156 Hoose LnDAVIE • COUNTY HEALTH DEPARTMENT
L IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment an Disposal Rules (10 NCAC 10A .193 -.1968) Permit Number
Namer'{
Location
Subdivision Name (49 5e.1 Lot No. _ Sec. or Block No.
Lot Size � House Mobile Homey Business Speculation
No. Bedrooms_ No. Baths _ No. in Family Q—
Garbage Disposal YES iLJ NO x Specifications for System:
Auto Dish Washer YES t NO ❑ /v 00,
Auto Wash Machine YES NO -❑
Type Water Supply _1 40 kIN'y
moo' X :3' x(1
I. ��z) �6x,
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
_t -
Improvements permit by \\—�
*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 day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed by
F
Certificate of Completion Date
*The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
1A- 3
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
1. Permit Requested By
2. Address
3. Property Owner if Different than Above -���5
Address
4. Permit To: a) Install Alter Repair
b) Privy Conventional Other Type
Ground Absorption
Home Phone l4c;i
Business Phone
c) Sub -Division Sec. Lot No.
5. System used to serve what type facility: House Mobile Homed Business
IndustryOther
b) Number of people a
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms a Bath Rooms— Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions ; / 1�re,
b) Land area designated to building site
c) Sewage Disposal Contractor /a
10. Do you anticipate any additions or expans
What type?
of the facility this sewage system is intended to serve?
This is to certify that the information is correct to the bet of my knowledge.
ZZZ2�rlZL
ate Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
nn 1 i
"Na r\
DCHD (6-82)
on 4'b Or-'' 1 V CL"� n4ti
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date L4 — 114 ----
Address
14Address Lot Size 1, ' A
FACTORS AREA 1 ARFA 2 AREA 3 ARFA d
1) Topography/ Landscape Position
S
S
P
S
PS
PS
U
U
U
U
?) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, 2:1 Clay)
S
PS
S
PS
(note
U
U
U
U
I) Soil Structure (12-36 in.)�\
Clayey Soils
�J
A
S
PS
S
PS
U
U
U
U
Ij Soil Depth (inches)
S
S
S
PS
PS
PS
U
U
U
i) Soil Drainage: Internal
C&
S
PS
S
PS
U
U
U
U
External
/3
S
S
lP$J
S
PS
PS
U
U
U
U
i) Restrictive Horizons
Available Space
PS
PS
S
PS
S
PS
U
U
U
1) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
Site Classification
�R's9S
U—UNSUITABLE S—SUITABLE PS— ovisionally Suitable
Recommendations/Comments:
Described by �` Title Date g /
SITE DIAGRAM
DCHD (6-82)
•
7'$3.00
DEED TRANSFER CHECKED
Excise Tax TAX SUPERVISOR
Fl ED FOR REGISTRATION '
June 19, 1987 4:20 P.M.
AND eECc;tDED N DDDR '• 138 rAer 247
J. K SMITH. REGISTER OF DEEDS
VIE COUNTL&Ae
Gy
ASZ:STANTX30W REGISTER OF DEEDS
Recording Time. Book and Page
Tax Lot No. ........ Parcel Identifier No..........................................................................
Verifiedby .......... : .............................. . ...... ............ ...... County on the .. ........ day of ........................................................ 19............
by.............................................. .....1 .....................................................................
11
Mail after recording to'.:7�7•.../,... ..�6�../........... ;,7104=a ...... XfAz....... e�%f..lT........................................
This instrument was prepared by .....-George.-W... Martin, ••Attorney••at••Law,••Mockoville.•• NC .
Brief description for the Index
NTE
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this .-I 9JL.. day of ........June ................... .......... , 19.87 •. , by and between
GRANTOR
CHARLES VANWAGNER NOOSE. SR. and wife,
EMILY W. HOOSE
GRANTEE
GERALD S. HOOSE and wife.
DARLENE E. HOOSE
Enter in appropriate btock for each party: name. address.. and. It appropriate. character of entity, e4& 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 altuated in the City of . Jerusalem .... ........ Township,
Davie .. . ... . County. North Carolina and more particularly' described as follows:
BEGINNING at an iron in the line of John W. Carter (DB 40. page 327) Northeast corner
of Henry Adam Lagle and Northwest corner of the within described tract; and running
thence with Carter's line, South 51 degs. 50 min. 01 sec. East 261.89 foot to.a stone,
Northwest corner of Billy L. Hellard (DB 125. page 88); thence with Hollard line.
South 04 degs. 53 min. 06 sec. West 228.97 feet to an iron; thence North 51 degs. 50
min. 01 sec. West 281.57 feet to an iron in the line of Henry Adam Lagio; thence.with
Lagle line North 09 degs. 12 min. 09 sec. East 218.78 feet to the POINT AND PLACE OF
THE BEGINNING. containing 1.194 acres more or less as surveyed December 4. 1986 by
Frances B. Greene and being a portion of those lands described by.deeds recorded In DB
134. page 678,'Book 111. page 857 and Book 117, page 858.
TOGETHER with the above described lands there is conveyed a perpetual easement of
Ingress and ogress 30 feet in width leading from the same to the right of way of SR
1802 (locally known as Will Boone Road) said 30 foot easement having as its western
boundary the following described course and distance: BEGINNING at the southwest corner
of the above described 1.194 acre tract and running thence with the line of'Renry Adam
Lagle. South .19 degs. 45 min. 47 sec. West 625.39 feet to an iron in the right of way
of SR 1802. said easement hereby conveyed being appurtenant to the above described
1.194 acre tract and runs with the same in'the hands of all persons whomsoever.
