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266 Edwards RdHEALTH DEPARTMENT RELEASE ♦._ri u elV.S Fo Davie County Health Department 210 Hospital Street 7 P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Chris TYler Address: 1552 Liberty Church Rd City: Mocksville State/Zip: NC 27028 Phone M (336) 492-5011 dre s266 Edwards Road oadksvi � NC 27028 MOBILE HOME # of Bedrooms: 2 # of People: 2 *Water Supply: N/A Basement: F� Yes ❑ No 'Proposed Improvement: New Mobile Home r For Office Use Only *CDP File Number 122998 - 1 G1000000004 County ID Number: valuated For: HDR/WWC PERMIT VALID 0 9/ 1 1/ 2 0 1 8 UNTIL: r Property Owner: Chris TYler Address: 1552 Liberty Church Rd City: Mocksville State[Zip: NC 27028 Phone #: (336) 492-5011 Property Location & Site Information Subdivision: Phase: Lot Township: Directions Edwards road 1/2 mile site on right Type of Business: Total sq. Footage: No. Of Employees: It is the responsibility of the owner to maintain a 5 foot minimum setback between the wastewater system and any part of the structure foundation, including porches, decks, and any other appurtenances. If you are unsure as to the exact location of the septic system, please have a licensed installer or inspector locate the septic system for you. The local county health department in no way implies that the proposed construction meets the required setbacks from the septic system unless otherwise noted. This release only shows that this property has an approved wastewater system that appears to have met the permitting requirements at the time it was installed. This release in no way expresses or implies that the existing subsurface sewage treatment and dispose system serving the site will continue to function for any period of time. Applicant/Legal Reps. Signature Required? OYes ONo Applicant/Legal Reps. Signature,* *Date: *Issued By: 2244 - Daywalt, Andrew *Date of Issue: 0 9 1 1 2 0 1 3 Authorized State Agent: **Site Plan/Drawing attached.** Total Time:(HH:MM) OHand Drawinq OImport Dravvinq 0 1 11 Hours 0 0 Minutes PAID as Phone: (336) - 753 - 6780 Davie County Health Department Environmental Health Section P.O. Box 848 210 Hospital Street Courier # :.09-40-06 Mocksville, NC 27028 ON-SITE WAS CERTIFICATION FOR DWELLING ba be kwe (Check On Replacement Remodeling Reconnection 0 Name i y Ie c Phone Number_(Home) Mailing Address: l az- (Work) ((%/V , C Email Detailed Directions To Site:(",) &a/PJ cou,4,rdS Please Fill In The Following Information.About The EXISTING Facility: Name System Installed Under: Type Of Facility: /11 V6a le Drc 4_� Date System Installed (Month/Date/Year): Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes No If Yes, For How Long? Lik Any.Known Problems? Yes < Do If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: /t4o h' l e �'I rrge o- Number Of Bedrooms: Number of People Z-- Requested By:ns=S 1 Date Requested: - Z-6 - /3 (Signature) For Environmental Health Office Use Only Omentso. Disapproved <er ff—/)- /`�f�� S� Environmental Health Specialist. Date: *The signing of this form by the Environmental Health Staff is Un no way intended, nor should be taken as a guarantee or limited) that the on-site wastewater system will function properly for any given period of time. Payme : Cas Check Money Order # Amount:$ U U .VU Date: n�L (Qh Paid By: Received By: V-1-14AKY Account #:(0 6(i Invoice #: Appraisal Card Page 1 of 1 s 8/28/2013 4:13:44 PM 1TYLER CHRISTOPHER Retum/Appeal Notes: G3-000-00-004 66 EDWARDS RD UNIQ ID 9963 300867 ID NO: 4890757193 COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1 eval Year: 201 ax Year: 2014_ _. 1.006 AC EDWARDS RD 1.006 AC 1.006 AC SRC- Inspection raised 9 on 06/07/2012 01002 CALAHAN TW -01 C- EX- AT- LAST ACTION 20121031 --UCTION MARKET VALUE DEPRECIATION CORRELATION OF VALUE DETAIL OTAL POINT VALUEE%. BASE BUILDING USE MOD Area UAL RATE RCN ]E-YBAYB REDENCE TO 1 00 1 % GOOD EPR. BUILDING VALUE - CARD A03USTMENTS 97 OTAL ADJUSTMENT TYPE: Vacant EPR. OB/XF VALUE - CARD 4,50 ACTOR 4ARKET LAND VALUE - CARD 15,11 OTAL QUALITY INDEX STORIES: rOTAL MARKET VALUE - CARD 19 61 OTAL APPRAISED VALUE - CARD 19,61 OTAL APPRAISED VALUE - PARCEL 19,61( OTAL PRESENT USE VALUE - PARCEL OTAL VALUE DEFERRED - PARCEL OTAL TAXABLE VALUE - PARCEL 19,61 PRIOR UILDING VALUE BXF