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181 Granada Drive Lot 62. . , HEALTH DEPARTMENT RELEASE ".;A& I Davie County Health Department Environmental Health Section 210 Hospital Street Mocksville, NC 27028 Phone:336-753-6780 Fax:336-753-1680 Applicant: Scott Smith Address: 1036 Paterson Ave City: Winston-Salem State/Zip: NC / 27103 Phone #: (336) 782-1647 J For Offirp Usp Only *CDP File Number: G7 -040 -BO -005, County ID Number: 30 Evaluated For: HDR/WWC Permit Valid Until: 06/13/20 Property Owner: Andrian Whittington Address: 181 Granada Drive City: Advance State/Zip: NC / 27006 Phone #: Property Location 6 Site Information Address: 181 Granada Drive Subdivision: Woodvalley Phase: Lot: 62 Road#: Advance NC 27006 Township: *Structure: SINGLE FAMILY # of Bedrooms: # of People: Directions:Hwy 158 right on Hwy 801 right on Hillcrest, right on Mocks Ch Rd. left on Beauchamp Rd Right into LaQuinta Dr. Left on Sonora Drive right on Granada 2nd on left *Water Supply: N/A Type of business: Basement: ❑ Yes EX No Total sq. Footage: No. Of Employees: *Proposed Improvement: Replace Mobile Home *Release Conditions: It is the responsibility of the owner to maintain a 5' 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. **Site Plan/Drawing attached.** Total Time: (HH:HH) O Hand Drawing Olmport Drawing 1 Hours 0 Minutes Activity Code: S -13 -AUTHORIZATIONS - EXISTING SYSTEM REUSE Phone: (336) - 753 - 6780 Davie County Health Department Environmental Health Section _ P.O. Box 848 H, 210 Hospital Street Courier # : 09-40-06 Mocksville, NC 27028 ON -SIVE WASTEWATER CERTIFICATION (Check One) eplacement Remodeling Reconnection Fax: (336) - 753-1680 Name: –4sroA- 'Sw.l1111 Phone Number (Home) Mailing Address—_101 O 0,&4-u ii4• \05 r S PA. N - L 7-1 I W Detailed Directions To Site: L 5 b I4 14— 9 1 $ 1D H -L torca4- it Maz..k-s Cl. Rrl FiZ� Q ac r Z� 1 L) Property Address: Please Fill In The Following Information About The EXISTING Facility: I • d0 Name System Installed Under: Type Of Facility: Date System Installed (Month/Date/Year): Number Of Bedrooms: 3 Number Of People; Is The Facility Currently Vacant? es No If Yes, For How Long? Any Known Problems? Yes If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: _l,\�� tv%jk A. Number Of Bedrooms:--�,_Number of People_ Pool Size: Garage Size: — Other: Requested By: Date Requested:_ 'a Z3• t7 (Signature) For Environmental Health Office Use Only �pprove-,j7D Disapproved Comments: Environmental Health Date: *The signing of this form by the Environmental Health Staff is M 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 of time. Payment: Cash Check Money Order #� Amount:$�7go -- Date: S/�L/ /� 3 Paid By: S(` _ 1 n Received By: 1 /v�ttQ9-� Account # l Inv 41 G�� 1Z1 �e� Fuge with Hdader and Menu 4u Group Tree ( !i ! 