229 Plantation LnDavie Countv, NO
Tax Parcel Report IM Wednesday. October 5. 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
WAKNJ-NG: THIN 16 1VU'1' A bUKVEY
Parcel Information
G90000001304
Township:
Shady Grove
5799183442
Municipality:
SHADY GROVE
8304334
Census Tract:
37059-804
FOREST DANIEL J
Voting Precinct:
EAST SHADY GROVE
229 PLANTATION LANE
Planning Jurisdiction:
Davie County
ADVANCE
Zoning Class: DAVIE COUNTY R -A
NC
27006
75.54 AC OFF PEOPLES CRK (11.420 AC)
11.42
11/2014
009730374
11
287
351500.00
178430.00
550690.00
Zoning Overlay:
Voluntary Ag. District:
No
Fire Response District:
ADVANCE
Elementary School Zone:
SHADY GROVE
Middle School Zone:
WILLIAM ELLIS
Soil Types: PaD,PcB2,PcC2
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
20760.00
Freatures Value:
Total Market Value:
550690.00
Davie County,
All data is provided as Is without warranty or guarantee of any Idnd 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
np f1 N�4
NC
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 webslte.
,DATION NO:4 ,1 8 %ADAVIE`COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
ermittee'sP.O. Box 848
Name: OAJ7 r r�r%/� C° Mocksville, NC 27028 Subdivision Name:
M j
/�//� /`fi?i1 r�r+ Phone# 336-751-8760
Directions to property: jt � /` �;� � Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION
Tax Office PIN:#
Road Name: Zip:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This FonrdAuthorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r' i' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
4, �l .. `_f +/ IS VALID FOR A PERIOD OF FIVE YEARS.
AL EALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE �� # BEDROOMS # BATHS #OCCUPANTS _j GARBAGE DISPOS es r No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUST_Ile
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) W NEWSITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH
ROCK DEPTH LINEAR FT
REQUIRED SITE
IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLUENT FILTER* *RISER(S) IF 6" BELOW FINIISHED GRADE*
h
f ,iv
-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 THE DAY OF INSTALLATION. TELEPHONE # IS (7Wj 63091760)t M
OPERATION PERMIT
AUTHORIZATION NO. 7�
SYSTEM INSTALLED BY:
r-
0 RMIT BY:
vs� Jr
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", B1
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
DATE: ZC - 2-&
&
IN NO
COMPLIANCE
y"
0.fdAVIE COUNTY HEALTH DEPARTMENT lU'
®� IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
•NOTE: Issued in Compliance with G;6.of North'Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A ,1934-.1968) Permit Number
Name r1� T Date�? - ? - �'L~% h- , � % 98
Location \ r vv�_c.��: �_ ��,=�:n, �� lam. W s �•�� —� (�
t� 1-1 \ Jr Cl1�c 'hoc—T_
Subdivision Name Lot No. Sec. or Block No.
Lot Size ��'.•� Howse f'/ Mobile Home Business Speculation
No. Bedrooms No. Baths— No. in Family
Garbage Di posal YES �NO"[]NO`' ,
Sp
ecifihtions for System:
Auto Dish Wastier �Y�S ,, NO -❑ /
Auto Wash Machine YES NO�p ,5
Type Water Supply )r )(
'This permit Void if sewage system described below is not installed within 36 months -from date of issue.
}
a
i AA c)
F^
h
U �
Improvements permit by —S,
`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 Numb.Qr: 704-634-5985.
Final Installation Diagram: System Installed byR-1) g g=
X
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.
Drafted by: Stafford R. Peebles, Jr.