VALUE 4,65 .AND VALUE 14,54 RESENT USE VALUE EFERRED VALUE OTAL VALUE 19,190 PERMIT CODE DATE NOTE I NUMBER AMOUNT OUT: WTRSHD: SALES DATA FF. ECORD ATE DEED INDICATE SALES OOK AGE R TYPE PRICE 0886 677 3 0I WD Q V - 1400 008E 193 6 00 WL X I 0191 221 11199 WD X V HEATED AREA NOTES H 15 PP e comments 2012 SUBAREA UNIT ORIG % ANN DEP % OB/XF DEPR. GS RPL ODEL SCRIPTIONLTH H NIT PRICE COND LDG L B AYB EYB RATE V COND VALUE ORAGE 2 5 1,00 15.0 10 _ L 197 197 S"REPLACE TYPE AREA CS 1 DS SITE 1 4 500.0 10 L 199 19 S 10 45000 UBAREATOTAL OB %F VALUE 4,500 OTALS UILDING DIMENSIONS NO INFORMATION IGHEST OTHER ADJUSTMENTS LAND TOTAL ND BEST USE LOCAL FRON DEPTH / LND COND AND NOTES OA UNIT LAND LINT TOTAL ADJUSTED LAND LAND SE CODE ZONING TAGE DEPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES URAL AC 0120 216 0 1 2.4910 4 0.9000 10 +00 +00 +00-20 RP I 6,700.00 1.006 AC 2.24 15,021.4 1511 SHAPE OTAL MARKET LAND DATA 1.006 15,11C OTAL PRESENT USE DATA 0 http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=G100000004 8/28/2013 0 6 140 TAXAt7LC Excise Tax DEED BOOK ._ L_41PAGQU .06696 nfrn eoe rre✓.•��• Nov�nher 22,,7p17996 �3�:118 P.M. -a9 �. .221 HUu:v I SaC!tf, r,:faS::+ t � i Assistant Pecording 71me, Book and Page TaxLot No . ............ : ............................................................................. Parcel Identifier No........................................................................... Verifiedby........................................................................ County on the ................ day of ......................................................... 19............ by............................................................................................................................................................................1................................................. `i1S Tur kt eef (2 ock v G Z'7 18 Mailafter recording to.....................i................................°0�...p..............f...l.J.I.4.y...................... Q.................................................. .................................................................. :............................................. ......................... .... ........................................... This Instrument was prepared by .............George...W....Maxtin,...At.toxne)r at...Law.,..Mackovilla...NC...2102.8................... Brief description for the Index NORTH CAROLINA NON -WARRANTY DEED THIS DEED made this .......G...... day of ...........September .............................. 19...8.8...., by and between GRANTOR CONNIE L. BOLIN GRANTEE LONNIE GRAY BOLIN Enter In appropriate block for each party. name, address, and, it appropriate, character of tailty, e•4 corporation or partnership The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in the City of..................................................................... gaaahaq................_.,_„ Township, Davie ............................... County, North Carolina and more particularly described as follows: BEGINNING at a point in the Eastern right of way of SR 1355, the Northwest corner of that tract described by Deed Book 91, page 902, Davie County Registry and runs thence North 88 degs: East 120 feet to a point; thence South 5 degs. 30 min. East 80 feet to a point; thence South 88 degs. West 120 feet to a point in the Eastern right of way margin of SR 1355; thence with said right of way North 5 degs. 30 min, west 80 feet to the BEGINNING and being a portion of those lands described by Deed Book 91, page 902. THIS CONVEYANCE is made pursuant to N.C.G.S. 39-13.3(c) for the purpose of severing the existing tenancy by the entirety and conveying the property above-described in fee simple to Grantee. It is further intended and agreed that this conveyance is made pursuant to the provisions of N.C.G.S. 52-10 and G.s. 29-30(a) to extinguish any claim by Grantor of any marital interest in the above-described property, which shall henceforth be the sole and separate property of grantee, and to extinguish any present or future claims of Grantor for equitable distribution which may arise under N.C.G.S 50-20 et se. N. C. an Angie. Form No. 7 ©1977—arrraawsfa.,f..,a,r fn.raf,ww.a.ar,aw DUE) Tn,^,:.rW11R CHEC'ED DATE oy -JZ. 7AX :iUPEFV1::::7