120 Joe Langston RdW. a
HEALTH DEPARTMENT RELEASE
Tyd �SYA]F y
Davie County. Health Department
210 Hospital Street
- P.O. Box 848
mow°" Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: Eric Brown Construction
Address: 144 Ashley Brook Lane
City: Mocksville
State/Zip: NC 27028
Phone #: (336) 345-9719
PERMIT VALID 0 3 1 y /.1 0 a 0
UNTIL:
Property Owner: Luther and Ruby Cain
Address:
City:
State/Zip:
Phone #:
Property Location & Site Information
Address 120 Joe Langston Road Subdivision: Phase: Lot:
Road # Advance NC 27006 —
SINGLE FAMILY Township:
*Structure: Directions
# of Bedrooms: # of People: Hwy 158, Left on Farmington Rd to end, right on Hwy 801 Joe
Langston on right.
*Water Supply: NIA
Basement: n Yes n No Type of Business:
Total sq. Footage:
*Proposed Improvement:
Garage and Porch
No. Of Employees:
Porch is to be added to the left side of the home maintaining a 5 foot setback to any portion of the septic system
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:.
*Issued By, 2140 - Nations, Robert
Authorized State Agent:
*Date:
*Date of Issue:,0 3/ 1 7/.1 0 1 5
**Site Plan/Drawing attached.**
Hand Drawing 0 Import Drawing
cnaiactan
Remaining
635
Drawing Type:
HEALTH DEPARTMENT RELEASE
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Health Department Release
CDP File Number: 190702 - 1
County File Number:
Date: 03/ 17/ 2015
O inch
Scale: O Block = ft.
O N/A
Drawing Type:
HEALTHDEPARTMENT RELEASE
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Health Department Release
Page 2 of 2
CDP File Number: 190702 - 1
County File Number:
Date: A3./ 17/ 2 0 15
Davie County Health Department
4
1836 Health Section
P.O. Box 848
ate' 210 Hospital Street
Courier #: 09-40-06
Mocksville, NG 27028
Phone: (336) - 753 - 6780
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Fax: (336) - 753-1680
Name: / /%i91z1`l �OR%?ST Phone Number 717& 3-115r 9 7I 9' (Home)
Mailing Address: /yy IG -`1 A v 01-eyk 1-4 (Work)
r— /�S�t/y We— Email Address:
Detailed Directions To Site: -�r` 4/6) �'4✓/f 7�n S� IV
Property Address:7ZV 77
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Type Of Facility:
Date System Installed (Month/Date/Year): i 0 Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes ,Lo) If Yes, For How Long?
Any Known Problems? Yes No If Yes, Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: `�. Number Of Bedrooms: Number of People
Poo ear Garage Size: XX � Other: _lah
Requested By:
(Signature)
Approved Disapproved
omments:
Date
For Environmental Health Office Use
in1y
�/7
Environmental Health Specialistv�l A0 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 Money Order # Amount.$ Date:
Paid By: Received By:
Account #: 0 TOA Invoice #:
f -� appraisal Card
1N LUTHER LEE GIN RUBY M Rltvrn/ApP9e1 Nebe: PRn:NI C6-000-00-064-03
20 JOE LANGSTON RD PLAT: Il/357 UNIQ ID 2019
304149 NN: 26- CHANGE OF OWNERSHIP D115 -P5 IO NO: 5012703462
COUNTY 1. (100), FIRE TA% (IN) GRD NO. 1 o/ 1
oval Yur: 3013 T6R Yur. 2015 TR 2 MILLER/WRIGHT.879 AC 0.970 AC SRC-U.P4eeon
nludb li en 0l 1 01503004 FA RMINGTON TW -03 Cl. FR -00 EX. AT. LAST AMON 20150114
CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE
n1.15-3
ER.
R
EASE
SU—M 0.5300
ub Floor Sykhm - 4 SE
MOD Aro UAL
PATE
R[N EYe
AnPEOEN CE TO MARKET
vNO 53,920
1 wase e.a0
•brier WEI1.•09 TYPE: SIngb Amity R4RdmW1 Singb F4mIN NMA4nUH EPR. OB/XF VALU I - GRD 120
ood on Shaethln o wood 30.00 ARXET GMD YAWE•GRD 21,710
eennq Serve tun• 03 STYLE; 1. 1.0 SUry OTAL MARKET VALUE -CARD 75,750
goo
oeflnq Corr- 03
:DTALAPPGISED VALU! • CARC 75,750
.1 Wall ConMrvNon• 2 TAL APPRAISED VALUE PARCEL 75,750
nell
Soerd or Wood WLII 14.00
nlrwr Wall ConetrvNen • 5 OTAL /RESENT USE YAW! • PARCEL
ell M1eetroh .00 VAWE DEFERRED -PARCEL I
DIAL
nlrM Fbor Carer • 09 AL TAXABLE VAIY! • PARCEL 75,750
OT
.-Hr Floor Covor • 12 PRIOR
.od+ • i S • + UILDING VAIUE 56,060
utinq Ful • 02 I ;AT I BXF VALVE 1,5611
II Wood or Col 0.00 I I AND VALUE 20,250
utin9 Typo - 04 7 I RESENT USE VAWE
rted Alr• .CTed 4.00 I I EFEMIUVS:WE
i Cond....... 1,, -01 1 1 TAL17
000 0 0
rrN/e9ihnoms/Half- I 1
threomk I 1
I 1
+ • 11 • ♦ PERMIT
AS -3 FUS -0 LL -0
S -11 F
o1 +• 34 --+
A-
S -
AS0 1 I
all-B+threeme I I OW: WTRSHD:
A - 1 1 SALES DATA
• B FF.