»ELO 800KiSLPACI�
Mail so 102 S. Cherry Street, Winston—Salem, N. C. 27101
lN.ma) 40-1 and ft—ow) IGtYI 1 Ur) ( D)
Mail future tax bilk to:
. INMn.I (iu..t and NumMr) Icityl ,A state) ( lD)
THIS DEED Made this the 26th day of September -19 06 by Stephen L. Robertson
and wife Jean Robertson
Davie
of Fonlytlt County, North Carolina.
part4p,_of the fust part, to &nnie Dean Kessinger and wife, Judy Lynn Kessinger
Of "County, North CuoUna, part ies of the second pan; ;
itnesseth that the said part ies of the fust pan, in consideration of (S 10.00 t 0-V,C- ) Ten .dollars
and other valuable,consideration to be paid by the said pan ies' of the second
part. the receipt of which Is hereby acknowledged, has/have bargained and sold, and by these presents do bargain, nil and con-
vey unto the said pan ies of the second part and their heirs a tractor parcel of Wad in ftwecounty. North Grolina, in
Shady Grove Township. and bounded as follows:
See Exhibit A attached hereto and incorporated herein.
. .
STATE OR , oTlaTF OF pp 'STATE OF
NORTH CAROU 11C 7S+ CAI'01 to'. !: NORTh CA �l N
$30.00 J;3.00
Together with and subject to rights of easement previously conveyed by Grantor recorded
in Book at page
Subject to Restrictive Covenants recorded in Book 133, page 417; Book 133, page 427 and !'
Book 133, page -432.
PROPERTY A00AESS BLOCK LOT
The above land war conveyed to grantor by (See Book No: Page ) t
O.OtlAVE
AND TO HOLD the aforesaid tract of parcel of land all privileges and appurtenances thereunto belonging to the said put . tt
ies of the second part and their heirs and assigns forever: And the said part ies. of the fuss part do
enant that theY • Ware seized of said premises In fee and IlUethe right to convey the same In fee simple; that the same
are free from enctrmbrancts; and that they will warrant -and defend the said tick to the same against the claims of all persons .
whatsoever. 1.
INT NO R to s " art aAel_of the first part 419 hereunto sat rneir nds and" s
wr,, 9
Step n L.'Ro 'Robertson Seal) —'� Ro er son —(Seal)
STATE OF NORTH C LINA —. tForfyth uoty
I, t4 C 4�s . 'a Notary Public of Forsyth County, North Carolina..
do hereby certify that Stephen L, Robertson and wife, Jean Robertson
grantor(s), each personally appeared before me this day and acknowledged the execution of the foregoing deed of conveyance.
Witlt�e#�;n�ans. kcal or stamp this the 26th day of September Ice 86
(Notarial
.
(Notarial Stamp or Sal)
`—Notary Publk —
My commission expires
f
i
���..Notary Public,
Forsythunyo .V—
! STATE OF NORTH CAROL1kk—M;iyt%t';ZamtyV. tear
{.
a Notary Public of Forsyth County, North Carolina,
do hereby certify that
grantor(s), each personally appeared before an this day and acknowledged the execution, of the foregoing deed of conveyance. i
1
(Notarial Stamp or Seal) Witness my hand and notarial seal or stamp this the
day of
My commission expires . {9 _
, Notary Publ'le . .
STATE OF NORTH CAROLINA — County
The foregoing (or annexed) certificate _ of She=M D. {lorton.
tdOtozy Public of ForwAh cminty
Films e u.a nMn, and allit:lal tilts tri tM e116CW len Nle In. C.,lt{tula_ PASS" uDwl)
is tow certified to be correct) This the V;
day of ter ,19 BF. at ' .
STAMPS S 4:45 PM and reoo ded in Deed Book 134, pn�5
. Register of Deedaa J. K. Smith
Probate and Ming fee S paid
By.
