSTEM CONSTRI�TIDN I5 VRLID FOR R PERIOD DF FIVE t5) YEARS.
�i��� �%r� -� �� �.s��l�/,%'��./�
.
ENVIRO�lENTAL F TH SPECIALIST DATE
DCHD 10/95
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1VE
P�9AY -� 19�6
1. Application/Permit Requested By � � � `/'/
Mailing Address ��5 l�x-�f�� Home Phone�'7o��S�l�/
(Ylc<��5����� `� ( �'�� Business Phone �3�1 ` ,��`l�
2. Name on Permit if Different than Above
3. Application for:
4. System to Seroe
p Business
❑ General Evaluation
❑ House
❑ Industry
5. If house, mobile home: Subdivision
No. of People �
No. of Bedrooms �c,
°�0-8�eptic Tank Installation Permit
�Idlobile Home ❑ Place of Public Assembly
❑ Other
No. of Bathrooms �
Dwelling Dimensions �,u,��—�,�
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
7. Type of water supply: O Public Q�Private
8. Property Dimensions �1� �� rf'-- C►1 �t1GC(f5 Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Unknown
Section Lot #
O BasemenUPlumbing
❑ BasemenUNo Plumbing
L9'GVashing Machine
�Dishwasher
�Garbage Disposal
❑ Yes �-No
❑ Community
'NOTE: Improvements Permits shall beyalid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
( �a-��- 2a '�' i� E, a j� Sr� �
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c� � GUH � T 8�c�c tfa�rsC -����.'�. Orcc�t �
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YI�OYEItTI� ZN�DILN�ITION ItEC1UZXED:
Tax Office PIN: # �����d0��.�
PROPEIZTJ A�bRESS, as follows:
1Zoad Name: �(�/Xjj, R(�(�'
cLt�: ����Jr Ile-
SU$MZZ tl PL�IT WZTH ZHZS ttPPLICtITZON.
�Revisions ef,fective October 1� 1995.
�a���
Thi�to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
in rred�from this a��licaiion.
ATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. I OWN the property. •�. I DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the Davie County Health Department nter u on a ove described
property located in Davie Counry and owned by ��� d
to conduct all testing procedures as necessary to determine s' site's ' bili or a gr und abso tion e treatment
and disposal s tem. '
�--��� — / U/
DATE SIGNATURE
DCHD (1/93)
.
. �_. , DAVIE COUNTY HEALTH DEPARTII�ENT
Environmental Health Section
Soil/Site Evaluation
NAME e � DATE EVALUATED � /��,�
ADDRESS PROPERTY SIZE /�� �
PROPOSED FACIILTY � .�A?'��� LOCATION OF SITE �itlw�-
Water Supply: On-Site Well �/ _ Community Public,
Evaluation By: Auger Boring v Pit Cut �/
FACTORS 1 2 3 4
Landsca e osition L
Slope 7. ,� �- _ __
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture Aroup
Consistence
Structure
MineraloRy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CL�SSIFICATION
LONG-TERM ACCEPTANC
SITE CLASSIFICATION:
M1��1
c• 1y,• i.
` C G
� �
i1 /�d /� /
- � ,, i � �
LDNG-TERM ACCEPTANCE RATE�:
REMARKS: %fi/P��G'-�/O ,
DCHD (O1-9o1
EVALUATED BY: ,.CY�i�/
OTHER(S) PRESENT:
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-Silt,y �:lay loam� SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moist
VFR- V��.-y 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
Stru cture
,iC--Syn�le grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Min eralo�y
1:1, 2:1, Mixed
Notes
fiorizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil w etness - Inches from land surface to free watec' 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 - gal/day/ftz
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health SecEion
PO Box 848%210 Hospital Street
Mocksville, NC 27028
Phonec � (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑
Name: ..�� �t i�v '� • �/�.- � �� f� �� Phone Number: (Home)
Mailing Address: � ��l�_�L��_�-C'-� ' �, b w�'"'� � b � r � io �-3 (Work)
i�'` a� lC"s � i/� �
Detailed Directions To Site:
(�� � 1 r� -�—,� �' fi ,�-r� -I--z..��, ,�. r� /. �:.� .��,,. /� �
Property Address:
Please Fill In The Following Information About The Existing Dwelling.
Name System Installed Under: � � u�— �1 a/ � �,.M- ,• �� P Type Of Dwelling: %M' �
Date System Installed(Month/Day/Year): G'/ �/'c� Number Of Bedrooms: r' Number Of Peopl�
Is The Dwelling Currenfly Vacant? Yes C9�No ❑ If Yes, For How Long? �\/ 1e -� ' '
Any Known Problems? Yes ❑ No C9-/If Yes, Explain:
Please Fill In The Following Information About The New Dwelling.
Type Of
Requested By:.
Of Bedrooms: � Number Of People: �-_
For Environmental Health Office Use Only
Approved � Disapproved ❑
Comments:
Environmental Health
Requested• � � — `%�--0 '�.�i
�
'"The signing af this form by the Environmental Health Staff is in no way intended, nor should be taken as a
Quarantee(extended or limited) that the on-site wastewater system.will function properly for any �iven period of time.
Payment: Cash ❑ Check ❑ Money Order 0# Amoun� $ Date:
Paid By: Received By:
Account #: Invoice #: