816 Rainbow RdDavie County. NC
Tax Parcel Renort 19 G% Friday. October 7. 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City: ADS
State:
Zip Code:
Legal Description: 1
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
WAKIN1INU: IHILN 1J INU1 A NUKV' Y
Parcel Information
D600000028 A
Township:
Farmington
5852731342
Municipality:
63204000
Census Tract:
37059-802
SANDERS BARBARA SMITH
Voting Precinct:
SMITH GROVE
816 RAINBOW ROAD
Planning Jurisdiction:
Davie County
fANCE
Zoning Class: DAVIE
COUNTY R-20
NC
Zoning Overlay: DAVIE COUNTY QD
27006-6714
Voluntary Ag. District:
No
43 AC RAINBOW RD LIFE ESTATE
Fire Response District:
SMITH GROVE
1.18
Elementary School Zone:
PINEBROOK
4/2015
Middle School Zone:
NORTH DAVIE
009850643
Soil Types:
EnB
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
60240.00
Outbuilding & Extra
6260.00
Freatures Value:
28390.00
Total Market Value:
94890.00
94890.00
F -&
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 Countys GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
.� ✓aCo
AL`THOWIZATION NO: DAVIE COUNTY HEALTH DEPARTMENT
t
Environmental Health Section PROPERTY INFORMATION
Permittee's'. r°"" P.O. Box 848
Name: Mocksville, NC 27028 Subdivision Name:
�, ;ry �. �.�/ Phone # 336-751-8760
Directions to property:%� Xi A� Section: Lot:
Tax Office PIN:#,:5ad�>�- 73 -
Z2rT a �>
Road Name kL1-'�'V t i Zip:,
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This FonrdAuthorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article I I of G.S. Chapter 130A, Wastewater Systems, Section .1900Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
7.
DAVIE COUNTY HEALTH DEPARTMENT_
IMPROVEMENT AND OPERATION PE ' I S`) PROPERTY INFORMATION
PertUitte:'st -
Narrtts:_,.�`,f.�i ti Subdivision Name:
Directions to property: r ig!` , r' Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:t.�-,
I N /
Road Name.. 'f�1 J Lf 1�c � Zip:. )L7
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of aseptic tank system or any wastewater. system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT•IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
` INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS — # BATHS # OCCUPANTS 4�— GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPES # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY / DESIGN WASTEWATER FLOW (GPD) NEW SITE_ REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK A19 GAL. TRENCH WIDTH ROCK DEPTH �cS� LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
Ag tl�& 'T e0 76.1 rr
IMPROVEMENT PERMIT LAYOUT *APPEOVED ErFLt E11T FILTE13* 1,121SErNS)
I12r 1'I[IISIII;II G1th17EF
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEP7,1,-
I
NT F(
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY,OF I TION
I
OPERATI
PERMIT
r V.0 �(r V Z 2 (SYSTEM
V-0 yX s �� r,
FIN SPECTION OF THIS SYSTEM
iL HO #IS (336)751-8760.
AUTHORIZATION NO. % OPERATION PERMIT BY: DATE:
•'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96 (Revised)
APPUCA]ION FOR SIZE EVALUATION/IMPROVEMENT PERMIT & '
t�
Davie County Health Department 15 Q i�
EnWivamenfal Health Section
Nr P.O. Box 848/210 Hospital Street MG2 9 yip
Mocksville, NC 27028 (336)751-8760
y tt 1 EtUYlR03Ur.tENTAL. HEALTH
CAI, t In
11
***IPtPORTAWZ*** THIS APPLICATION CAMOT BE PROCESSED UNLESS AL
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed SGS'n t)C4JY2fr'Contact Person
Mailing Address 'M Ro,tfnw(") V,N Home Phone
City/state/ZIP ACkkAAC-e ���t a7U� (p Business Phone Ll 5 S- TO
2. Name on Permit/ATC if Different than Above
Hailing Address
3. Application For: VSite Evaluaattion
4. System to service: 0 House W Mobile Home
s. If Residence: # People
Dishwasher 0 Garbage Disposal
City/state/?iz
0 Improvement Permit/ATC Y Toth
0 Business 0 Industry 0 Other
# Bedrooms - # Bathrooms _1;Z
lashing Machine 0 Basement/Plumbing 0 Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # sinks
# Commodes # Showers # Urinals # Nater Coolers
IF FOODSERVICE: (i Seats Estimated hater Usage (gallons per day)
7. Type of water supply: @-County/City 0 Well ❑ Community
e. Do you anticipate additions or expansions of the facility this system Is intended to serve? 0 Yes wo
If yes, what type?
***IMPORTANT*** CLIENTS AIUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBTIITTED by the client with THIS APPLICATION.
Property Dimensions: WRITLJHRECTIONS (from Mocksville) to PROPERTY:
'rax Grime PIN: ft. L s, � (✓i� /�o� �i P-Mb6e PCA OVA
Property Address: Road Name g cLi n 6,w r?,a(-
city/zip Aavlc, riC. 970040
If in a Subdivision provide information, as follows:
Name:
G n K� be I vG A,`f�e
IIUW� W «le. .
Section: Block: Lot: Date Property Flagged: e//GL-
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits)
issued hereafter are subject to suspension or revocation, if the site plans or Intended use change, or if the information
submitted in this application is falsified or changed I, also, understand that I am responsiblefor all charges incurredfrom
this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department 01
to enter upon above described property located in Davie County and owned by 1��•
to conduct all testing procedures as necessary to determine the site suitabilih-.
DATE nl- C9 `(S 'K SIGNATURE
'THIS AREA MAY BE USED FOR DRAWING YOUR SITi'E PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
5
Revised DCHD (07/98)
Account No.
Invoice No. 7
sti ff��a,a.: "tis f ..�...{ x ��..i �,•� Nf • �.:. oils �•*h*�,j:i':
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME Jil/ ��C DATE EVALUATED a?Zg2jE vT�
PROPOSED FACILITY _z�'gkl' PROPERTY SIZE CTAte'
����-,
SUBDIVISION ROAD NAME d�i�.Aj`jJt�7,✓
Water Supply: On -Site Well Community
Evaluation By: Auger Boring c/ Pit
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH `oe
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: 0 [;d -'C 4
LONG-TERM ACCEPTANCE RA
REMARKS:
DCHD (01-90)
LEGEND
Landscape Position
EVALUATION BY: &/,
OTHER(S) PRESENT:
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
CONSISTENCE
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wet
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
Structure
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subaneular blockv PL - Platy PR - Prismatic
Mineralogy
1:1, 2:1, Mixed
Notes
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
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DEED BOOK-,--- -0 a - PACEw-.�,
NO TAXABLE CONSIDERATION STATED
Excise Tax $ 0
FILED FOR REGISTRATION
FEBRUARY 25 1999 11:15 Ate__
DATE TIME
AND RECORLED IN BOOK 209PAGE. 67
HENRY I. SHORE, REGISTER OF DEEDS
DAVIE COON C
BY Deputy
Recording Time, Book and Page
Tax Lot No. P-6 Parcel Identifier No. _14-01
Verified by County on the day of 19_
by
NO OPINION ON TITLE IS EXPRESSED OR IMPLIED
Mail after recording to:Grantee 114 1?Gi4bcw k Aolwnc- YIS, 9700(c
This instrument was prepared by: Robert Lee Saunders & Associates, PA, 112 N. Main St, Salsb.
Brief Description for the index Septic Tank Easement
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this 23 day of February, 1998, by and between
GRANTOR
Carolyn S. Smith and husband,
Virgil G. Smith)'D4caa�S�oL,
Jason Sanders
GRANTEE
Enter in appropriate block for each party: name, address, and, if appropriate, character of entity,
e.g., 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 , Farmington Township, Davie County, North Carolina and more
particularly described as follows:
A perpetual easement for the placement, maintenance, and repair of a septic tank field over and upon
the following described tract:
BEGINNING at an iron rebar set in the line of Barbara Smith (now or formerly) (DB 78/375), said iron
being S 85-59-10 E 197.02 feet from a V20 existing iron found in the right of way of Rainbow Road (SR
1441) 8' +/- from the centerline of SR 1441; and runs thence with the line of Smith S 86-00-20 E 100.70
feet an iron rebar set, corner of Smith and Deborah A. Taylor March (DB 132/850); thence with March S
85-57-10 E 210.18 feet to an axle found in a ditch, corner of March, Luke V. Smith (DB 62/120), and
Carolyn S.* Smith (DB 144/691); thence with the line of Carolyn S. Smith S 03-50-20 W 215.42 to an
existing 1" iron, corner of Carolyn S. Smith and Faye Smith Myers (DB 144/693); thence with the line
of Myers S 03-50-50 W 121.54 feet to a 1" existing iron in the line of Myers; thence with Myers N 85-
59-35 W 297.52 feet to a % " existing iron in the line of Myers; thence with Myers N 01-36-35 E 91.73
feet to a 1" existing iron; thence N 85-58-30 W 196.94 feet to a 3/4" existing iron in the right of way
of SR 1441, corner of Myers; thence with the right of way'of SR 1441 two lines as follows: 1) N 01-31-
40 E 35.59 feet 2)N 01-31-40 E 29.93 feet to an existing %" iron, corner of Faye Smith Myers (DB
125/765); thence with Myers S 86-00-25 E 196.91 feet to an existing 5/8" iron, corner of Myers; thence
with Myers N 01-34-45 E 180.03 feet to an iron rebar set in the line of Barbara Smith, POINT OF
BEGINNING, as shown on Easement Survey for Jason Sanders dated 2/5/99 by Stone Land Surveying Co.
N.C. Bar Assoc. Form No. 7 ° 1977
Printed by Agreement with the N.C. Bar Assoc. #003
0 gal :I 1
the p'roperty.hereinabove described was acquired by Grantor by instrument recorded in Book
+� Page
TO HAVE AND�TO'HOLD the aforesaid lot or parcel of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
And the,Glantor.covenants with the Grantee, that Grantor is seized of the premises in fee
simple, hAs,4t-he right to convey the same in fee simple, that title is marketable and free
and clear& all encumbrances, and that Grantor will warrant and defend the title against
the lawful claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
Easements, Restrictions,. and Rights of Way of Record.
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has
caused this instrument to be signed in its corporate name by its duly authorized officers
and its seal to be hereunto affixed by authority of its Board of Directors, the day and
year first above written.
By
ATTEST:
(Corporate Name)
President
Secretary (Corporate Seal)
`I
iI
cri (SEAL)
Carolyn S. Smith
6QCAASED (SEAL)
Virgil G. Smi
(SEAL)
(SEAL)
c�
NORTH CAROLINA, Rowes County.
. a Notary Public of the County and State aforesaid, certify that
_ �,✓ ,Q• Grantors,
personally appeared before me this day and acknowledged the execution of the
foregoing instr ment. Witness my hand and official stamp or seal, this _
r?A day of 1.[rJct,a 19`717.
'I 4 t'di i' ♦e •.7
My commission expires: a
' 1{ Q_k, Notary Public
SEAL -STAMP NORTH CAROLINA, Rowan County.
I, a Notary Public of the County and State aforesaid, certify that
personally came before me this day and acknowledged that he/she is
Secretary of , a North Carolina corporation, and that by authority
duly given and as the act of the corporation, the foregoing instrument was
signed in its name by it President, sealed with its corporate seal
and attested by him/her as its Secretary. Witness my hand and
official stamp or seal, this day of
19
My commission expires:
Notary Public
The foregoing Certificate(IS) of Linda M. Whitaker . Notary Publie of Davie County
is/m3tmxcertified to be correct. This instrument and this certificate are duly registered
at the date and time and in the Book and Page shown on the first page hereof.'
HENRY L. SHORE
REGISTER OF DEEDS FOR
DAVIE
COUNTY
By Jsn aAxj A Deputy/ c egister of Deeds.
N.C. Bar Assoc. Form No. 7 ° 1977
Printed by Agreement with the N.C. Bar Assoc. #003
Nom`
This property Is subject to at easements, tight—of—ways,
V
I
DB 125 O PG 7651
Mop not for rseardobion. Iv
j
CPFP WO- Pipe
SIT 1444
Precision 1:10.000+
Cat sin
FPO-- anew act
Bost: — ack sue
PK—Nag Set
CL +/— of SR 1441
O CL +/— SR 1444
Tax Lot 14.02
strealsand assessments, x any, as the maim may appear or
(�
Stone Land Surveying Company
Sam
SR.
LEGEND ~ (
#
UAPPED: 113 Drum Lane Phone (336) 998-4733
Oil
R/w — "t—of—Way Gn er Una
N
Rainbow N
raced in the office of the Register of Deeds. Clark of Court.
Town County Tax office
A
no Line
i
-
I
U A
SR 1441
1
S 02e12'40"W
Tax Lot 28
or or which may have bun oequind by
preeeriptiva use. This so my Is subject to cry facts that
Tax Lot 30
N
O
Tax Lot 31
20&06'
Tax Map D-6
Tax Map 0-6
and husband
Tax Map D-6 r**o
I
n/f Barbaro Smith
I
n/f Deborah A. Taylor Manch
I
n/f Luke V. Smith
Virgil G. Sm
a and accurate title seorck NOT furnished
DB 78 O PO 375
+
& Walter W. Nowkki
S 86'00'25"E 196.91'
and wife To us tbtY 15s
DB 144 O PG 6 G 6 91
DB 132 O PG 850
Rosa J. Smith
120
?
5/8" QR
I
I
DB 62 O PG
This mop or drawing and any accompanying
�
29.93'
2.650 Acres +/-
mckay MM (Not to Seals)
doctwnants an furnished to the persons) named
thereon and no alterations, w
or as by others
� �
tte Une
I
I
1" VP
S 85059110"E 0"E S
88 6F20"E
S 85.57'10"E 210.18'
Axle Found In Ditch
1�, I
197.02'
100.70' IRS
m� tp
aRt7
J
1/2" ETR.
r
-
I declare that on
vN.
Found 8'+/- from ..
CL of SR 1441 $
r
we surveyed the property shown on
N (p '
to
this plat:
04 c
Tax Lot 14
I
Q
I I
Tax Map D-6 z
►
i/
n
n/f Faye Smith Myers
Nom`
This property Is subject to at easements, tight—of—ways,
:j
I
DB 125 O PG 7651
Mop not for rseardobion. Iv
j
CPFP WO- Pipe
196.94' N 85.58 30"W 1" E7P
Precision 1:10.000+
Cat sin
FPO-- anew act
Bost: — ack sue
80 0
Tax Lot 14.02
strealsand assessments, x any, as the maim may appear or
(�
Stone Land Surveying Company
I
LEGEND ~ (
#
UAPPED: 113 Drum Lane Phone (336) 998-4733
Oil
R/w — "t—of—Way Gn er Una
N
Tax Ma D-6
raced in the office of the Register of Deeds. Clark of Court.
Town County Tax office
A
1/2" EIR
tstH+9 _
Powel Po u
U A
1
a
n/f Carolyn S. Smith
or or which may have bun oequind by
preeeriptiva use. This so my Is subject to cry facts that
N
O
I
N
and husband
be disclosed by fug
Tax Lot 14.01
Virgil G. Sm
a and accurate title seorck NOT furnished
+
S 86'00'25"E 196.91'
DB 144 O PG 6 G 6 91
as of this dot..
i
?
5/8" QR
Proposed tld7ity Easement
This mop or drawing and any accompanying
�
29.93'
2.650 Acres +/-
doctwnants an furnished to the persons) named
thereon and no alterations, w
or as by others
G
i
t:
1/2" t7R
by coordinate computation
1" VP
Is perma w uNmss outheArd by
m� tp
Storm lard Surveying Co. .
