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232 Indian Hills RdDAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 /Fax # (336)753-1680 REPAIR OPERATION PERMIT 0 ,N Tax PINIEH #: H700000104 SubdivisionInfo: Localion/Address: '232 Indian Hills Drive -27006 P opefty, Size:'. 20 Acres Operation Permit shall indicate the system described on the ATC has been installed 'G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," a guarantee that the system will function satisfactorily for any given period of Manufacturer /) I Tank Date Tank Size d (7 system instanea By: JL4'✓k.Le ��G'�p�_ E.H. Specialist: � �e: ( & GPS Coordinate: DCHD 11/06 (Revised) 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 #: 990005050 Tax PINfEH #: H700000104 Billed To: Robert Logan 'Subdivision Info: Reference Name: REPAIR PERMIT LocationYAddr � ::`:232 Indian Hills Drive-27006:.. Proposed Facility: Residential Repair Pcbpe§A� lie: t]lQW4.pa. ' ❑Expansion ` A Tffib'br'fhis58.®fllorization 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 change. Residential Specifications: # Bedrooms # Bathrooms # People_ Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size —az Type of Water Supply: bounty/City ❑Well ❑Community Well , System Specifications: Design Wastewater Flow (GPD) . (1 Tank Size( AL. Pump Tank GAL. It t. V Trench Width �� Max. Trench Depth Rock Depth Linear Ft.'�r� Site Modifications/Conditions/Other: �zPLa� Contact the Davie County Environmental'Henith Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Tele hone # (336)751-8,760. S New Z� // � 1, el�U iS �1cX �uY►u W1h� Ito tit ovt2 �!-. CP L; Pt � µ � x 1 Environmental Health DCHD 11/06 (Revised) Date: • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION Account #: 990005050 Billed To: Robert Logan Reference Name: REPAIR PERMIT Proposed Facility: Residential Repair Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: H700000104 Subdivision Info: Location/Address: 232 Indian Hills Drive -27006 Property Size: 20 Acres Date Evaluated: Community Evaluation By: Auger Boring I Pit Public X Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % 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: EVALUATION BY 1 ti LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: Q REMARKS: LEGEND Landscape Position 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 1lZQist VFR Very friable FR Friable FI -Firm VFI - Very firm EFI Extremely firm 3y'_et 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 Mineralog 1:1, 2:1, Mixed LYfltsS 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 DCHD 05105 (Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ UiiiiiiiisNON MEMNON MMEMMEiiiiiiiiiiiiiiiaiiiiiiii ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■e►ee■■■���.■■■■e■■■__::e■■■■■e■eee■��■e■■e■e■■■e■ee■■■■ee■■■■■■■■e■ ■■■■■■■-■�_•■■■e■ sra�rr�t�■■■ee■■■se■■■■■1�■e■e■■■eee■■■■e■ee■■■■■■■■e■■ ■■■■■■■■■■■■■■■ii��1l1J:.i■■■■erii■■■■■■III■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■�:�c:ccs■■■■■■■■■■■■■■■■■■■�r,�■■■■■■■■■■ ■■ MEN ■■■■■■■■■■■■■■11■Eslir-4 all!■■■a■■■■II■■■■■■■■■A■7■■7■■Ca■coC■e :■■■ ■■■■■■■■■■■■■■■■■■■Ile■r/■■■■■■■■■■■■■V■11 r�7■!!�=5��`iC�11l��:Zc■CaCsi■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Addatt h& DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION 4 APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) (y d 44a wo PHONE NUMBER .SS ��%I GS Vv'NS, DIVISION NAME LOT # ONS TO SITE DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY 4 NUMBER BEDROOMS NUMBER PEOPLE SERVED Z VY TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT, Rev. 1193 Appraisal Card nAV1F entiNTV_ Nr: Page 1 of 1 1 r17r7n17 Ce7Re16 AM LOGAN ROBERT EARL & LOGAN MARY SUE POLKEY 1,17-000-00-104 32 COMANCHE DR _ UNIQ ID 13852 6032400 ID NO: 5769803330 COUNTY TAX,FIRE TAX CARD NO. 1 of 1 Reval Year: 2009 Tax Year: 2012 20 AC INDIAN HILLS RD 22.340 AC SRC= Inspection kippralsed by 19 on 09104/2008 07001 SHADY GROVE TW -07 C- EX- AT- LAST ACTION 20100922 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE Foundation - 3 FOBS Funtional 0.1000 ontmuous Footing 8.00 Eff. BASE bsolescence I Standard 10.7000 ub Floor System - 4 I wood 11.100 USE MOD Area OUAL RATE RCN EYS AYB CREDENCE TO MARKET xterior Walls - 09 03 02 11,0421 9538.00 3959 196 196 GOOD 20.0 DEPR. BUILDING VALUE - CARD 7,92 ood on Sheathing or PI wood 0.00 TYPE: Mobile Home (Single Wide) Manufactured Home DEPR. OB/XF VALUE -CARD 70,56 xterior Walls - 30 MARKET LAND VALUE - CARD 203,56 luminum in I Siding 33.0STORIES: 1.0 Story TOTAL MARKET VALUE - CARD 282,04 Roofing Structure - Ol Flat 4.00 OTAL APPRAISED VALUE - CARD 282,04 Roofing Cover - 12 Metal 3.0 OTAL APPRAISED VALUE - PARCEL 282,04 Interior Wall Construction -4 Plywood Panel 24.0 OTAL PRESENT USE VALUE - PARCEL Floor Cover 08 Interior - OTAL VALUE DEFERRED - PARCEL Sheet Vinyl e 8.0 OTAL TAXABLE VALUE -PARCEL 282,04 Interior Floor Cover - 14 Carpet 0.00 PRIOR UILDING VALUE 10,34 Heating Fuel - 02 II Wood or Coat 0.00 BXF VALUE LAND VALUE 157,60 Heating Type - 04 Forced Air - Ducted 5.00 PRESENT USE VALUE DEFERRED VALUE Ir Conditioning Type - 01 None 0.02 TOTAL VALUE 167,94( + - - 10.-+ Bedrooms/Bathrooms/Half-Bathrooms /1/1 0.000 I W D D I 3 1 Bedrooms BAS -2FUS -0 LL -0 0 0 I I PERMIT Bathrooms BAS - 1 FUS - 0 LL - 0 + 5 - + - -10--+-7--+ CODE DATE I NOTE I NUMBER AMOUNT I I 7 1 Half -Bathrooms BAS - 1 FUS - 0 LL - 0 1 I I OUT: WTRSHD: +----------35------.-----+ I SALES DATA I B A S 1 FF. INDICATE 1 I RECORD DATE DEED SALES Z 1 BOOK PAGE MO R TYPE /U PRICE I I 0190 009 9 199 WD Q I 11250 1 - I 0190 091 9 199 V 11250 OTAL POINT VALUE 6.00 BUILDING ADJUSTMENTS uali 3 AVG 1.000 ha a Desl n 5 FACTOR 5 1.100 Ize 3 Size .900 OTAL ADJUSTMENT FACTOR 0.99 OTAL QUALITY INDEX 95+ -6--+ +-----------36-----------+ I ICAN I I 3 1 1 0 0 - 1 I I HEATED AREA 981 I+-----------36-----------+ +---13---+ NOTES ATE LOCKED = 2 AC POND OWNSHIP CORRECTED LEFT EIGHBORHOOD CODE SAME SUBAREA UNIT I ORIG % ANN DEP % OB/XF DEPR GS. RPL ODE DESCRIPTION LTH THUNIT PRICE GOND BLDG#L/B AYB EYB RATE V COND VALUE TYPE AREA % CS 01 TORAGE 1 4 121 91 15.Cl 10 L 119711991 S1 151 79 AS 981 LOO 3727869 IMETAL BLDG 1 81 601 4,8001 15.3 L 120081200M S1 1 91 6976 N 36COIC 1368 TOTAL OB XF VALUE 70,560 DD 100O25 95 FIREPLACE 1 UBAREA OTALS 1,441 1 39,59 BUILDING DIMENSIONS BAS=W7WDD=NIOWIOS10E10$W15S7W35S12E8SllE13NICAN=E36NlOW36S10$N10E36N19$. LAND INFORMATION HIGHEST THEIR ADJUSTMENTS LAND TOTAL NO BEST USE LOCAL FRON DEPTH / LND COND NO NOTES ROA UNIT LAND LINT TOTAL ADJUSTED LAND LAND USE CODE ZONING TAGE DEPTH SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES MH HOMES IT 0201 145 1 0 1 1.0000 4 0.9800 07 +20 +00 +00 -15 1 PW 1 9,300.00. 22.335 AC 1 0.98 9,114.00 203561 PERKING OTAL MARKET LAND DATA 22.335 203,560 OTAL PRESENT USE DATA a http://maps.co.davie.ric.us/ITSNet/AppraisalCard.aspx?parcel=H700000104 1/12/2012 NORTH CAROLINA DAVIS COUNTY THIS DEED made this the 8th day of July, 1965, by CLARENCE EUGENE GRUBBS and wife MARY LORSNE GRUBBS of Davie County, State of North Carolina parties of the first part, to THOMAS MARVIN COOK and wife, DISSIB MULL COOK ,il 'Aof Dade County, State of North Carolina, parties of the second part; WITNESSETH THA the said parties of the first part, in consideration of($10.00 o.v.c.) Ten Dollars and Other Valuable Consideration to then paid by the said parties of the second part, the receipt of which is hereby acknowledged, have bargained and sold, and by these presents do bargain, sell and cone save and except a right-of-way of egress and ingress running from the said state soil road to the below -described property; said driveway running along the North line of F. L. Lowe to said property; and said right is given for so long as said granteed own 145 feet of property described in the first call below, said 145 feet running with the center of said state &oil road and being a portion of the Western boundary as described below unto the said par ties of the second part and their heirs a tract or parcel of land in the County of Davie and State of North Carolina, in Shadygrove Township, and bounded as follows: BEGINNINiG at an iron stake, said iron stake being the Southeast corner of F. L. Lowe, said stake also being in the middle of a soil state road, running thence with the middle of the above said road South 6. 