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706 Williams Rd � `' � HEALTH DEPARTMENT RELEASE For oNice use on�v *CDP File Number 120974- 1 ..�,�a Davie County Health Department �,,d ,...-�.�. 1700000030 ,. , .,�Y � 210 Hospitat Street Counry ID Number: � ��'•_ P.O. Box 848 Evalua . C '`��^" Mocksvilie NC 27028 Phone:336-753-6780 Fax: 336-753-1680 RMIT VALID 0 4 / 1 7 / 0 1 8 UNTIL: Applicant: David Calloway Builders Inc., Property er: Richard and Dorothy Williams Address: PO Box 5131 Address: 706 Williams Road Ciry: High Point City: State2ip: NC 27262 State2ip: NC 27006 Phone�: (336)382-8781 Phone#: Propertv Location 8.S(te Information Address�06 Williams Road Subdivision: Phase: Lot Roa Advance NC 27006 SIN FAMILY Township: �Struc Directions #of Bedrooms: #of People: hwy 64 East,Left on Fork Bixby Rd.then Left on williams Road `Water Supply: WA Type of Business: Basement: �Yes❑No Total sq.Footage: No.Of Employees: 'Proposed Improvement: Pool/Pool house and Spa 'Release Conditfons It is the responsibility of the owner to maintain a 5'minimum setback between the wastewater system and any part of the sVucture foundation,including porches,decks,and any other appurtenances. If you are unsu�e as to the exact location of the septic system,please have a licensed installer or inspector locate ihe septic system for you. The local county health department in no way implies that the proposed constn.iction meets the�equired seibacks 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 vr 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? QYes �NO ApplicantlLegal Reps.Signature: *Date:, f � '`Issued By: 2244-Daywalt,Andrew *Date of Issue:. 0 4 � 1 � � a 0 1 3 Authorized State Agent: � �iU �*Site P an/Drawing attached.�* TotalTime:(HH:MM) 0 1 Hours 3 0 Minutes 0 Hand Drawing �I mport Drawing � � � _ ., .:� .:: �.:� i ;f� _. . _ , ' " � ,S � ' �:�r>"�' o' � '� . -�� Davie County Health Department �O Ps I� � - Environmental Health Section � _ , � �� : -- � P.O. Box 848 � � C� ~ ,�`�,,, 210 Hospital Street �; � � �, . O U �'�. �� Courier# : 09-40-06 "• 1911 C(�� z� ��/ Mocksville, NC 27028 v '7" Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFICATION Fax:(336)-753-1680 (Check One) Replacement Remodeling Reconnection � Name:�i U � � ) ��'f I..J��,Lj �J��j' Phone Number ��(O ' �0 Z' ' �� 1 (Home) Mailing Address: f-�'(�, �%:��1 S { � 1 �?j�• ��/�Cj � S��'"'�(Work) _l�1 C� k! �. �.,�, z 7 �(E, � Email Address: c{!�rVt � 7� Ca�N�;_Tc k-} `�t A i�' ,Iv tr t Detailed Directions To Site: PropertyAddress: ��(Q �,{fi��/�t�/'�l,s /C� " Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: �'�l f��jd�N V V� /I f��'�'�..� Type Of Facility: ��t�-��i Date System Installed(Month/Date/Year): �"17� Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes �To If Yes,For How Long? Any Known Problems? Yes No I�#'Yes,Explain: / Please Fill In The Following Information About The NEW Facility: Type Of Facility: - �U X,7 IS�. -� � �} Number Of Bedrooms: � Number of People� Pool Size:_ ��,t'�� Garage Size: Other: V Requested By: . " , Date Requested: �-� —� �� (Signature) For Environmental Health Office Use Only " Approved Disapproved Comments: Environmental Health Specialist � � � � �� ; ! Date: � � ' �� *The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee (extended or limited)that the on-site wastewater system will function properly for any given period i time. Payment: Cas � Check Money Order # r Amount:$ .� Date: � Paid By: Received By: Account#: �iL�� Invoice#: �iy ",�� 12��?� � ; �.� . � �� g��c ��-� � �� Existing House -�1t�j 1 �G� �—.___�--.�.a..