:j
trolled Access
CRCP
p�
Mop not for rseardobion. Iv
j
CPFP WO- Pipe
196.94' N 85.58 30"W 1" E7P
Precision 1:10.000+
Cat sin
FPO-- anew act
Bost: — ack sue
80 0
.. z
3/4" EIP c
Ilk
2-05-99
Stone Land Surveying Company
G
:j
LEGEND ~ (
S15098
UAPPED: 113 Drum Lane Phone (336) 998-4733
Tax Lot 14.03 wan
R/w — "t—of—Way Gn er Una
Tax Mop D-6
�' — p Iron PIW EP — Edge of Pavement I
EIRFj kon Rebar FC FFace
I rrj
tstH+9 _
Powel Po u
Cil — Concrete Monument _ Ught N.1 1/2.. pR 297.52' N 85'59'35'W
PA - Pon Rebar Set 1/2'
Property line
"s
trolled Access
CRCP
p�
- Rhein Concrete Pipe
CNP - t:oruvgatw veli Mope
S� gM Book
Book
CPFP WO- Pipe
ce - �
;�Conugabw
year Flood Boundary
Omr0 trtlrltke
--a Feng
Cat sin
FPO-- anew act
Bost: — ack sue
80 0
80 160 240
GRAPHIC SCALE — FEET
2-05-99
Tax Lot 14.03
Tax Map 0-6
n/f Faye Smith Myers
DB 144 O PG 693
Easement Survey for:
Jason Sanders
Tax Lot 14.03
Tax Map D-6
—1" EIP
Tax Lot 14.01, Tax Mop D-6
Current Owners: Carolyn S. Smith
and Husband Virgil G. Smith
Deed Book 144 O Page 691
SCALE 70wlSNIP COUNTY STATE
DATE
1" ss 80' Farmington Davie North Carolina
2-05-99
Stone Land Surveying Company
JOII NO.
MT,BL George Robert Storm, PLS L-3162
S15098
UAPPED: 113 Drum Lane Phone (336) 998-4733
1MP N0.
S15098
GRS Mocksviile. N.C. 27028
NO TAXABLE CONSIDERATION STATED
Tax Lot No.
Verified by
by
Excise Tax $
FILED FOR REGISTRATION
DECEMBER 4, 1998 9:05 A.M.
DATE TIME
AND RECORDED IN BOOK ILLPAGE778
HENRY
,�L SHORE, REGGIISyTEQ1R OF DEEDS
W"' I
Deputy
Recording Time, Book and Page
Parcel Identifier No.
County on the day of
NO OPINION ON TITLE IS EXPRESSED OR IMPLIED
19_
Mail after recording to:
This instrument was prepared by: Robert Lee Saunders, Robert Lee Saunders & Associates, PA,
112 N. Main St, Salsbury, NC 28144
Brief Description for the index
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this day of November, 1998, by and between
GRANTOR
L. V. SMITH
. and wife
ROSA SMITH
GRANTEE
JASON SANDERS
Enter in appropriate block for each party: name, address, and, if appropriate, character of entity, e.g., 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 I Township, Davie County, North Carolina and more
particularly described as follows:
Being a perpetual easement and non-exclusive right of way upon the properties described in
Deed Book 38 at Page 397, Davie County Registry, to install and maintain such sanitary sewer
system out -fall drainage lines and tanks as may be required by the property authorities in
connection with a residence upon the lands of Jason Sanders, Grantee, which lands of Grantee
are located directly adjacent to the lands of the Grantor herein.
DEED TRANSFER CHECKED
N.C. Bar Assoc. Form No. 7 0 1977
DEED BOOK PAGE 5
The property hereinabove described was acquired by Grantor by instrument recorded in Book
38`, Page 397...
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
.And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee
simple, has the right to convey the same in fee simple, that title is marketable and free
and clear of all encumbrances, and that Grantor will warrant and defend the title against
the lawful claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
Easements, Restrictions, and Rights of Way of Record.
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has
caused this instrument to be signed iii its corporate name by its duly authorized officers
and its seal to be hereunto affixed by authority of its Board of Directors, the day and
year first above written.
SEAL -STAMP
SEAL -STAMP
(SEAL)
L.V. SMITH
(746 �-Z� ( -4
ROSA SMITH
NORTH CAROLINA, a0k— County.
a Nota Publi o the County and tate aforesaid, certify that
Grantors,
personally appeared before me this day Ad acknowledged the execution of the
foregoing instrument. Witness my hand and official stamp or seal, this _
4uoH3f- a,F, /9q9
Notary Public
OFFICIAL SEAL. y
Notary Public, North Carolina
COUNTY OF DAVIE
4EATHER L BOOZE
My Commission Expires August 24, 1999
NORTH CAROLINA, County.
I, a Notary Public of the County and State aforesaid, certify that
Grantors,
personally appeared before me this day and acknowledged the execution of the
foregoing instrument. Witness my hand and official stamp or seal, this _
_ day of , 19_.
My commission expires:
Notary Public
The foregoing Certificate(it) of RRATHF.R T._ ROOTF., NOTARY PUBLIC OF DAVIE COUNTY
is/a= certified to be correct. This instrument and this certificate are duly registered
at the date and time and in the Book and Page shown on the first page hereof.
HENRY L. SHORE REGISTER.OF DEEDS FOR DAVIE COUNTY
By Deputy/XURRM&-Register of Deeds.
N.C. Bar Assoc. Form No. 7 0 1977
f
We, Barbara Jane Smith Sanders, Mary Carolyn Smith Smith, and Carl Lee Smith give
authorized permission to let Jason T. Sanders have the right of an easement to use the
existing septic tank and to cross over onto our late mother, Rosa Smith's land.
Signed:
X <Oa4-ie�'
I, Mary Carolyn Smith Smith give my authorized permission to allow Jason T. Sanders to
cross over onto my existing land for septic tank use.
Signed:
This has been seen by me this M - day of !v U. 1998.
My commision expires: aooa
AUTHORIZATION NO: " 1706 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's, may " P.O. Box 848
Name: Mocksville, NC 27028 Subdivision Name:
Phone # 336-751-8760
Directions to property:
Section:
Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# - -
SYSTEM CONSTRUCTION
Road Name: .�'llvt-v J K -'Zip: A
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
C1 / ty ✓s ' /j/✓`/' i '" IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
,., i fin.• .. . , .. -ra w:n,+-=• >+::y:4 s. w:r a _
1706 DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
t�3Names Subdivision Name:
Directions to property: el , Section: Lot:
i IMPROVEMENT
PERMIT Tax Office PIN:# _
? :Road Name /5�t�1�r1L-;�'i�1 `- Zip: . ' el al
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r ***NOTICE*** TILS PERMIT IS SUBJECT TO REVOCATION IF SITE
a r PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH S ECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMSAi�Z _ # BATHS _ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPES # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) 2� �'(_) NEW SITE REPAIR SITE ?�
SYSTEM SPECIFICATIONS: TANK SIZE �0 GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT:
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
r
t�Oil�<'
5�. off
C
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
"*THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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.
DCHD 05/96 (Revised)
0 ; APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
I �� Davie County Health Department
Environmental Health Section
P. O. Box 848
Mocksville, NC 27028
(336)751-8760
C 0 WR
JUN 2 619%
EIIVIROtAlENTAL HFAT11
DAVIE CDUZJD
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed 3Ctso c1 MeJ S Contact Person 1 �ct 50 n
Mailing Address U � lQ RC'y1VOLD RCA Home Ph(ne6)
City/State/Zip A010C14CJe_, a 700 (0 Business Phon-330
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: ❑ Site Evaluation
n,
4. System to Serve: Ll House 2" Mobile Home
5. If Residence:
❑ Dishwasher
6. If Business/Other:
# People q
❑ Garbage Disposal
Specify type
# Commodes 0
If Foodservice:
# Showers
# Seats
City/State/Zip
❑ -Improvement Permit & ATC
❑ Business ❑ Industry
# Bedrooms a
II Washing Machine ❑ Basement/Plumbing
# Urinals
V/ Both
❑ Other
# Bathrooms I—
❑ Basement/No Plumbing
# People # Sinks
Estimated Water Usage (gallons per day)
# Water Coolers
7. Type of water supply: W" County/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes UNo
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PTG,THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: \/_a
Acre,
I WRITE DIRECTIONS (from
Office PIN: # �� sa
Mocksville) TO PROPERTY:
Tax
-
-
'� k« ) S 46
Property Address: Road Name
n 11__
09 RGI�� (�Y30
j�^ II
Py(%
I
1
1 12abow pa
�C% owTe_
�.c, a7od(
n
;
City/Zip
0� m les gotjr\ 4he
If in Subdivision provide information, as follows:
1
1
1 ro6d1 ) a nC� t S a n
Name:
Section:
Lot #:
I
1
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter
are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is
falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to
the Authorized Reprreese-ntative of the Davie County Health Department to enter upon above described property located in Davie County
and owned by r Set tide✓ to conduct all testing procedures
as necessary to deter//mine the site suitability.