1= / 1+ ► N Main Report Page 1 of 1 CRYSTAL REPORTS' HEALTH DEPARTMENT, RELEASE For Office Use Only *CDP rile Number: Aa ,' Davie County Health Department G7 -040 -BO -005 Environmental Health Section County IDNumber: 1 210 Hospital ,Street 30. Nocksville, NC 27028 lvalwted tor: Phone:336-753-6780 Faz:336-753-1680 HDRNVWC Permit Valid Until: 06/13/2018 Applicant: Scott Smith Property Owner: Andrian Whittington Address: 1036 Paterson Ave Address: 181 Granada Drive City: Winston-Salem City Advance State/Zip: .NC / 27103 State/Zip:NC / 27006 - Phone #: (336) 782-1647. Phone: Property Location i Site Information Address: 181 Granada Drive Subdivision: WOOdvalley Phase::Lot: 62 Roads►: Advance NC 27006 Townships *Structure:. SINGLE FAMILY of Bedrooms:. / of People: Directions:Hwy 158 right on Hwy 801.right on-; Hillcrest, right on Mocks Ch Rd: left on Beauchamp Rd Right into LaQuinta Dr: Left on Sonora Drive right on Granada 2nd on left, *Nater Supply: N/A ,Type of business: . Basement:'. ❑ yes NO Total sq. rootage: No. Of bployeas: . *Proposed Improvement: Replace.Mobile Home *Release Conditions: It is the responsibility of the owner to maintain,a.51. 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. **Site Plan/Drawing attached.** roti Time: (nz:mq Hand Drawing �mport Drawing lHours 0Minutes Activity Code: S-13-AUTHORIUZATIO_NS EXISTING SYSTEM REUSE "r Help Files Copyright ® 2008 Custom Data Processing. Inc. All rights reserved. (cdpnrptnc version2.0.6 3/26/2013 isd5.2.1 db=kyprodl) https://portal.cdpehs.com/CDPNRPTNC/VW REPORTS/ReportView.aspx?POPUP=Y&... 6/14/2013 i MW ; 4 f R \ 4w��` 0U N� Printed -May 23, 2013 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie County's 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 or arising out of the use or inability to use the GIS data provided by this website. Appraisal Card nAvTF rntiNTY_ Nr Page 1 of 1 S/At/'1M7 a."..;O Au HITTINGTON ADRIAN ALEXANDER Return/Appeal Notes: G7-040-60-005 181 GRANADA DR UNIQ ID 11513 301474 ID NO: 5870236389 COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1 eval Year: 2013 Tax Year: 2013 LOT 62 LAQUINTA SECTION 2 1.000 IT SRC- Inspection Appraised by 05 on 11/02/2012 07302 LA QUINTA TW -07 C- EX- AT- LAST ACTION 20130319 CONSTRUCTION MARKET VALUE DEPRECIATION DETAIL CORRELATION OF VALUE OTAL POINT VALUEEff. BASE BUILDING USE MOD Area UAL RATE RCN EYB AVBREDENCE TO 00 % GOOD EPR. BUILDING VALUE - CARD ADJUSTMENTS 97 OTALADJUSTMENT TYPE: Vacant EPR. OB/XF VALUE - CARD 4,7 ACTOR 4ARKET LAND VALUE - CARD 10,00 OTAL QUALITY INDEX STORIES: OTAL MARKET VALUE - CARD 14,76 OTAL APPRAISED VALUE - CARD 14,76 OTAL APPRAISED VALUE -PARCEL 14,76( OTAL PRESENT USE VALUE - PARCEL OTAL VALUE DEFERRED - PARCEL OTAL TAXABLE VALUE - PARCEL 14,76 PRIOR UILDING VALUE BXF VALUE 5,81 .AND VALUE 12,00 RESENT USE VALUE EFERRED VALUE OTAL VALUE 17,810 PERMIT CODE I DATE NOTE I NUMBER AMOUNT OUT: WTRSHD: SALES DATA FF. RECORD DATE DEED INDICATE SALES GE M R OOK[294 TYPE / PRICE _ 0174 5 19 WD Q I090406 10 01 WD A V 1000020061 3 199 WD U V016070 8 1991 WD U V HEATED AREA NOTES ROM WOODVALLE HOMES ROM NCNB SUBAREA UNIT ORIG % ANN DEP % OB/XF DEPR GS RPL ODE ESCRIPTIO LTH HUNIT PRICE COND LDG L B AYB EYB RATE V GOND VALUE FENCE 50 10.4 _ L 199 199 S 261 TYPE AREA 6 6 REPLACE 8 H SITE 1 4 500.0 L 196 197 S 10 450 UBAREA OTAL OB XF VALUE 4,761 OTALS UILDING DIMENSIONS NO INFORMATION IGHEST OTHER ADJUSTMENTS1 TOTAL NO BEST USE LOCAL FROM DEPTH / LND COND AND NOTES OA LAND UNIT LAND UNT TOTAL ADJUSTED LAND LAND SE CODE ZONING TAGE EPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES BL HM SUB 0200 0 0 1.0000 0 1.00(10 PW 1 10,000.0 1.00C IT 1.00 10,000.00 1000 1 1.00 OTAL MARKET LAND DATA 10,00 OTAL PRESENT USE DATA C i http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=G7040B0005 5/31/2013 o® W_�t70 Ud-Tax agr00 FILM ro"P900"VaTgx August 21, 1991 9:55 A.M. DAn .