288 Shutt RdDAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
REPAIR OPERATION PERMIT
Account #: 990005981
Billed To: Norman Carlton
Reference Name: REPAIR PERMIT
Proposed Facility: Residential Repair
Tax:.Pli�Iil N #: G800000060
Subdivision lnfo,:._
Loca(16n!Adi fe?i s . '. 288 Shutt Road -27006
Property Size; — 48.62 Ac
ATC Number: 6005
**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: ZJCAK.T. ManufacturerUt Oro
Tank Date i� Tank Size
Pump Tank Size I Bedrooms Z _
System Installed By: f,3,✓-., Installer#: Date: y /2
GPS Coordinate:
a
Environmental Health Specialist:
DCHD 11/06 (Revised)
Date: `Z
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990005981 '. Tak PIN,EH #: G800000060
Billed To: Norman Carlton ; ttbdivision lnfo:
Reference Name: REPAIR PERMIT l acaiiortiAdlre's' 288 Shutt Road -27006
Proposed Facility: Residential Repair Ptoperty Size- 48.62 Ac
Site Type: ❑New Aepair ❑Expansion
ATC Number: 6005
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior 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 chance.
Residential Specifications: # Bedrooms 02— # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size q25 4___
System Specifications
Site Modifications/Conditi
Type of Water Supply: OCounty/City ❑Well ❑Community Well
Design Wastewater Flow (GPD) Tank S ize(r ) FAL. Pump Tank --"GAL.
u ���� r /
Trench Width 3(zMax.. Trench Depth Rock Depth'—O� Linear Ft.='
Contact the Davie County Environmental He6lth Section for final inspection of this system between
8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760.
3' ,
Environmental Health Sp
DCHD 11106 (Revised)
Date: 2
4
co
i
' DAVIE COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST ,
APPLICATION IP/ATC OSWW REPAIR
Name &Mgj(1 &t1j0 ) Telephone Number q& -g 77,
Address M -�� d
Nailing Address (if different from above)
mail Address: D �� Z
Subdivision Name Lot # ro VeIS
Directions /4vv gol G %C
if
ate System Installed %910 Name System Installed Under 0IM'41V & f &4)
Type Facility Number Bedrooms_ Number People Served
T e Wate Supply , / Specific Problem Occurring c
e ? 41
Date Requested Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE, AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
Signature of owner or Authorized Agent
Initial Fee Date REHS 4
Revisit Charge Date Reason
�j
Revised 2-2011 '
It5(W l
G
Davie County, NIC Tax Parcel Report Wednesday, November 28, 2012
416
-1815
40 m
goo
Parcel Number:
G800000060
NCPIN Number:
5789575670
Account Number:
12876000
Listed Owner 1:
CARLTON LARRY
Mailing Address 1:
326 SHUTT ROAD
City:
ADVANCE
State:
NC
Zip Code:
27006-7433
Legal Description:
48.75 AC SHUTT RD
Assessed Acreage:
48.62
Deed Date:
2/1971
Deed Book / Page:
000830632
Plat Book:
Plat Page:
Building Value:
226540.00
Outbuilding & Extra
2800.00
Freatures Value:
Land Value:
326040.00
Total Market Value:
555380.00
Total Assessed Value:
555380.00
WARNING: THIS IS NOT A SURVEY
Parcel Information
Township:
Municipality:
Census Tract:
Voting Precinct:
Planning Jurisdiction:
Zoning Class:
Zoning Overlay:
Voluntary Ag. District:
Fire Response District:
Elementary School Zone:
Middle School Zone:
Soil Types:
Flood Zone:
SHADY GROVE
37059-804
EAST SHADY GROVE
Davie County
DAVIE COUNTY R -A
No
ADVANCE
SHADY GROVE
WILLIAM ELLIS
PcC2,C hA, PcB2, PaD, WeC
AE,X
r 1 All data is provided as is without warranty or guarantee of any kind either expressed or im f ied including but not limited to the
Davie County, NC '
t 1 implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
i harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
i
DEED BOOK 63
STATE OF NORTH CAROLINA—Davie County.
THIS DEED, Made this_--!.?!!! day of ..................March-_.........._......__, A.D., 1961..,
wife Mae Potts and H. H. Hoots and wife, Dorothy A. Hoots
......................... . ............................................................ ......................... .. . ....... ........... 9 . ..... . ................................ .... ............... . .......... . .........
of ............ klfig . . ..... . ............... County and State of . . ...... of the first part, . ..................... .........
