366 Cana Rd 3avie County, NC a Tax Parcel Report J Friday, September 23, 201 E
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WARNING: THIS IS NOT A SURVEY
aParcel Information
Parcel Number: G400000011 Township: Mocksville
NCPIN Number: 5830123595 Municipality:
Account Number: 8302565 Census Tract: 37059-806
Listed Owner 1:. STREET SHEREE S ETAL Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: 1235 WOODWARD ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 51.32 AC CANA RD P/O LOT 3 Fire Response District: WILLIAM R. DAVIE
Assessed Acreage: - 57.18 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 9/2013 Middle School Zone: NORTH DAVIE
Deed Book/Page: 009370861 Soil Types: GnB2,EnB,MsC,MsB,ChA,MsD
Plat Book: 0001 Flood Zone:
Plat Page: 090 Watershed Overlay: DAVIE COUNTY
Building Value: 154910.00 Outbuilding&Extra 61990.00
Freatures Value:
Land Value: 289300.00 Total Market Value: 506200.00
Total Assessed Value: 279390.00
9 Iv�� All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
ADavie 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
POU�N-- NC or arising out of the use or Inability to use the GIS data provided by this website.
r Davie County Health Departmentarx
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Environmental Health Section
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-: .. P.O. Box 84$ v
210 Hospital Streetka °
r �, Courier # : 09-40-06.
Mocksville, NC 27028 14
Phone:(336)-753-6780 Fax: (336)-753-1680
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Name: WO M AI d 6611 6eM 7,v�- Phone Number c ShP fP Si �t'l2� (Home)
Mailing Address: ,�,3�p q� �!a (Work)
x,0029
Detailed Directions To Site:
Property Address: -No Ximq W.
Please Fill In The Following Infor>mation/About The EXISTING Facility:
Name System Installed Under: �IUC�L° 1yr� l�S Type Of Facility: us�
Date System Installed(Month/Date/Year): &t) Number Of Bedrooms: 1 Number Of People:_
Is The Facility Currently Vacant?Q No If Yes,For How Long?
Any Known Problems? Yes eff Yes,Explain: `
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: / / Number Of Bedroom., Number of People
Pool Size: Garaize Size: Other:
,( Requested By Date Requested:
J (Signature)
For Environmental Health Office Use Only
�isapproved
Comments:
Environmental Health Specialist 14Date:
*The signing of this form by the Environmental Health StaffVs 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 (LecO Money Order # Amount:$ Date: -MA
Paid By: Received By: r7
Account#: Invoice#: f An