[ 7a AM 11cao1Cm a NOCK ' �1D.►soCAU "EMT 1. SHOW or Dews DAVK COLN".IFC Assistant Recording Tlme, Book and Page TaxLot No........................................................................................... Parcel Identifier No..............................................................:....:....... Verifiedby......................................................................... County on the ................ day of ......................................................:., 19............ by.............................................................................................................................................................................................................................. Mail after recording to mien..Xe..�G'�......4✓�4/v?J�(.�....� ��y�m.5'x�r%/r ✓`T.�. 1l�tG.�t............... ....................................... :......... .......... ............................. ...... .610.1Pff"5..�...... f./,....0/.'W.. N �.Sl�r�r.. yG.......7i/G:�..................................- This instrument was prepared by ...........PoxgA... In... I.C1 A,.. At(orney,..a.C..LBy,...Mockt}vlllg,,.2iC..................................... Brief description for the Index NORTH CAROLINA GENERAL WARRANTY DEED THIS DEED made this......1.9....: day of.......Apgtt&.t.................. .................... :., 19..91.,,,. , by and between GRANTOR GRAY A. POTTS and wife, BETTY W. POTTS GRANTEE HAROLD SLOCUM OSEN and wif,e CAROL H. OSEN • Enter in appropriate block for each party: name, address, and, if appropriate, character of entity, eq. 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..................................................................... Shady,Grove........... Township, ..............................Davie.......... County, North Carolina and more particularly described as follows: BEING known and designated as Lots Numbers 62 and 63 of Block B, Section II, in the LAQUINTA Subdivision according to the plats of said Subdivision, filed with the Register of Deeds of Davie County, North Carolina. This description taken from the document recorded in Deed Book 115, page 733, Davie County Registry. Reference Plat Book 4. page 132, Davie County Registry. For back title, see Deed Book 108, pages 890, 796 and 102, Davie County Registry. This conveyance is made subject to restrictions, reservations and easements of record. NTE:GWM file no. 470.00003 N. L. Bar A w.c. Furs, N..3 DEED TRANSFER C::' ':7-_'- DATE ��-� I.91 %�A41f . • V • GRANTEE General Index to Real Estate Conveyances — Davie County, N.- C. 17 ..�.... . - _ .. __. _ �p/— .QOe.e .t Preps Th .rmrA.` as Fist Len., .r l.Nn. d w.