709 Cana Rd 3avie County, NC Tax Parcel Report g a, Friday, September 23, 201 E
f,�_ p f
q 94
780 r
,-T
739
r——
7
140 733
112
�/1 -----704
699 Q 688
----- 695 V
__._._....-- ___........ -_ __..._............_.... ....__��.---.... _.6.Z7...... ..... .QI%.............. -_........................__................................................................._......
WARNING: THIS IS NOT A SURVEY
Parcel Iaformation.
Parcel Number: F40000002802A Township: Clarksville
NCPIN Number: 5830073519 Municipality:
Account Number: 41704000 Census Tract: 37059-801
Listed Owner 1: JORDAN JAMES C Voting Precinct: CLARKSVILLE
Mailing Address 1: 711 CANA ROAD Planning Jurisdiction: Davie County
City: - MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 8.82 AC CANA RD Fire Response District: WILLIAM R. DAVIE
Assessed Acreage: 7.79 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 5/1984 Middle School Zone: NORTH DAVIE
Deed Book/Page: 001210606 Soil Types: EnB,MsC,ChA
Plat Book: 11 Flood Zone:
Plat Page: 121 Watershed Overlay: DAVIE COUNTY
Building Value: 134100.00 Outbuilding&Extra 19310.00
Freatures Value:
Land Value: 59190.00 Total Market Value: 212600.00
Total Assessed Value: 212600.00
All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie 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
np UN�4 NC or arising out of the use or Inability to use the GIS data provided by this website.
y
ECEZ E
OCT 2 9 2012
Davie County Health
'�o P8 I� Environmental Health Section
P.O. Box 848
210 Hospital Street
C�
O U �'t +a� Courier# : 09-40-06 1911
Mocksville, NC 27028_,
BY.
Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFICATION—,, Fax:(336)-753-1680
(Check One) Replacement Remodeling Reconnectio
Name: Sl C Phone Number (Home)
Mailing Address: �j (Work)
Email Address:
Detailed Directions To Site:
Property Address: -72 '2 aa, ! V cl l OW000 9 0.,1,x} 1(,le,
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: \10tr J O Type Of Facility:
Date System Installed(Month/Date/Year): !� a f '!2q Number Of Bedrooms:_�Number Of People:�a n�/Z
�`— -3
Is The Facility Currently Vacant? Yes No 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: f Number Of Bedrooms: Number of People_
Pool Size: Garage Size: Other:
Requested By: Date Requested: Z g,7
g ture)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date: 111V2012,
*The signing of this form by the Environmental Health SYaff 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:$ Da
Paid By:'j Ci.)O dReceived By:
Account#: 5q7b b Invoice#: 3
.y Davie County Health De art, C
t$�s Environmental`Health Section :
R0 Box 848 1
p 210 Hospital Street L
O 't
JA I Courier# : 09-40-06 1911
:. Mocksville, NC 27028
Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFIC Fax:(336)-753-1680 '
(Check One) Replacement Remodeling Reconnectio
NamePhone Number (Home)
Mailing Address: Work)
Email Address:
Detailed Directions To Site:
M.
Property Address: �D c'--/ �Gl Gs i'a�e l F" exjcob2 oa�} ac
Please Fill In The Following Information About The MSTINGFacility: a� (�{/ j��cSjj.,eld
Name System Installed Under: \JUl(of O Type Of Facility: .xLy��n
Date System Installed(Month/Date/Year): y !?J(—Number Of Bedrooms:__62�, _Number Of People:�a Jia,/Z
Is The Facility Currently Vacant? Yes No If Yes,For How Long? tw
3 `
Any Known Problems? Yes No If Yes,Explain:
Please Fill In The Following.Information About The NEW Facility:
Type Of Facility: �' f Number Of Bedrooms: Number of People_
Pool Size: Garage Size: Other:
Requested By:' Date Requested:
gnature) .N ,
For Environmental Health Office Use Only
Approved Disapproved Y
Comments:
Environmental Health Specialis Date: /
.*The signing of this form by the Environmental Health 77 is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment Cash Check Money Order # Amount:$ _Daje� NOW
Paid By:\-) JUfC,t�l.n. �. Received By: �1•-S. f t
t
Account#: Invoice#: ��
lr 1�p eNkiZ 4p C,1
f j
Sn
I j
74ss leon�
IZDtapE�
a -
�
0 2
� a ,g
zt-
7//C.&A
/�Oc�v;llF NG
�cSI�oWE2 (�n��✓� �� ��j�NF:: 33(0-998,�Dlo .