301 West 145 feet to an iron stake located in middle of said road- thence North 85. 00' West 379 feet to an iron stake; thence South 50 60, West 100 feet to an iron stake located in a North line of Clarence Carter; thence North 85. 001 West 1,179 feet to an iron stake said iron stake being located in 0. A. Potts Eatate East line and sa;d iron stake further be- ing located North 2. 30+ East 943 feet from a ateae; thence with said Potts East line North 2. 30' East 748 feet to an iron stake located in a South line of said Potts Estate* thence with said South line d said Potts Eatate South 87. 3 1 East 1190 feet to an iron stake, said iron stake being a Northwest corner o% C. E. Grubbs; thence South 3. 301 East 394 feet to an iron stake said iron stake being a Northwest corner of F. L. Lewy; thence South b• 301 West 150 feet to an iron stake, said stake being Southwest corner of F. L. Lowe; thence South 83• 70":Eift 334 feet to the place of BEGINNING. Being a 20 acre more or less tract of land located in Shadygrove Township as surveyed by S. L. Tolbert. The grontess are given the right of egress and ingress in a driveway runn- ing from the state soil road as described above along the North line of F. L. Low for so long as said grantees own 145 feet of psoperty described above running with the center of said state soil road and being a portion of the Western boundary of the above described property, and no longer. STAMPS PAID $1.10 TO NAVE AND TO HOLD the aforesaid tract or parcel of land and all privileges and appurtenances thereunto belonging to the said parties of the second part and their heirs and assigns forever. The said parties of the first part do hereby covenant that they are seised of said pprreeai"s in fee and have the right to convey the same in fee simple; that the same are free from encumbrances; that they will warrant and defend the said title to the sane against the claims of•all persons whatsoever save and except 1965 taxes paid bycantor and egress and ingress right-of-way an described above so long as grantees own 14 feet of road frontage on said state soil road and no longer. IN TESTD40MY WHEREOF the said parties of the first part hereunto set their hands and seals. ft2921 ugene bn a s (SEAL) ace (SEAL) roue ru s NORTH CAROLINA FORSYTH COUNTY I, Ines J. Roberson a Notary Public of Firsyth Count�1 North Carolina, do hereby certify that CLARENCE ERAS GRUBBS and his wife, MARY LOR81t9 GRUBBS, grantors, each personally appeared before me this day and acknowledged the execution of the foregoing deed of.conveyance. Witness my hand and notarial seal this the 8th day of July, 1965. Ino: J. Roberson (SEAL) My commission expires: January 169 1966 otary blit NORTH CAROLINA, DAVIE COUNTY The foregoing certificate of Ines J. Roberson, a Notary Public of Forsyth County, North Carolina is adjudged to be correct. Let the said deed and this certificate be registered. Witness my hand this the 10 day of July, 1965, n pity ler Superior Court Filed for registration on the 22 day of June, 1970 at 3:00 o'clock P. M. and duly recorded in the office of the Registe of Deeds of Dade County, N. C., in Deed Book 80 Pogo 594. J. K. Smith, Register of Deeds By: Nancy Deputy Register of Deeds • � ' o�n 11oaJ-�L' pAc��� . . FILED FOR REGISTRATION 1-12-88 10140 Ata DEED TRANSFER'CHECKEDu�`► _ AND afecaofo m eooK 141 racr 592 J. K Shurq. CLGIS%'• OF 4 .1 ny 9e DAVIE CVJ:.TY ,J. C. TAX SUPERVISOR ion! n r,::qac, NO TA7;ADLE CONOIDERA71024 STATED. ; Excise Tax Recording Time, &wk and Page Tax Lot No..........:..,: ................. i'urcel Identifier No................................................................ Verifiedby....................................................................... County on the ............... day of ..:.. ..... ....... ...... ........ .... ,....... , 19........... ' by i Mail after recording to ...Thomas•M.* Cook•,..,6930.O1d,•Ya11ey..School•,Road. Kerner sv,i,lle.,,••NC 27284.,. „ I This instrument was prepared by ..