1 I ECORD AT[ DEl0 NDICATE SALES
OTAL POINT VALU[ 2.000++ ++ OUR AGE O 1 RIC
I P A B 1 013E 223 12
DC
3000 190 12 OCt 1%9 43 9 WD ANP
A.",
5 FARORS
I+•••+174 t5f f WD %OTAL
.1000
AD]USTMENT FAR00. 1.130 CiP[P 0165 312 9 WD U V
OTAL QUALITY INDEX 104 1 0 0
1 +-B •+
I i
I s
♦ + 7 • + • - + • l 1 • ♦ HEATED AREA 1,742
7PT0 7
+7•+FOP MOTES
M POUN BAILEY
VSAREAUNIT
ORIS %
ANN DEP
4A
OS/XF DEPR
D[ [SCRIPTION
UN T N
NA ►RICE GOND LDOt AYB EYB
RAT[
COAD
VALUE
5 1 272 100 92602 4 HEO
1 M
56 1.1
4 e12
EI 00 070 4077 OTAL OB XF VALUE
IN
P 6
0 49 005 146
[REPLACE 3* '5"*" 2,250
Sln la
UPARRA
OTAL9 1,547 11,727
[WIND DIMENSIONS B/S-W2451SW2530E2PTD�S 7E7NIW7SE7FOP-57E6N7W0SEI9N0 FEP-ESN10W05 I0SN22W2NIB3 PT RENS FAT-N30W13530E131 SSS.
7NER
DJUSTMENTS
1GHEST
NO BEST
USE LOCAL
FROM
DEPTH/ LAD
COAD
ND NOTES
RF AC LC TO
tOAD
LAND
UNIT
TOTAL
LAND UNT TOTAL
ADIUSTED
LAND OVERBID[ LAND
5E
COD[ ZONING
TAGE
EST 612[ MOO
PACT
TYP!
PRICE
UNITS TYP ADIST
UNITPRICE
VALUE VALU[ NOTES
URA
0
♦ r
.
00
OTAL MARKET
LAND DATA
O.NO
21,710
DIAL PRESENT USE DATA
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CA
0
New Peyrn A
ag'
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Owner: CAIN LUTHER LEE
Page 1 of 1
http://66.226.39.229//ITSNet/AppraisalCard.aspx?parcel=C60000006403 1/21/2015
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............................ County, North Carolina and more particularly described as follows:
BEGINNING at an iron in the Southern edge of the paved portion of NC
Highway 801, Northwest corner of the within described tract which said iron
is located North 85 dogs. 37 min. 37 sec. East 92.65 feet from an iron
marking the Northeast corner of that Milton F. James tract described by
deed recorded in Deed Book 133, page 641, Davie County Registry and running
thence from said point of BEGINNING in tha'right of way of NC Highway 801
North 85 dogs. 37 min. 37 sec. East 128.56 feet to an iron located in the
Southern edge of the paved surface of NC Highway 801 located South 21 degs.
49 min. 11 sec. West 34.68 feet from a nail at the centerline of the
intersection; thence with the Western margin of SR 1446 South 00 degs. 09
min. 56 'sac. West 115.64 feet to an iron in-the edge of the road; thence
South 03 degs. 48 min. 00 sec. West 122.52 feet to an iron at the edge of
the road; thence South 09 dogs. 51 min. 28 sec. West 79.38 feet to an iron
at the edge of the road, Southeast corner of the within described tracts
thence North 85 degs. 05 min. 04 sec. West 110.84 feet to an iron; thence
North 00 dogs. 49 min. 41 sec. East 296.82 feet to the POINT AND PLACE OF
BEGINNING, containing 0.879 acre, more or less, as surveyed February 5,
1992 by Sam Hall and being a•portion of lands described by deed recorded in
Dned Book 144, page 800, Davie County Registry and being further designated
as a portion of parcel 64, Davie County Tax Map C-6.
nte:gwm
Dar Assoc. Form No -3 01976. Revised 0 1977 —a•m smo n s a co. im.. en in. Hanna:.. m a floss
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