N. C. Do A—. Forty No. 3 t IM ItMwd L 1177rn.v a..o., wt nws
F..u.ANw.w r.wa.easa�-rw, '
Appraisal Card Page 1 of 1
DAVIE COUNTY. NC 9/11/2013 1035:27 AN
HOOSE GERALD S HOOSE DARLENE E Retum/Appeal Notes: KS -000-00-066-01
156 HOOSE LN UNIQ ID 20547
6803500 D305 -P24 ID NO: 5747814772
COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1
eval Year: 2013 Tax Year: 2014 1.19 AC N OFF WILL BOONE 1.440 AC SRC= Owner
Appraised by 19 on 05/20/2008 05004 FAIRFIELD TW -05 C- EX- AT- LAST ACTION 20110712
CONSTRUCTION DETAIL MARKET VALUE
DEPRECIATION
CORRELATION OF VALUE
Foundation - 3-
Standard 0.2700
ontinuo5.0 US
MO
EO
Area
UA
BASE
RATE
RCN
EYB
AYB
REDENCE TO MARKET
ub Floorr System stem - 4
lywood 8.00 59
01 11,9071
103 72.10
13749
198
198 % GOOD 1 73.0
)EPR. BUILDING VALUE - CARD 100,370
xterior Walls - 10 TYPE: Modular Single Family Residential
)EPR. OB/XF VALUE - CARD 2
Iuminum/Vin I Siding 29.00
MARKET LAND VALUE - CARD 13,02
oo0ng Structure - 03 STORIES: 1 - 1.0 Story
OTAL MARKET VALUE - CARD 113,41
able 8.0
oofing Cover - 03
TOTAL APPRAISED VALUE - CARD 113,41
s halt or Composltlon Shingle 3.00
nterior Wall Construction - 5
TOTAL APPRAISED VALUE - PARCEL 113,41
)rywall/Sheetrock 20.0
nterior Floor Cover - 08
heet Vin (/Laminate 6.00
OTAL PRESENT USE VALUE - PARCEL
nterior Floor Cover - 14
OTAL VALUE DEFERRED - PARCEL
OTAL TAXABLE VALUE - PARCEL 113,41
:arpet 0.0 +"'-25----+
eating Fuel - 03 I U B M I
PRIOR
as 1.00 1 I
UILDING VALUE 103,85
Heating Type - 04
I
VALUE SO
I BXF
Forced Air -Ducted 4.0 3 3
LAND VALUE 13,02
Ir Conditioning Type - 03 0 p
PRESENT USE VALUE
Central 4.0 I 1
DEFERRED VALUE
Bedrooms/Bathrooms/Half-Bathrooms I
TOTALVALUE 116,970
/2/0 12.00C I I
Bedrooms +----25----+
BAS-3FUS -0LL- 0
Bathrooms
PERMIT
B'AS -2FUS -0LL- 0 IWDD I
CODE I DATE NOTE I NUMBER AMOUNT
ffice 1 1
4 4
+----28-----+--16--+-12-+
ROUT: WTRSHD:
OTAL POINT VALUE 100.00 I BAS I
BUILDING ADJUSTMENTS 1 I
SALES DATA
uali 3 AVG 1.000 0 1
FF'
INDICATE
a Desi TOR 4 +4+ 1
4 FAC1.050
1 5 1 P 3
RECORD DATE
DEED
SALES
BOOK
PAGE M R
lz
iz e 3 Size 0.980 0 0 0
TYPE
/jj
PRICE
OTAL ADJUSTMENT FACTOR 1.03 +4+ I
0138
247 6 198
WD
U
I V
I 300
OTAL QUALITY INDEX 10 I I
1 I
0 I
+-----33------+-12-+-11-+
1 W D D 1-
HEATED AREA 1,680
0 0
NOTES
+- 12-+
OWNER
FROM CHARLES V HOOSE SR
SUBAREA
UNIT ORIG %
ANN DEP % OB/XF DEPR.
G1342L4(171' ODE ESCRIPTIONLTH
HUNIT PRICE COND
I
BLDG
L B
AYB
EYB
RATE V COND VALUE
1 8 5.1 10
L
194
199
5 2
TYPE A 24 HED
BAS OTAL OB XF VALUE 2
-ITP
BM
DD
IREPLACE 1 - None
UBAREA
.2,81 137,49
OTALS
UILDING DIMENSIONS BAS=WI2WDD=N14W16S14E16 W44S1oSTP=W4SI0E4N1D S20E33WDD=S10E12N10W12 E23N30 PTR -N50 UBM=S30E25N3DW25 S50$.
NO INFORMATION
IGHEST
THER ADJUSTMENTS
LAND TOTAL
ND BEST
USE
LOCALFRON
DEPTH / LND
COND
NO NOTES ROA
UNIT LAND UNT
TOTAL
ADJUSTED LAND LAND
SE
CODE
ZONING
TAGE
DEPT SIZE MOD
FACT
RF AC LC TO OT TYPE
PRICE UNITS TYP
ADJST I
UNIT PRICE VALUE NOTES
H HOMES IT
0201
0
0 2.0410 4
0.7500
10.15 +00 +00 +00 1 PD 1
5,900.00 1.441 AC
1 1.5311
9,032.90 1301
OTAL MARKET LAND DATA 1.441 13,020
OTAL PRESENT USE DATA
0
r
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=K50000006601 9/11/2013