DATE @& — I 4�K SIGNATURE
Revised DCHD (06-96)
YOU MAY USE THE BACK Of THIS FORM fOR DRAWING YOUR SITE PLAN.
. ; DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME /�/I DATE EVALUATED
PROPOSED FACILITY,7"➢' PROPERTY SIZE
SUBDIVISION ROAD NAME
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit
Public
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group(/
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
'
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: d f
LONG-TERM ACCEPTANCE RATE: /Zf
REMARKS:
DCHD (01-90)
Landscape Position
END
EVALUATION BY: �& G/
OTHER(S) PRESENT:
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
CONSISTENCE
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wet
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
Structure
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
Notes
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
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Davie County Health Department
andHome Health agency
N� N 224 �a Environmental�lealth Section
GPRH60 P.O. BOXCO 848 / 210 RIER 09-40-06L STREET
V' pNE M
�GS� 336 �cj1- MOCKSZLE, N.C. 27028
PHONE: (704) 634-8760
July 23, 199A
Jason Sanders
816 Rainbow Rd.
Advance, HC 27006
Re: Site Evaluation
Rainbow Road
Tax PIN: #5852-73-1342
Dear Client(s):
As requested through your application, Robert B. Hall, Jr., R. S. ,
Environmental Health Specialist(s) with this office, visited the aforementioned
site on July 22, 1998. The purpose of said evaluation(s) was to determine the
soil/site suitability for the installation of an on-site sewage system. The
result(s) of the evaluation(s), a copy of which is attached, indicate that the
site is unsuitable for the installation of an on-site sewage system for the
following reason(s):
Rule .1941 (3B) - Soil Characteristics: Expansive Clay
.1943 (a) - Soil Depth
.1944 (a) - Restrictive Horizons
Due to the limitation(s) on your site, this office is not aware of any
modifications or alternative measures that can be implemented at the present
time to upgrade the classification from *unsuitable' to 'provisionally
suitable." Your application for an Improvement Permit must, therefore, be
denied.
You have the right to an informal review of this decision by the
Environmental Health Director of this office and also by the regional staff of
the Department of Environment, Health, and Natural Resources. You should
contact this office to arrange for this further review.
You may also wish to obtain the services of a private consultant to
collect site-specific data and submit such data and a system design to this
office for technical review. A site may be reclassified to provisionally
Page 2
Jason Sanders
July 23, 1998
suitable provided written documentation, including engineering, hydrogeologic,
geologic or soil studies indicates to this office that a proposed on-site
sewage system or a proposed alternative system can reasonably be expected to
function satisfactorily. The substantiating data from these studies must
indicate that:
A. The effluent (wastewater) will receive adequate treatment;
B. The effluent (wastewater) will not contaminate any ground water
or surface water; and
C. The effluent (wastewater) will not be exposed on the ground surface or
be discharged to surface waters where it could come into contact with
people, animals or vectors.
Finally, you have the right to a formal appeal of this decision if you
file a petition for a contested case hearing with the Office of Administrative
Hearings, P. 0. Drawer 27447, Raleigh, N.C. 27611-7447. A copy of a petition
form can be provided to you upon request. The petition must be received by the
Office of Administrative Hearings within thirty (30) days of the date of this
notice. The hearing may be held in Davie County.
If you file a petition for a hearing, you must send a copy of the petition
to Mr. Richard Whisnant, DEHNR, Office of General Council, P. 0. Box 27687,
Raleigh, N.C. 27611-7687.
Please call or write this office if
additional assistance. Telephone number:
Address:
RH/wd
Enclosure(s): Soil -Site Report
Billing Statement
you have any questions or need any
336/751-8760
Davie County Health Department
Environmental Health Section
P. 0. Box 848
Mocksville, N.C. 27028
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section