� \� _ � � ---��-.�__4� f �� __--��_, �`' '�l� �°'�� . � : :. ............._........_... �� r ... 9'paUo dao ......... f . ,.. . ....._.. ......................................................... _ _. _ .. .... .... .. ..........�.... .__.�._�..w_ ............... � ./ ; ,, . ............... ........... ----- _.�_.._... �_.�..�.. �.:��_�'.:�' . �._ '._._.. . 12'x 12' PorCh n _ - �_.___..__._"""� ;.-.' (�� .G ,��* �R�� a�l�Cc.7' G� !?� e.c'�.,�` t./....�_...__..... _,,.,� 4 . . . . . _ �� x 4 -}�,tt ! � a . - � _ � f C� Sto�e VeCteer •�, �� ,,,r � ` � � . Swirriming Poo! ��f;�� a� � ; � � O .'.�:�'�C�� l= . � l�— . } � 4 I � - � � t � � i��:�--- _._.'_ .�:� .�.„�: �-�,�� ; __��t � •.,�,�s � �� __ i E';.�+�-'r�t; .�� ; �.,_....�._.._w. �".�=:w`..___�__ ..._-_..., . __._�� _...._._�____�._`�.! . � 4p50 44}5ti 4050 4050 ,,,�� X Zo so��ri�m ►�� :� R��hard & Elair�� 1NillEams � - . �._.._.____. , . , Advance IVc -�c,7,� rC .��? yG:;` t��<< r ✓ ^ �-----�---- _.....�1 6 34' Wide x '�a' Tall x 80' Lang ,� „ . 38' x 8' x �` Connecfor ta house � `� � �__.�'_' _ ___.. '___._.'_�__.— .�V��' •' '"'_""' � � tiTATE OF NORTH CAROLINA-Davle Count�. THIS DEED,Made thie the......2...............day of••••••••..........__....._........ApI'.11....._..........._...................._..._.•••......, 19.�4••••.....,by ........._..........._........................�'41.�'f.�n,Ode7,1 Millifine._and_rif�,�_Dorothy.H:.pillia�s _. _ ..... .__._.__....__.....•••-•••.__••-•- ot.........11as1l._................_CouatY.state oi xorth Carollna.Dart-Saa_.ot the tuet P�. to..._..._._..........•••_....._........-••...._.._...... ...�ticha�.:Xa..M�,�,S.A�A...�AA_!(S.�R�._DRX'.4.L.�4T$��R.A..xa_X��,�I.a.........._...of.._.....__�.w.�R................Connty State of North Carolina,part.._Sesot the eecond part;Witnenaeth That the esid parkles....of the firet patt in eonnideration of (E..1Q...S?Q.....................) ....T!!�l..De��llT9...lnd,oLher._��luabla..ceaaid�ry�isna.___-..:-•••••.............................._.....to the,••..............�d by the esid part..ie�...of the seoond part,the receipt ot wLich ia henby acknowledged,fop/Lave barSained and sold,and by theae preeente do..._._._.bargain,eell and convey unto the eaid part�.A.il....of the eecond pnrt and..._.��1l�.I........ heire a tract or panel of land in the County of Davie and State of North Carolina,in_..._.Sha�j...C�aZ�_......___..__..Y_.._._..... Townahip,adjoining the Iands oi.._.._.._.......•••............._._._._........_................•••••••••--�--................................................................................... and others,and bounded ae follow�: • A certain 12 2S acr� Lract ot land l�in6 on th� South aid� of Yillia�'a ltoad (If. C. �`1610) in ShadT Oro�e ioxaahip, Da�i� Count�, llerth Caro- lina, ad�oinins l�Iar►in 0. lfiilia�a oa th� EaaL, Ector Burt�n �a ths 3ouLh�Ylmer lle7d aad lnrl Lni�r on th� M�at and d�acribed as follons: DLfiINAING at a �oint ea ths Aorth aid� ef pa�a�nt of Nilliaaa ltoad ( (lf. C, �`1610) xher� a branch llora throu�h a cnlnert und�r said ltoad. Mar�in 0. Milliais� n�x corner� and Lh� lerth�aat c�raer ef th�.xithin d�acribed loL, and runain6 thenc� xith ths c�nL�r of tha said Draach aa � iL a�and�ra ia a 3onth�naL directioa th� tollexin6 iour ealls ud di�- tances: So�th a d�6e. 30 aia. Mest 62.0 te�t Lo a p�inL aL uuth ot cul- ! nrt; South 42 d�aa. ;5 sin. M�at 202. fe�t Le }oint in braach; So�rth 21 d�6a. M�aL 3� f��L to roint in br�ach �L 3priu br�aeh; Eontk 27 de6a. 30 ain. X�et 32a te�t to aa iron atak� at Mnd ia branch; th�ne� l�ttins aaid �ran�h SouLh 