Donald A. Reinke and wife. Sandra S. Reinke
..... . ............................... . .. ... . ....... .... ........ . ...................
of..._...._Da.v1e...... . ....... . . .... . ...... . .. County and State of ....... ...... Awnt Q.Ar.Q.111
IML ........... .... . ....... —1 of the second part:
WITNESSETH, That the said ......... PAt*qA_!of tlt flmt Ran . . ...... _...._..—_._..--____.»...__.._..-_»...............
in considerationdollars and other valuable considerations ..DDLLARs.
to t!19.&___paid byPAZtjLeA.JaLION the receipt of which is hereby acknowledged, ha..2K.9
bargained and sold, and by these presents do grant, sell or convey to g f h.q. and their
xk r _jMqM4_p
e .Uj� ........... ..................
State
. ... . ............. -heirs and assigiis, a certain lot, tract or parcel of land in unty, tate of North Carolina, adjoining the lands of
...._........»...._...»:.».._..._....._..»._._......_.......................................................................... . ................... .. .. and others, bounded as follows, viz:
Lot #2: BEGINNING at iron stake or stone Dewit Shelton's
corner and running S. 88 degrees Z. 1105 feet to a
post oak, corner of Church Lot; thence S. 171 feet to
an elm tree; thence E. 247 feet to a corner in the Howell
Road; thence with the Howell road S. 3 degrees W. 412
feet to a corner; thence N. 88 degrees W. 1398 feet to
a corner in Joseph White's line; thence N. 3 degrees W.
587 feet to point of beginning and containiAg 16 1/2
acres more or less.
For back title see Book 63, page 424, in the Register of
Deeds in Davie County, North Carolina.
STAMPS PAID $2.75
TO HAVE AND TO HOLD the aforesaid tract, lot or parcel of land, and all privileges and appurtenances thereto belonging to
the saidparties of the secoMLPIZLand t!Le_kn bpirs and assigns, t he J r -..-.—only use and behoof forever.
And the said.. ................. f.rtlitm.seL..VBA-and-theltein, executors and administrators,
covenant........—with said_ pe rt I es...joif.-the and assigns, thaLthey Are
seized of said premises in fee, and lia.Ylaight to convey in fee simple; that the same are free and clear from all encumbrances, and
that_t16_Ydo --hereby forever warrant and will forever defend the said title to the same against the claims of all persons whom-
soever . . . . . .. . ...................
IN TESTIMONY WHEREOF, the said 2411i.0 (?f tbA hereunto .. . .......
hand.A . ..... and seal -A_ the day and year first above written.
Attest: -A!_.A1MfV!Aftr — ----- — - — ------------ - --------------------
............. !Lt M. Potts . .. . . ........... _(Seal)
Mae Potts __......_..—._......(Seal)
H. H. Hoots . . . .......................................(Seal)
Dorothy A _ -Hoots . . . . .........................(Scall
STATE OF NORTH CAROLINA . ..............................................._...COUNTY.
I. ............................................................ . ............................. Clerk of the Superior Court, hereby certify that................................................
. ........ . .. . ........ . .. . . .. . .. . .................. ......... ....................................................... . . . . . .. . .. . ........... . ..................................................
personally appeared before me this day and acknowledged the due execution of the annexed deed of conveyance. Let the instrument,
wnh this certificate, be registered.
Witness my hand and official seal, this ......................................day of.............__ ...» _._ .... ....... A.D. 19
............ ........ Superior Court.
STATE OF NORTH CAROLINA . ................... P4XIA ..................... COUNTY.
1, Maxalene S AJ.%;W
. X1.4.qr
_jL_ . .......................................... . ....... . Notary Public, do hereby certify that
J. M. Potts and wife Mae Potts and H. H. Hoots d :La._-orothv A. Hoots
.......................... .... . .... 1111--Xt- . .. . ......... ........... . ....... . ......................................
personally appeared before me this day and acknowledged the due execution of the annexed deed of conveyance.
Witness my hand and notarial seal, this.......... 17.................day of ........................ . ..Chi.........._._............. A.D. 19AL.
My commission expires.- 3? -26-61 qX.8 -•—,-- ............... N. P. (Seal)
.............................
STATE OF NORTH CAROLINA—DAME COUNTY.
The foregoing certificate of Maxalexi.e..aA.Alexajader .................. a Notary Public ...................... County.
is adjudged to be Correct. Let the same, with this certificate, be registered.
This................................day of. ............. . ................................................. A.D. 19-..-.-.
Witness my hand and official seal, this ........... 211 ...............day of ........................... . ....... Marc
h___ . ..... A.D. 19
H., ...... . . ...................... Clerk Superior Court.
Filed for registration on tape ................ ............. day of ......................... March
.................................... A.D. 19 and
registered in the office of the Register of Deeds of Davie County N. C., this .......... R_Q_._.__..day of. ................... A.
!Rnoi ...............................
1961...>at1At.99 o'clock A M., in Book .............63...................of Deeds on page ... . .......... 63.2 ..................... etc.
. . . ............. . ..... Register of Deeds.
..............