4&9c, Gd't Deputy. M1t
_
or
., DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section /J ^
PO Box 848/210 Hospital Street Com" S jB S
Mocksville, NC 27028 c C'
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑
✓ 6, 5'9 6 (Home)Name: Phone Number:
Mailing Address: (Work) -
/Ad 0 ctx, AJ (. -z-7 v o
Detailed Directions To Site: �%� �C f o �,"u % " T h )^ i G 1- - C ci n'tt ' tj
-}1��� l /� _ � c.,`. ✓((N ,rte �)� . U J'1 7_'& � ���� 5 / �1 F.n,.�' �C((
(��5 �(.l.yo te_-P4 cYv In, ii fCL ltii �G(,•tN.._ C1n&rl{
�. tilt c,( �(_.� 14$ �i4<,jp;,, f-" '. lam% U'f r'•f' Gut_,c;-
Property Address: V
Please Fill In The Following Information About The Existing Dwelling:
� rr
Name System Installed Under: /t 0-e X V UY\ Ft c -2. TypeL O� f Dwelling:
Date System Installed(Month/Day/Year): yt' S " I • Number Of Bedrooms: �i Number Of People: -5
Is The Dwelling Currently Vacant? Yes ❑ No>3� If Yes, For How Long?
Any Known Problems? Yes No ❑ If Yes, Explain: 6y^ Q
L% �a ¢ .ems.,, C
Please Fill In The Following Information About The New Dwelling:
Type Of Dwelling:--� ►'� Number Of Bedrooms: Number Of People:
Requested By:' f Date Requested:
,,(Si ature
For Environmental Health Office Use Only
Approv Disapproved ❑
Co nts: G',?a" i �" .r7 ''t is ` / �S'i✓ ,f �� e : ��/ : /11
L
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 of time.
a
Payment: Cash ❑ Check CI M ney Order ❑ # c_a_ - Amount: $ Dated
Paid By: "�a �a r -� ti Received By:
Account #: t Invoice #:-
5
{
VIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 0
*NOTE: Issued in Compliance with G.S';, of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A.1934-.1968) Permit Numb ' er
Name Date IbN 4.798
Location
1) .5
S_
WON cs,
Subdivision Name Lot No. Sec. or Block No.
Lot Size 1 Howse, Mobile Home Business __ Speculation
L
No. Bedrooms No. Baths No. in Family
Al
Garbage DIposal YES � NON,E]
Specifihtions for -System:
Auto Dish Washer
Auto Wash Machine YES N NO
X
Type Water Supply mL
*This permit Void if sewage system described below is not installed within 36 months -from date of issue.
Improvements permit
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 Numb.Qr: 704-634-5985.
Final Installation Diagram: System Installed by 1?9AI a,4=.
P1
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.
,AUTHORIZATION NO: j 371/4 DAVIE COUNTY HEALTH DEPARTMENT
_ Environmental Health Section
Permittee's X r P.O. Box 848
PROPERTY INFORMATION
Name:��-r!!z Mocksville, NC 27028 Subdivision Name:
y
Phone # 336-751-8760
Directions to property:/��l�j !�`,7,�i /�"r,� Section:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#_
SYSTEM CONSTRUCTION
_ Lot:
Road Name: Zip:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter I30A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r x Lf !! +✓ IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
I
ir� R tom.,+nM .,•;. ', - .. .
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS
Permittees
PROPERTY INFORMATION
Name: L `t %CI%j+t" i r' ; ��"'i r Subdivision Name:
Directions to property,-'z;/i�x f, t , �`,;; Section:
IMPROVEMENT
PERMIT
Tax Office PIN:#
Road Name:
Lot:
Zip:_
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
constructionlinstallation of a system or the issuance of a building permit.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
` ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
• ,fi, f''r z �;' } - -1 PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE Z;Z # BEDROOMS —_<-- # BATHS # OCCUPANTS ,� GARBAGE DISPOSA es r No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY / DESIGN WASTEWATER FLOW (GPD) 5 NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH s) c., ROCK DEPTH LINEAR FT. ate% /
REQUIRED SITE MODIFICA
r—
IMPROVEMENT PERMIT LAYOUT *RPPROVED EFFLUENT FILTER* *RISER(S) IF 611 EEIlLOU FINISHED G; ADEt-
f � T
A
"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 THE DAY OF INSTALLATION. TELEPHONE # ISJ/(704153�4W769 }: