178 Hide A Way LnKEALTH DEPARTMENT RELEASE
Davie County Health Department
210 Hospital Street
T- P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: Garth and Carly Regan
Address: 178 Hid Away Lane
City: Advance
State0p: NC 27006
Phone #:
(336) 655-5853
For Office Use Only
'CDP File Number 157967 -1
F8-000-00-139-20
County ID Number:
valuated For. HDR/WWC
PERMIT VALID 0 g/ 1 a/ 2 0 1 9
UNTIL
Property Owner. Garth and Carly Regan Q
Address: 178 Hitt; Away Lane
City: Advance
State2ip: NC 27006
Phone #: (336) 655-5853
I-- Property Location & Site Information
Address 178 Hide Away Lane Subdivision:
Road # Advance NC 27006
'Structure: SINGLE FAMILY
# of Bedrooms: # of People:
'water Supply: NIA
Basement: ❑ Yes a No
'Proposed Improvement:
Screened porch 1406
Phase: Lot:
Township:
Directions
Hwy 158 East right on Hwy 801, Cross RailRoad tracks, take a left, go
to stop sign, go left then left on Manhattan Lane right on Hide Away
Lane
Type of Business:
Total sq. Footage: No. Of Employees:
. J
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: 'Date: /
'Issued By: 2140 -Nations, Robert
Authorized State Agent:
*Date of Issue: 0 9/ 1 2/ 2 0 1 4
**Site Plan/Drawing attached.**
eHand Drawing 0Import Drawing
Feb 112 O ` 1 i p
C
davie county envhealth
336 751 87866
Date: I
Received /
6
Davie County Health DepaAment
q�$ ! Elivironmental Health ,'lection
VVI
Ott A�
1
Phone: (336) - 751- 8760
P.O. BOX 848
210 Hospital Street
Courier # : 09.40-06
Mocksville, NC 27028
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement ❑ Remodeling Sr Reconnection 0
p.2
Fax: (836) - 751- 8786
Name: 'GAg. r+) --k C�2L�. s rr _ PhoneNumbera3Ce 4eE�'G 5253 (Home)
Mailing Address: I 6)Cq LO_ 33$ 4 (Work)
Detailed Directions To Site: Tt , v -v\ r i-- ofd �501 oni-D Uk-d r� PQ 4 -urn
(-A- 0 t1 ) M^HCl hai[CD . ! exy e A- GLt1' 'cy ( ( 0yJ !Q Ra.t)e S�
Property Address:_ 1-743 1-1y� 1_» a (_ It_2-___
Please Fill In The Following Informs tion )Int The IMSTEW FaclUty: tea -d 00 —b0 - oq 'z'0
Name System Installed Under._ /,, _Type Of Facility:
Date System Installed (Month/Date/Ycar):_ I �-UU D 0 Number O Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes :1 No,, If Yes, For How Long?•
Any Known Problems? Yes ❑ NoX If Yes, Explain:.
Please Fill In The Following Informa•don About The NEWFaciNty:
Type Of Facility: 14 -_ f o Number Of Bedrooms: Number Of People
Requested By Date Requested: T 10 1/
Si afore)
:?or Environmental Health Mice Use only
Approved ❑ Disapproved ❑
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Env-munenbd Health Staff is in no wa;'� intended, nor should be taken as a guarantee
(extended or limited) thafthe on-site wastewater system will function properly for any given period of time.
Payment Cash ❑ Check ff Money Omer 0
Paid By: q on 0 _ Received B}
Account #• Invoice
MR
ROBERTSON REBECCA BROWN
ROBERTSON JERRY W
Grantee s : 3
RIVERS CAR
RIVERS CLAUDE BRIAN
Recorded Date:
11/9/2004
Instrument Type:
DEED
Starting Book & Page:
0581 0027
Description:
4.236 ACS S G TP
Instrument Number:
0010008
Book Type: cord Boo
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Book: Page: system
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0581
0029:
E',t5 i 1'1IG029
EXHIBIT A
BEGINNING at a railroad spike located 3 feet North of the centerline of SR 1656 (Underpass
Road), being the northernmost comer of the herein described tract and the new eastern comer of
Jerry W. Robertson (Deed Book 130, Page 414); thence in the right of way margin of SR 1656
(Underpass Road) South 38 degs. 42 min. 06 sec. East 110.47 feet to a point located 3.7 feet
North of the road's centerline; thence continuing South 44 degs. 53 min. 32 sec. East 83.31 feet
to a point located 3 feet North of the centerline of the road; thence with the right of way margin
of Southern Railroad South 21 degs. 38 min. 59 sec. West 42.61 feet to an iron; thence
continuing North 68 degs. 11 min. 14 sec. West 25.18 feet to a pinched iron; thence continuing
South 21 degs. 37 min. 52 sec. West 200.10 feet to a pinched iron; thence continuing South 68
degs. 24 min. 14 sec. East 25.11 feet to a pinched iron; thence continuing South 21 degs. 38 min.
59 sec. West 199.45 feet to an iron; thence continuing South 19 degs. 28 min. 53 sec. West with
a radius of 1,067.29 feet, an arc of 68.61 feet, a delta of 3 degs. 41 min. 00 sec. and a chord
distance of 68.60 feet to an iron being the southernmost comer of the herein described tract;
thence with the northern line of Suzanne Sandifer Dorsey (Deed Book 177, Page 17 1) North 56
degs. 26 min. 50 sec. West 476.63 feet to an iron being the westernmost comer of the herein
described tract, said iron being located South 56 degs. 26 min. 49 sec. East 775.39 feet from an
iron on the East side of a creek bank being the Southwest comer of Jerry W. Robertson (Deed
Book 130, Page 414); thence with Robertson's new eastern line North 42 degs. 56 min. 42 sec.
East 351.47 feet to an iron; ; thence continuing North 65 degs. 07 min. 42 sec. East passing
through an iron at 207.93 feet for a total of 237.93 feet to the POINT AND PLACE OF
BEGINNING, containing 4.236 acres, more or less, as surveyed by Grady L. Tutterow,
Professional Land Surveyor, on September 14, 2004, Drawing #21404-3.
SUBJECT TO easements and restrictions of record.
FOR BACK TITLE, see part of Deed Book 130, Page 414, Davie County Registry. See also
part of Tax Map F-8, Parcel 139, located in Shady Grove Township, Davie County, North
Carolina.
TE/rAF
X:/My Flles/Real Est DesdRivers,Claude Brian, File No. 20357.1
ctson and►f
414)
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