458 Cana Road Lot 2Davie County, NC
Tax Parcel Report Wednesday, November 9, 2016
- - - - - - - - - - -
402
458 1200
1212
% i
1211
1227
' SVI
S9
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WARNING: THIS IS NOT A SURVEY
as All data Is provided Is without unmanly or guarantee a any kind either expressed or Implied Including but net limited to the
Implied mmantles of merchantability or f1mesz for a particular uss. All users 0 Davis County's GIS webs to shall hold harmless th a
County of Daft North Carolina, Its egent@6 conwftanta� ccontractors or employees fifrom any and ad dalms or causes a action due to
or arising out of Me use or Inability to use the GIS data provided by this unflrsifte. I
Information 7 —
Parcel Number:
G400000061
Township:
Mocksville
NCPIN Number:
5830040176
Municipality:
Account Number:
8303419
Census Tract:
37059-806
Listed Owner 1:
COX CHAD ALLEN
Voting Precinct:
CLARKS\11LLE
Mailing Address 1:
458 CANA ROAD
Planning Jurisdiction:
Davie County
City: MOCKSV1LLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
LOT 2 CANA ACRES
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
1.98
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
4/2014
Middle School Zone:
NORTH DAVIE
Deed Book I Page:
009560619
Soil Types:
GnB2,MsB
Plat Book:
0009
Flood Zone:
Plat Page:
062
Watershed Overlay:
DAVIE COUNTY
Building Value:
191650.00
Outbuilding & Extra
9610.00
Freatures Value:
Land Value:
39600.00
Total Market Value:
240860.00
Total Assessed Value:
240860.00
' SVI
S9
(
Davie: County,
NC
as All data Is provided Is without unmanly or guarantee a any kind either expressed or Implied Including but net limited to the
Implied mmantles of merchantability or f1mesz for a particular uss. All users 0 Davis County's GIS webs to shall hold harmless th a
County of Daft North Carolina, Its egent@6 conwftanta� ccontractors or employees fifrom any and ad dalms or causes a action due to
or arising out of Me use or Inability to use the GIS data provided by this unflrsifte. I
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DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
Account #:
990004408
OPERATION PER11% PIN/EH #: 5830-04-2310
Billed To:
Wayne & Jean Brewer
Subdivision Info: Cana Acres Lot # 2
Reference Name:
Location/Address: Cana Road -27028
Proposed Facility:
Residence
Property Size: 2.009 Acres
�•
ATC Number:
4731��
* f E2rni-- -3 gMrOOP"
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC has been installed
in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems,"
but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of
time.
System Type S.T. Manufacturer 86nF Tank Date 10-13 Tank Size 1"b
Pump Tank Size IOW ST 7 6e
System installedBy:�rtaghtfiaLL E.H.Specia Date: 3— 13-g
A)\ I-U� 14W9
ATC Number: 4731 1 Site Type offl4ew ❑Repair ❑Expansion
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Sectionprior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms 3 # Bathrooms # People BasementO Basement plumbingD
Non_Residential Specifications: Facility Type # People_ # Seats_
A Square Footage(or Dimensions of Facility)
Lot Size 2 d,'C ZES Type of Water Supply..,21:5ounty/City OWell ❑Community Well /I
System Specifications: Design Wastewater Flow (GPD�O Tank Sizel1�AL. Pump Tank `QWGAL.
Trench Width Max. Trench D pth � Rock Depth NA Linear Ft. y�
Site
Contact the Davie Codnty Environmental
R -1A — 9-102.m_ nn the day
Section for final inspection of this system between
\3M� FSK t»F C Lr.A3
Ire
^ 4?)YI
Environmental Ijealth Specialjsf
DCHD 11106 (R vised)
DAVIE COUNTY ENVIRONMENTAL HEALTH
P
r
P.O. Box 848/210 Hospital Street
f
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
1
1
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #:
990004408 - Tax PIN/EH #:
5830-04-2310
Billed To:
Wayne & Jean Brewer Subdivision Info:
Cana Acres Lot # 2
Reference Name:
Location/Address:
Cana Road -27028
Proposed Facility:
Residence Property Size:
2.009 Acres
ATC Number: 4731 1 Site Type offl4ew ❑Repair ❑Expansion
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Sectionprior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms 3 # Bathrooms # People BasementO Basement plumbingD
Non_Residential Specifications: Facility Type # People_ # Seats_
A Square Footage(or Dimensions of Facility)
Lot Size 2 d,'C ZES Type of Water Supply..,21:5ounty/City OWell ❑Community Well /I
System Specifications: Design Wastewater Flow (GPD�O Tank Sizel1�AL. Pump Tank `QWGAL.
Trench Width Max. Trench D pth � Rock Depth NA Linear Ft. y�
Site
Contact the Davie Codnty Environmental
R -1A — 9-102.m_ nn the day
Section for final inspection of this system between
\3M� FSK t»F C Lr.A3
Ire
^ 4?)YI
Environmental Ijealth Specialjsf
DCHD 11106 (R vised)
Aug 03 07 09:61a
P IbIVFI
AUG 3 2DO1
Type of Application: D'New System
davie county envhealth 338 751 8788
E EVALUATION/IMPROVEMENT PERMIT & ATC
Me County Environmental Health.
U P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
ent Permit Authorization To Construct(ATC) 4f Both
EN -pair to Existing System OExpansiou/Modiftcation 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.
APPLICANT INFORMATION
Name to be Billed LUO�//L� SFc�� .� ` r r Contact Person 4,Jk c i?GevY„ e r
Billing Address. HonSe Phone 2�1 art 4 oT
City/State/ZIP 1LIC66a;l% /VC 2,fg Busine is Phone
Name on Permit/ATC if Different than Above
Mailing Address �—t CityiState/Zip
rAUYhKIY 1NjVUKMA11UN*Date House/Facility Comers Flagged .W
NOTE: A survey plat or site plan must accompany this application. Included: 0 Site Plan OPlat(to scale)
(Permit ii valid for 60 months with site plan; no expiration with complet n plat.)
Owner's Name y'�in--rLI,,.0 _PhoneNumbe`�U�-&O3
Owner's Address cu _ ;5 City/ State/Zip ��2amCr_ A14070D(�
Property Address Ld¢e2 e a a.t a Qe res City_
Lot Size Ape . TaxPIN#
Subdivision Name(if applicable) e/ Sectior/Lot# 6_9
Directions To'Site:
P. 1
1t the answer to any or the following questions is "yes", supporting documentation must be attached. _•
Are there any existing wastewater systems on the site?
[]yes Eft -lo
Does the site contain jurisdictional wetlands?
Oyes Enlo
Are there any easements or right-af•ways on the site?
PiYes ONo VO "
Is the site subject to approval by another public agency?
❑Yes Mlo
Will wastewater other than domestic, sewage be generated?
❑Yes Win
IF RESIDENCE FILL OUT THE BOX BELOlq F)!
# People S- # Bedrooms # Bathrooms :!91 Garden Tub/Whirlpool Wfes C1No
Basement: OYes PgNo Basement Plumbing: UYes O No
IF NON -RESIDENCE FILL OUT THE BOX BELOW
Type of Facility/Business _. Total Square Footage e:fBuilding # People
# Sinks # Commodes _ _ # Showers # Urinals
Estimated Water Usage (gallons per day.l (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: # Seats
Type system requested, MConventional DAccepted Olnnovative OAltemative 00ther
Water Supply Type: i$ County/City Water 0 New Well OExisting Well 0 Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes
If yes, what type? _
e M.
This is to certify that the information provided on this application is true and corre et 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 ccnduct necessary inspections to determine compliance with applicable laws and rules.
I understand that I am responsible for the proper identification and labeling of pro .perty lines and corners and locating and flagging
or staking the house/facility location, propos, d well location and the location of mmy other amenities.
C Site Revisit Charge
Property ou er's4�owner's gal dve signature
Date(s):
O Client Notification Date:
Date EAS:'
Sign given OYes ONo - Account # O
Revised 11/06 i Invoice #
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TRACT I lg9p!/•Q�
REF:: D.B.• 66, PG.' 584 q „� Q
t` l TAY UAD. r--: .4 P/!1 PARCEL 12 _.0.
i
APPLICATION FOR SITE EVALUATION/IMPROVEM e�
Ig (' Lg U `� Davie County Health Department
n Environmental Health Section
1 l i SEP ' 6 20.6 D P.O. Box 848/210 Hospital Street
,
Mocksville, NC 27028
BVIRONMENTALHEALTH (336)751-8760/ Fax (336)751-8786
O... CW
Application or:. rte va uatio mprovement Permit 0 Authorization To Construct(ATC) 0 Both
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
nVFORMATION Is PROVIDED.. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed J Contact Person
Billing Address Home Phone
City/State/ZIP ,�u�iness Phone
Name on Permit/ATC if Different than Above G�,
Mailing Address City/State/Zip
rAurr,Ai I IINrViCN1AUUIN
NOTE: A surveyplat or site plan must accompany this application.
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Street Address City Tax PIN# r' 7iZ
Subdivision Natne' S ctio )Lot# Lot Size
Directions To Sits: r )4
Date House/Facility Comers.Flagged r(/
If the answer to any of the following questions is "yes", suppo ing d cumentation must be attached.