27 d�6a. 3� _�. Mest 92 i��t to an iron r�d in Ector DBrt�a line; th�nc• North a5 d�6a. SO �in. M�at 232.5 te�L Lo an irou pip� on th� 3outh eid� of Draneh and oa Lh� East�rn �d6� o! a l�n�; th�ac� � North 36 d�6a. 20 �in. M�at 375•5 f��t �►ith EL�r llo�d lia� t� an irea ' pi�s; th�ace llorth 3 d�sa. 15 sin. E�at 620 t��t witd Enrl Lni�r lias to I d�e6t Baet �3 fii hrit�Milliaaei�oad ?OdTRE�soni16i�a�rir►cs�o��crnxs IlfO, containin6 12.2a acr�a, aor� or leaa. STAIrR3 PAID �.00 � � � The atove lana wae eoaveyea to IIcancor ey -__._..._.....__.____.__..._._..._._......_....see aoox xo....�a...Pase_3?3... Tp HAVE AND TO HOLD the doreeaid trut or parcel of land aad all yrivilegee and apyurtenancea thereunto belon¢inY��e aaid partlaa...of the eecond part•,a *�•�+• *eire and aeaisne forever. And the eald part..i�O.of the firet part do.._..__covenant that.........._......_......»_tbeJ!.......iX/are eeized of esid premises in fee end ..............--.............tbe right to coavey tLe same!n fee simple;that the eame are free irom incumbrances;and that......LhD.T.......... will watrant and defend the said title to the same against the claIme of all peteona whstacever. IN TESTIMONY WHEREOF the said yartl.lD_of t6e firat patt..�lA.14..._...henunto eet.J.�70.11'.....hand..�.......and aea1.A........ _..•-•.......----........................................... ._._...(Seal) .....�iL[j.A.._�dtu.X��I�A..............---�-------..._(Seal) ..................:...�----...................................___._.__........(seap .....Dero�h7...M,,,Milliaae.........................----�--....(Seaq ..........................................................•-••....._.........�._.......(Seal) ......._.............................,-......................................................(Seal) ............................................................................__.__.......(Seal) ..........__........................._..........................................---......(Seal) . _-__--_--='----_-___-_-_-''_".--�---- ._.. . . -- ------- - ---- STATF OF NORTA CAItOI.INA.-- �!�14n-••••__.._._._..._.._._.._...Connt7, I,...._...��b:�']!�_Ba_....�!'.D�.��_..__._�....._...._...._...»....._......_......a NotarY Public,of aaid CountY.do hereby certity that 1�artin Od�ll ililli�ae and xiSe, Doroth� ![. williaea grantora,eaeh pereonally appeared befoe'e ma tLie daY and ac�nowledged the eacceution of the foregoing deed of rnnveyance. Witneas my hand and aotarial seul thie tha.___..2.......day of...__••-...._AP.�'.i1.....................:.19.69...... My commisaion expirea...NA7...�2.Q....._._.._.__39._T.�..... .._.._�t.4b�i..�...._�DI!A�t�...........�R4�l�..I.-••....N. P. STATE OF NORTH CAROLINA-Da�is Camt�.----------- - __ , _ . _. . . _ The fotegoinQ eertificate�ot_..._.IaLhr�a.A...!(cA�nis1...�nLar�r...l�1Sr..nf...Eoaran..C.onat�.._..___._.._... _........:......_._.._._................__..••-••._._.__...._.._.••••••.__.••••-.........._................_.............................................._.......................••••_...•••-_••••••• ie(� certified W be tarreck Thie tastrument was Dzesented tor reyietratioa this......�...........day of...........�Dx'�•�..................... 19...bs-•••.at12:1►S4tY., P.M.,and duly reoorded in the office of the Reqieter of Deede of Davie County,North Carolina ta Baok........Bl._...,Pa�e.......�r4�►.__ ' J.K.SM1TFi,REGISTEB OF DEEDS � Thts the..._�.._.d�y of_._......_._AP.x��a. ._.-.a.n.,is.44... i _............._..._.___..._.............._........._._.—.__...._.._._.._•••.... Br:.........xanc7._1litterow..._......................._..._._._..._... � DEPi]TY REGLSTE&OF DEEDS. I � Thta inatrument prepared by:......