•.Josepll..M....COltrane. Jr.....................:..............:.:.:....:....................,.... Brief descriptlon for the Index +(', NORTH CAROLINA. Ul"N1"RAL WARRANTY DE ED THIS DEED made this -70 Januar , 1q..88 , by and between t . day or .........., y GRANTOR THOMAS M: ;COOK and wife, BEATRICE SMITH COOK GRANTEE WILLIAM GRAVLEY COOK; ANITA ELLEN COOK FUQUA; r and BRENDA KAY COOK MARCHANT c/o Thomas M: Cook 6930 Old Valley School Road Kernersville, N.C. 27284 • R Enter In appropriate bleek for. each parlyt name, address, sod, if appropriate, character of entity, r s. corporation or partnership. The designation Grantor and Grantee as uAed.herein shall include s111d 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'vnlunbie cunsiderntioii paid by the ,Grantee, the receipt of which is hereby acknowledged, has and by th. +c + : ga �I n i n o it i simple, All that �AStF'� ���I• �� i�: �bo'� s t��' ��aYE ►�E�f �€fAflr€�d certain lot ur parecl of landAilunted fit the City of . n a... Shadygrove Toenehip. ... Davie County. North Carolina and rnorc p:uliculurly'descrlbcd its ftdl°wN: BEGINNING at an iron stake,• saidiron stake being -the southeast corner of -F.- L. Lowe, said stake also being in the middle of a soil state road, running thence with the middle of the above said road. South 60. 30' West 145 feet to an iron. stake located In .middle of said.road; thence North 856 00' West 379 feet to an iron stake; thence South 50 00' West 100 feet, to an iron stake I! located in.a.North line of Clarence Carter;* thence North 850 00' West1..179 'feet to an iron stake, said -iron stake being -located . in G. A. Potts Estate east line and said iron stake further being located -North .2°'30' East 943 feet from -a stone; thence with•said x Potts east line North 20 30' East 748 feet•to an Iron stake located, in _a south line of.said Potts Estate; thence with .said south line of said Potts Estate South 87° 3' East 1,190 -feet 'to an iron stake, said iron stake being a'.northwest corner of C. E. Grubbs; thence' South 30 30' East 394 feet to an'iron stake, said iron stak' being'a northwest corner of F.. L. Lowe; thence South 60'301 Wet 150 feet to an iron stake, said stake being southwest : cbrner.of.F. L. Lowe; thence South 830 30' East 334 feet to the ' place of -BEGINNING. Being 6.20 -acre more'or'less tract of land located-in'Shadygrove Township as.surveyed by S. L. Tolbert. N. C. Der AwH, Pum, No. J f� 1970, No" i! 1977 EXHIBIT A ANITA C. FUQUA AND HUSBAND, MICHAEL LEE FUQUA WILLIAM G. COOK AND WIFE, MYRA COOK BRENDA C. MARCHANT AND HUSBAND,-WAYNE M. MARCHANT T0. ROBERT EARL LOGAN AND WIFE, MARY SUE POLKEY TEH: 12085.1 11 BEGINNING at an iron stake, said iron stake being the Southeast corner of F. L. Lowe, said stake also being in the middle of'a soil state road, running thence with the middle of the above :said road,. South 6 degs. 30 min. West 145 feetto an iron stake located in middle of said road; thence North 85 degs. 00 min. West 379 feet to an iron stake; thence Souzh 5 degs., 00 min. West 100 feet to an iron stake located in a North line of Clarence Carter; thence North 85 legs. 00 min. West 1,179 feet to an iron stake, said iron stake being located in G. A. Potts' Estate East line and said iron stake further being located North 2 degs. 30 min. East 943 feet from a stone; thence with said Potts East line North 2 degs. 30 min. East 748 feet to an iron stake located in a South line of said Potts Estate; thence with said South line of said Potts. Estate South 87 degs. 3 min. East 1,190 feet to an iron stake; said iron stake being a Northwest corner of C. E. Grubbs; thence South 3 degs. 30 min. East 394 feet to an iron stake, said iron stake being a Northwest corner of F. L. Lowe; thence South 6 degs. 30 min. West 150 feet to an iron stake, said stake being Southwest corner of F. L. Lowe; thence South 83 degs. 30 min. East 334 feet TO THE PLACE OF BEGINNING. BEING a 20 -acre more or less tract of land located in Shady Grove Township as surveyed by S. L. Tolbert. TOGETHER WITH ALL EASEMENTS, rights of way and other appurtenances thereunto belonging. FOR REFERENCE see: DB 141-592 DB 82-594 DB 65- 88 DB 57-587 DB 28-511 DB 22- 44 NOTE: THOMAS M. COOK DIED IN FORSYTH COUNTY, PRECEDED IN DEATH BY DESSIE MULL COOK. TEH: 12085.1 11