Are there, any existing wastewater systems on the site? OYes [moo
Does the site contain jurisdictional wetlands? OYes Wo
Are there any easements or right-of-ways on the site? $ZYes ONo— W
Is the site subject to approval by another public agency? OYes Silo
Will wastewater. othet than domestic sewage be generated? Oyes EVo
lr NZ)JUENUlE I ILL UU'1' TTiE BOX BE
4 People # Bedrooms # Bathrooms_ Garden Tub/Whirlpool OYes ONo
Basement:OYes ONo Basement Plumb' g: ❑Yes ONo
IF NON -RESIDENCE FILL OUT THE BOX BELOW
'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: Xconventional OAccepted OInnovative OAltemative OOther
Water Supply Type: County/City Water 0 New Well ❑Existing Well 0 Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes kvo
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 understand that I ant responsible for all charger incurred
fi-onn this application. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to
conduct necessary inspections to del grlFylnl ce with ipliible laws a rules on the above described property located in
Davie County and owned by
J Site Revisit Charge
Property owner; or is legal repKsentative signature
Date(s):
/ V Client Notification Date:
Date EHS:
Sign given ❑Yes ONo Account #
Revised 2/06 Invoice #
APPLICATI03S
11qJ
SEP - 6 2006
E
ENVIRONmEriTAL HEALTH
SITE EVALUATIONAMPROVEM:
Davie County Health Department
Environmental Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax(336)751-8786
Permit D Authorization To Construct(ATC) D Both
***IMPORTANT`*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed J -
Billing Address __4-
City/State/ZIP
Name on Permit/ATC if Different than
Address
PROPERTY INFORMATION
JContact Person J a
173-1-7752- Home Phone
�., „ Iau$iness Phone
NOTE: A survey plat or site plan must accompany this application.
(Permit is valid for 60 months with site plan, no expiration with complete plat.) �� �� IS
Street Address City Tax PIN# 7 %ZZ
Subdivision Name etion/Lot# Lot Size
Directions To Site: r S I An1f, n )A 1,04.,
Date House/Facility ComersTlagged
If the answer to any of the following questions is "yes", suppo
Are there any existing wastewater systems on the site?
Does the site contain jurisdictional wetlands?
Are there any easements or right-of-ways on the site?
Is the site subject to approval by another public agency?
Will wastewater. other than domestic sewage be generate
IF RESIDENCE FILL OUT THE BOX
mentation must be attached.
DYes lido
DYes t3No
gYes ONO. 4.1 Lt_� «
DYes tiCgo D
DYes No
# People # Bedrooms '� /1/ ) # Bathrooms Garden Tub/Whirlpool DYes ONO
m
Basement: DYes ONO, Basement Plut g: ❑Yes ONO
IF NON -RESIDENCE FILL OUT THE BOX BELOW
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: Xonventional DAccepted CI movative DAltemative DOther
Water Supply Type:�County/City Water D New Well ❑Existing Well D Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? D Yes A -No
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 understand that I am responsible for all charger incurred
from this application. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to
conduct necessary inspections to det nj nce with f ble laws a rules on the above described roe located in
Davie County and owned by ///p T6 property
PropeFa
er s or otdF&rr's
oY
Date
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Sign given DYes 0 N Account # 6770P
Revised 2/06 Invoice #
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990002706 Tax PIN/EH #: 5830-04-2225.02
Billed To: Jeff Hayes Subdivision Info: Jeff Hayes Lot # 2
Reference Name: Location/Address: Cana Road -27028
Proposed Facility: Residence Property Size: 0.691 ac Date Evaluated: 7 qrZ_4&t_0_
_
Water Supply:
Evaluation By:
On -Site Well Community
Auger Boring Pit
Public
C`
SITE CLASSIFICATION: UJ
LONG-TERM ACCEPTANCE RATE:
REMARKS:
EVALUATION BY:�+ In
OTHER(S) PRESENT:
LEGEND
Lan&scape 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 - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
3Yxt
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
ct�tu
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineralogy
1:1, 2:1, Mixed
Nntes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water 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/ft2 DCFT OI /OS tRev4
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group
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ConsistenceHORIZON
III DEPTH
groupTexture
•
��111f�i.�i'�Ly���
LONG-TERM
C`
SITE CLASSIFICATION: UJ
LONG-TERM ACCEPTANCE RATE:
REMARKS:
EVALUATION BY:�+ In
OTHER(S) PRESENT:
LEGEND
Lan&scape 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 - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
3Yxt
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
ct�tu
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineralogy
1:1, 2:1, Mixed
Nntes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water 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/ft2 DCFT OI /OS tRev4