_.•_•••••••••••••••..._................__........................................................................._........................................_....... ', ?+�::�neTi•-Mlxia Co.loc..7i�hI�A .C. -f � - � Appr�aisal.�ard Page 1 of 1 DAVIE COUNTY NC - 4 2 2013 12:04:56 VM ILLIAMS RICXARD WAYNE WILUAMS DOROTHY ELAINE W Retum/Appeal Notes: I7-000-00-030 06 WILL[AMS RD � UNIQ ID 17154 9740000 D401-P22 ID N0:5768569528 COUNTY TAX(100),FIRE TAX(100) CARD NO.1 Of 1 . eval Year:2013 Tax Year:2013 12.28 AC WILLiAMS RD 12.050 AC SRC=InspeRion raised b 02 on 04/09/2008 04003 NO CREEK TW-04 C- EX•AT- LAST ACTiON 20120323 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OP VALUE � oundatlon-3 Eff. BASE • Standard 01600 � - . , ontinuous Footin 5.0 US MO Area UA RATE RCN EYB AY8 REDENCE TO MARKET ub Floor System•4 „ I wood g.0 01 01 3 368 110 77.00 262036198 197 %GOOD 74.0 DEPR.BU2LDING VALUE-CARD 193 91 Ex[erior Walls-10 TYPE:Singte Family Residen[ial Single Family Residential DEPR.OB/XF VALUE-CARD 7,51 luminum in I Sidin 29.0 MARKET IAND VALUE-GRD 116,64 oofing S[rut[ure-03 STORIES:2-1.5 Stories OTAL MARKET VALUE-CARD 318,06 able 8.0 ' '" oofing Cover-03 � � s halt or Com si[ion Shin le 3.0 OTAL APVRAISED VAIUE-CARD 318,06 nterior Wall ConstruRion-5 OTAL APPRAISED VALUE-PARCEL 336,06 � wall/Sheetrotk 20.0 nterior Floor Cover-08 heet Vin I/Lamina[e 6A � OTAL VRESENT USE VALUE-PARCEL OTAL VALUE DEFERRED-PARCEL nterior Floor Cover-14 OTAL TAXABLE VALUE-PARCEL 318,06 a et 0.0 +'- - --""qg""""'+ . eating Fuel•04 I F U S I PRIOR � � lec[ric 1.0 I 1 BUILDING VALUE 219,62 eating Type-SO I 5 BXF VALUE 7,96 eat Pum 4.0 Z I � 5 +------36-------+ NDVALUE 116,64 ir Conditioning Type-03 I � I PRESENT USE VALUE entral 4.0 I 1 DEFERRED VALUE drooms/Bathrooms/Half-Bathrooms I O OTAL VALUE 344 22 � /2/0 12.00 +-1 2-♦ drooms AS-1FU5-2LL-0 +----24----+ throoms I W D D I AS-1 FUS-1 LL-0 1 1 PERMIT ((�e 0 0 CODE DATE NOTE NUMBER AMOUNT }""2g"""}""Zq""'}"'lg"'"} OTAL POINT VALUE 100.00 I B A 5 I I I ROUT:WTRSHD: BUILDING ADIUSTMENTS I � 1 ' � Ize 3 Slze 0.870 I 9 SALES DATA FF. INDICATE � uali 4 ABAVG 1.200 I I RECORD DATE DEED SALES ha e Desi 4 FAROR 4 1.050 � +---2 2----+ M 0 I F G D I BOOK VAGE M R TYPE / / PRICE ._; OTAL AD]USTMENT FACTOR 1.10 I I I 0081 194 4 196 WD X I OTAL QUALiTY INDEX � 11 I 2 I I 1 2 - I I 2 - I I 2 +----27-----+6+--IS--+ I HEATEDAREA3,178 �;, � 4FOP +""22""+ '� +6+ NOTES sRECENT REMODEL2004 SUBAREA UNIT ORSG% ANN DEP % OB/XF DEVR TYPE GS AREA % RPL CS ODE DESCRIPTIONLTH HUNIT PRSCE COND BLDG#L/B AYB EYB RATE OV COND VALU AS 2 33 30 18002 1 TORAGE 30 1 120 15.00 100 _ L 194 198 53 22 39 GD 48 04 1678 1 TORAGE 24 20 480 15.00 100 _ L 194 198 53 22 158 OP 2 03 61 9 TABLE 2 3 72 20.0 10 � _ L 194 198 5 2 316 US 84 09 58212 10 ON PAVING 9 1 90 3.5 00 00 5 7 2363 DD 24 02 369 OTAL OB XF VALUE 7 511 IREPLACE 3-1 Story 2,70 . Sin le UBAREA 3,92 262,03 � OTALS � UILDING DIMENSIONS BA5=W18WDD=N10W24510E24 W52540E27 FOP=54E6N4W6EE21FGD=51E22N22W22521=N21E22N19;PTR=N30FU5=Ni5W48525E12N10E36$530$. LANDINFORMATION MIGMEST TMER AD)USTMENTS LAND TOTAL ND BEST USE LOCAL FRON DEPTH/ LND COND ND NOTES ROA UNIT LAND UNT TOTAL AD)USTED LAND LAND SE CODE ZONING TAGE DEPT SIZE MOD FAR RF AC lC TO OT TYCE CRICE UNITS TYP AD)5T UNIT VRICE VALUE NOTES URAL AC 0120 873 0 1.0990 4 1.2400+04+20+00+00+00 PW 7 100.0 12.05 AC 1.36 9 677.3 11664 OTAL MARKET LAND DATA 12.05 116,64 � OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNedAppraisalCard.aspx?parce1=I700000030 4/2/2013