«error ; ��Mm�rM sta�O efae� .em.. GL,..irCim A. Ids•yle, T.h M.d 11 8 N—.ed nbr to Bdf aai«Iod i e6wt te. wE• r•fw.nca. edd M wuexl PanNer t:w t�.w,e, N. C. . . Oats of Inst 196$ GRANTEES ;NEN NAMES GRANTORS PORSTUVWXYZ Shirley__) Caudill Raymond.. at.als. Tom W Gough Tom W et al Obert Wade. _.Gough_Tom.W et-al_.._ _ Zella R Gough L J Jr at ux Tom W Holt He J at ux William Seamon J C et ux R Wade Columbia T W Federal Land Bank of Shirley J Caudill Raymond et al illiard Jr Weaver Wayne B Jr etux Mad of lam Deed Deed ',78 Deed Deed ase Pion D T R & R QCD D T Recorded BRIEF DESCRIPTION 16 acres, Mocks Tw Tract, Clarks Twn Cal Twnps 2 tracts, Clarks & 1 acre, Clarks Twn chase Tract, Clark Lease & optionto pt 8 lots, Sam Foster Release & Reconveya Part Security on $ 16 acres, Mocks Cooleemee N. C. Jai Lot #2, Ruffin St. celled Twn r- Sub. ce o acr, a Twn SURNAMES Gordy _ _ Gough $WIN MA ES ABCDEFGH Harry J ;MEN NAMES IIKLMNO Lena S ;see 77 77 81 82.359 78 84 87 82 nE• 504 629 616 491 120 274 367 539 1968 1968 -. Gough _.-- Francga_S._ 1969 Gough D H 1969 Gough at al 1970 1971 Gorelick Tr -Gough- - - Gordy _Gourley Tr Frances S Harry J Lena S 1972 12 1972 Gorelick Tr Gourley Tr William Seamon J C at ux Willard Jr Whitaker_ Lawremm_ D T 83. 69 Lots Sam Foster S ck illeT�_ 1972 1973 Goss Don Nell A Reggie L Murchison John T at al Deed 88626 1 acre 1973.. - 1973 at al Lois W Stanley Claude C Deed - - -- Deed D.T- Deed Deed Deed 89 - 86 8� 89 - 89 90 257 583 5 1. 503 - 566 400 1.8 acres,_Cal Twn Farm Twn -- Lot #5, Woodlea Su acres - ._Goss Gordon Emma F - _ - —_ Roy J Vogler W L Jr at al 11.73. 1973 1973 ...Goreldak Tr al _-- William -_ Peebles-Lewis at ux Roy-) Lakey Jessie_James et vir Emma F _6 2 tracts, Farm Twn Farm Twn-- - ,4 lots�Woodlea De 15.93 acres, Farm ._.-_ .-.Gordon---et Gordon Gordon at al Emma F Emma F -- _ — Roy J Petticord Calvin L et ux Roy J q2pe Ivan. Harding etux 1973 1973 Gordon et al Emma F Y--_ Roy J _—• rooks J F et ux __— Deed 90 445 11.81 acres, Farm n 1973 Gorelock Tr--- .Gordon Wi> ]i-am _—. Qmas,.$_.A1bErL-et ux _- RoV_Q ogler W L Jr et al _ D T - QCD _ 87707 91 56 Lots - Woodlee Sub, Farm Lots 7,11,14 n 1973 Emma F - 1974 1974 Gough et al Frances S et al Rgbe CS _Wade. .Iiregory iiarold .Clauzell- Wi .��ard Jr- e_IR.9P6T_.NQrman._a.�7S_et Paul a pinta Corporation Deed o sen _D T Deed 92 69_ - 93.653 94. 96 37 85 -- 62 89 Quitclaim Deed of E_.asement.-� Lot 12 Sheffield ----.--` ---. 61, Blk B, Sec LaQuinta_Sub._L S G_ 11 _81_acres Farm 0.542 acres, Clark ark _- -- Gourle Tr ._.Y--.. Goin — ----.__ -Lot 1974_ 1974 Gordan et al Gough Emma F — Roy J rooks J F et ux ,__,.___•_ QCD_..._ n Twn T_o_m_W_ Trivette B F et ux—,--Deed - _9_75_ 975 976 Gough Gough._---- Lena S — et al Tom W ones Robert J Sub Tr - RSR 96 658 Release 6 Reconvey 87.525 acres 2.6 acres, Farm Tw ce _ aures E— Peggy_W ._-_Linville Myrtle W Deed 98 307 976 Gordy liaCMaor lizabeeth Janice ordy Harry John et ux rust Deed ed De 97 7 4 2 3 3 16 acres, Mocks Tw - 976 " 1977 1977 1978 1978 1979 1980 -children Gough_ Gough .Goshorn - __ -_ __ Goresh Gough --- _ __-- __r-• Gordon _ Tr - Gough—_' elma H -- _ -- -- ------ Corp Tr et al Zella R first Savings Service _- eed 100 100 102 104 105 109 17 — — _ 2.17 acres Right of Way easement ad- way, Clarks Twn 2.44 acres, 5 G Twn Est., Farm Twn Lot 4, Sec II, Creekwo 4 tracts -- - _ Counties Tracts in Davie d Cata a Clarks Twn 1,490 acres & easement __. James E Jr Ma�cja-ly!ers Richie Carl et al Myers Edd et ux RofW Deed Deed Deed- D T 631 399 315 341 836 Andrew C Pamela M -_ H 5 V Construction Co _ - Hege Helen L - Chandler Luther W et ux Robert Wade Wallace Eleanor Gough r Charles W --+- Inez Moore --�..._ Charles W Jr Frances Sparks _.________ _ • Deed 111 619 -- -;_