-97/-39SO
I
Li
\ by
\ oEKIrY-As
\
\
\
N ————
CENTER LINE OF NEW
EL
20' EASEMENT OCT-16-2012
N $g sa�61
UNE BEARING DISTANCE
L1 N 84'24'55 E 65.67
m r� L2 S 89'32'10' E 25.30
Q Z r L3 S 774848' E 33.76
L5 S 52'33'12' E 23.23
2 L6 S 4-V42'53* E 74.81
L7 S 59'39'29' E 26.40
1.8 S 73'36'33' E 28.44
f L9 S 66'54'13' E 39.51
L10 N 74 39'06' E 48.71
L11 S 75'31'18' E 154.52
AREA= 1.000 AC. CML12 N 26.30'00' E 13.00 M
BY COMPUTER
I __
IRON �j i 12 i
AVA
ryTING
A- GRAVELDRIVE '
C
_ - 1 D.B. 1z3 JORDAN
20' NEw � D'B >21, PC PQ 66'
FASEUENT I ` ` _ 606
�� a I✓ ' ��.._� WELL 12' EXISTING
j GRAVEL DRIVE
EXW175.16
1R0N'NG N 84'28'18'
160,08
z!1V*tl - RON NG - N 84-29,()3, y 1
RE
FRocji
I, Grady L Tutterow, certify that this plat was drawn A�►. 3� /
under my supervision from an actual survey made
under my supervision (deed descrion recorded in 3r
.Book ; Page , etc.) (other);that the
boundaries not surveyed aro clearly Indicated as drawn
from information found in PL Book Page
that the ratio of precision is calculated as 1' +20.000 ;
that this olat was arsoared in accordance with G.S.
N --.--
1
n A •�jJ CENTER UNE OF NEW
20' EASEMENT OCT-16-2012
04 4i fit.yam6'6-
' 0
i I LINE BEARING DISTANCE
61 Lt N W24'55* E 65.67
L2 S 89.32'10' E 25.30
pi yh I L3 S 77'46'48' E 33.76
L4 S 6752'07' E 27.11
L5 S 5Y33'12' E 23.23
1-6 S 4,V42'53' E 74.81
L7 S 59'39'29' E 26.40
LB S 73'36'33' E 28.44
L9 S 88'54'13' E 39.51
L10 N 74!39'06" E 48.71
1-11 S 75.31'18' E 154.52
AREA= 1.000 AC. ro I M L12 N 26'30'00' E 13.00 CM
BY COMPUTER
`\ .2y
I
22 1 ------ --'�--
10' EXISTING I
GRAVEL DRIVE I
JA
2D• N
1z3� JORDAN
D.P. >2>, pCC 6 60 6
Lw
NiTy EasEUENr 1 �
N 6S9S�'a
�..,, WELL 12• EXISTING
j Y GRAVEL DRIVE
+
. EXISTWG175.16
IRON N 84 p18•
160.08
v
SIP IRON NG N 8.29,
AG P
I, Grady L Tutterow, certify that this plat was drawn
under my supervision from an actual survey made t7�3
under my supervision (deed descn tion recorded in r
Book Page etc.) other);that the
boundaries not surveyed are clea indicated as drawn
from Information found in PL Book Page=;
that the ratio of precision is calculated as 1; +20.000 ;
that this plat was prepared in accordance with G.S. `��rrruur,r�
47-30 as amended. Witness my original signature, �. 1r
registration number aid seal ay of S .
SS/ ��j�•�
.1u4d ll(�i = SEAL - -
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Environmental Health q
P.O.Boz 848/210 Hospital Street
FUM
P 1 Mocksville,NC 27028
OCT 2 9 201
(336)753-6780/Fax( 3 53- 8
Applicati - provement Permit authorization To o truct(�f ---
Type of Application: ❑New System: ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
***IMPORTANT***THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPT,TCANT INFORMATION
Name C,
✓ Contact Person
Address CoVVfHome Phone3.,� -2999
City/State/ZIP 9 8 Business Phone
Email p,,
Name o it/ATC if Different than Above
Mailing Address ofs v F City/State/Zip
PROPERTY INFORMATION *Date House/Facility Comers Fagged
NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan lat(to scale)
(Permit is valid for 60 months with site plan,no expiration with complete plat.)
Owner's Name' ' _/' Phone Number.
Owner's Address ,116E City/State/Zi
Properly Address ff- City /1701 !%%/F itJC,2?O2-d-
Lot Size / fJC,r2F Tax PIN#
Subdivision Name(if applicable) Section/Lot#
Directions To Site: N ,` f DV S
If the answer to any of the following questions is•"Yes",supporting documentation must be attached:
Are there any existing wastewater systems on the site? /`YesNJJ�� SEE A�fAc AMgN1
Does the site contain jurisdictional wetlands? Yes ,/No
Are there any easements or right-of-ways on the site? Yes No
Is the site subject to approval by another public agency? _Yes _No
Will wastewater other than domestic sewage be generated? Yes✓No
TF RESIDENCE FIT J,OT TT TNF.BOX RFLOW
#People I e, #Bedrooms �_ #Bathrooms�_ Garden Tub/Whirlpool ❑Yes Ao
Basement: ❑Yes o Basement Plumbing: ❑Yes 2<0
IF.NON-RF,SMF,NCR.FIT1,OUT THE BOX BFJ OW
Type of Facility/Business Total Square Footage of Building #People
# Sinks #Commodes # Showers #Urinals
Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: #Seats
Type system requested: ❑Conventional ❑Accepted ❑Innovative,, ❑Alternative ❑Other
Water Supply Type: ❑ County/City Water ❑New Well ( 'Existing Well ❑ Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes Xo
If yes,what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that
any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use changes,or if
the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative
of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules.
I understand that I am responsible for the proper identification and labeling of property lines and corners and locating and flagging
or staking facility location,proposed well location and the location of any other amenities.
Pro rty o er's or owner's legal representative signature Site Revisit Charge
Date(s):
Client Notification Date:
Dae ��� 'ft I I e (7 LA BHS:
04
Sign given ❑Yes ❑No Account#
Revised 11/06 "�o � - + Invoice#
•
lr c0e►'k2 4B Capt -' W '►1/ r �-2 C�} Cr——42 'Poo IX, ?IV C42NFfy
8
9
1
• , X3.0
.18
10
my,-ss: 711 CJN4
I1�Dc�s v%llF NC
a7o2
wf2
(s) 971 -39so
hl �
I/oo,
s .
v4h
I hereby certify that I am the owner of the property shown
and described hereon, which located in the County of Davie REVIEW OFFICER'S CERTIFICATE -,�-_ -
that I hereby adopt this plan of subdivision with my free consent, - Filed for registration at o'clock M. _-- , ---------
established
-established minimum building setback lines and dedicate all streets,
_ /
alleys, walks, parka and other sites and easement to public or Review officer of Davie County,tY _, 2012 and recorded in
private use as noted. Furthermore, I hereby dedicate all sanitary certify that the map or pkat to which this certification
\ sewer and water linenn�t the County of Davie is affixed meets all statutory requirements for recording. Plat Book Pae /
\ g
IN, JAMES C. JORDAN REVIEW OFFICER DATE Filling fee _ paid' Y. BFiENT SHOAF - DAVE Co. Regieter of Deeds
\ by a°ooh
O
\ DEPUTY—ASSWANIF
\ J�DARC ftD.
\
\
/�N -_—_. -- - - -- -
NO SCALE
cp � V •'C7 S t
•� • , t VICINITY MAP
(L �� A p�'j.► t CENTER LINE OF NEW
• �rji t 20' EASEMENT OCT--16-2012
C14 X94 i —
UNE BEARING DISTANCE
Lt N 84'24'55' E 65.67
p ,y t L2 S 89'32'10' E 25.30
t L3 S 7T46'48' E 33.76
o �� t L4 S 0
L5 S 52'33'12` E 23.23
2 t L6 S 44'42'53' E 74.81
L7 S 59'39.29' E 26.40
t LB S 7336'33' E 28.44
t L9 S 86'54'13' E 39.51
L10 N 74'39'06' E 48.71
i L11 S 75'31'18' E 154.52
AREA= >.000 AC.
(71E)L12 N 26'30'00' E 13.00 CM
_ N t C
BY COMPUTER R N
\
CRFµ
WEtt
- 7'
10' EXISTING
6s•40. ~' GRAVEL DRIVE I /
I
�.JO. `f'' �AN
D•D• 'z 'nPC2U NEW ;ss
y EASEMENT I \ ��s 9 d-G SO n
V /
CORKER( �\ \��` �/ / ''�'i'►.
0
I \ WELL •Y� 12• EXISTING;
/--C1� �/ ' /GRAVEL DRIVE
EX)S
•����r�, • �.�j Nr
IRON
N B417.25.1lie,
1B•
(TIE)
_4<_ rNcl N 8,41(2\9�oNTIE)
_• •/�
�./
T �qP
k,ra
I, Grady L Tutterow, certify that this plat was drawn A�r _� FROM
`/1 .
under my supervision from an actual survey made
under my supervision (deed description recorded in
Book - ; Page - , etc.) (other);that the
boundaries not surveyed are clearly indicated as drawn
from information found in PL Book Page -" • PLAT' P
that the ratio of precision is calculated as 1; +20.000 ;
that this plat was prepared in accordance with G.S. JAMES'
C.
������
47-30 as amended. Witness my original signature, ,.�.�N C!�Ft'�J .,. � l
registration number arld seal _L!' tf ay of P; S• ���
0177
2Q12�.. 2 12 i/ ;``s � r'F�� JUS . R
OWNER --------- -- DEVELOPS
`� 5�At_ - --- JAMES C. JORDAN
(Seal or Stamp) Registration Number L-262-1 711 CANA RD.��
Firm Licence Number F-0372 �� - ,� : MOCKSVILLE* N.C. 27028
CLAKSVILLE TOWNSHIP
DAVIE COUNTY, NORTH CAROLINA
Sua=or rtiif>n„ri.,,, far Subdivision — Davie Count North Caroling
1, Grady L Tutterow, Registered Land Surveyor, Number L-2527
certify to one or more of the following as Indicated by an X: DATE: OCTOBER--16-2012
X _a. That this In a plat of a survey that creates a subdivision of
land within on area of a county or municipality flat has an SURVEYED 9Y:
ls
ordinance that rof of athiss parcels of land; NOTES: 'TU`1"'TER01V SURVEYIIaG COMPANY
D. That this plot n survey at located in such a
7 NORTH SALISBURY STREET
porton a a county municipalitythat Isur�requkrbed as to an 10MOCI<SVILLE, NC 27028
ordinance that regulates parcelslsoof kind; 1. TOTAL TRACTS= 1
c. That this plat Is of a survey of an existing parcel or
parcels of land;
_d. That this plat Is of a survey of another category, such as the 2. TOTAL AC.= 1.000 AC. (336) 751-5616
recombination of exnoels, a court—ordered survey, or 1„ = 50'
other exception to the ninon of a subdivision; 3. NO NCGS GRID MONUMENT LOCATED WITHIN 2000 FT. 50 25 0 50 100 150
s. That tM I nfon»ation avalkable to this surveyor Is such
that I am unable tpfrnma. mna deteiration to the best of my NO APPROVAL REQUIRED BY THE4. AT THE DATE OF THIS SURVEY THERE IS NOT A DWELLINGprofooontalned In a. through d. above. DAVIE COUNTY PLANNING DEPT. LOCATED WITHIN THE BOUNDARIES OF THE 1.000 AC TRACT./I � L S .2�2 7 SCALE IN FEET
SignatureI� DAVIE COUNTY PLANNING DIRECTOR
Registration Number DAVIE NAME: COORD NAME: DRAWING NUMBER:
JORDPLAT 12212-3