140 Stone Wood Rd Lot 14 Davie County,NC Tax Parcel Report Friday,December 30, 2016
139
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WARNING: THIS IS NOT A SURVEY
_ Parcel Information
Parcel Number: M4050B0014 Township: Jerusalem
NCPIN Number: 5735594900 Municipality:
Account Number: 8306136 Census Tract: 37059-807
Listed Owner 1: SECRETARY OF HOUSING&URBAN DEV Voting Precinct: COOLEEMEE
Mailing Address 1: SHEPHERD MALL OFFICE COMPLEX Planning Jurisdiction: Davie County
City: OKLAHOMA CITY Zoning Class: DAVIE COUNTY R-A
State: OK Zoning Overlay: DAVIE COUNTY CZOD
Zip Code: 73107 Voluntary Ag.District: No
Legal Description: LOT 14 GLADSTONE WOODS Fire Response District: COOLEEMEE
Assessed Acreage: 1.32 Elementary School Zone: COOLEEMEE
Deed Date: 5/2016 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 010170460 Soil Types: GnB2,PcC2
Plat Book: 0007 Flood Zone:
Plat Page: 073 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
91 All data Is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the
Davie County, Implied warranties of merchantability orfitness 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
�pbN'S4 NC or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT _
Environmental Health Section
' P.O.Boa 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990003147 Tax PIN/EH#: 5735-59-4900
Billed To: Fleetwood Mobile Homes Subdivision Info: Gladstone Woods Lot#14
Reference Name: Location/Address: 140 Stonewood Lane-27028
Proposed Facility: Residence Property Size: 100x300x200x
**NOTE *This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater
system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this
Department prior to the construction/installation 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). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type #People 3 #Bedrooms #Baths
Dishwasher Garbage Disposal: ❑ Washing Machin Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply /0 Design Wastewater Flow(GPD) Site: New❑ Repair❑
System Specifications: Tank Size`�OtbAL. Pump Tank GAL. Trench Width� Rock Depth j{J Linear Ft.- w
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT- APPR VE FLUENT FILTER. RISER(S)IF 6 K BELOW
FINISIIED GRADE. ****NOTICE: Contact a representative of
D A County Health Department for final inspection of this
system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on th da o installation. Telephone#is(336)751-8760.****
-----------------
Environmental Health Specialist's Signature: Date:
DCHD 05/99(Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P.O.Boa 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
Account #: 990003147 Tax PIN/EH#: 5735-59-4900
Billed To: Fleetwood Mobile Homes Subdivision Info: Gladstone Woods Lot# 14
Reference Name: Location/Address: 140 Stonewood Lane-27028
Pro osed Facility: Residence
ATC Number: 3747
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of
G.S. Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATE=IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date: ls��
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate of Completion shall indicate the system d don Improvement/Operation Permit
. �
has been installed in compliance with Article 11 of GChapter 130 Secti n.1900"Sewage Treatment and
Disposal Systems,"but shall in NO WAY be taken as 'guarantee that he s em will function satisfactorily for any
given period of time.
D-4
Septic System Installed By: �Gi,' SO n
Environmental Health Specialist's Signature: / Date:
DCHD 05/99(Revised)
JD L�—k—
L S .
APPLICATION FOR SPIE EVAU ATIUN/10110Vl3IENT PERMIT St ATC
Davie County Health Doparttnent
• f✓rylrwtmenta/Hea/drSec�tian
P.O. Sox 848/210 Hospital Street
Moakaville, NC 27028
(336)751-8760 8 --
•a�.121PO2tTANTs*s THIS APPLICATION CANNOT bZ.PROCI:SSI:D MESS=.T=-AEQUIR}77�
11,70 MATION TS PROVIDED. Refer to the INSORMATION AULLESYN for inatructionil
1. Nam; to be 0111ad ��E �D dYY/d Contaeb Person
Hailing Address 1220-✓ORdA
T7/S�hEr Ramo phone -~• _ _.•-
' city/stats/21P .Sm-ro gi. ,eX d-F62-s 000lneso Man.70'�-87a_�SD
2. Ram;on Pemith&c if Different than Above
Uailtng Address City/Stat;/tip
3. Application For: Q Site Evaluation .❑,impr"ainlnt Permit/ATC (Doth
It. system to service: ❑ House C,Mobile Home ❑ Susinesa ❑ znduatry M Other _••___.
S. Type system ragaestad, I.coawmcinaal ❑"eons;tional 1n0difiad ❑ innovative
? + �.
S. If aeaidaacse !! People -- p e¢tLtpoao9 a Dathioofau ,
Oplahxasber ❑CArbage Disposal Al-bine Machina ❑2as;ment/Plwab1M ❑aasemwat/no Plumuta0
7. Yf aua1naal/Sndu4t7/otbart•*rify type i People 0 sinks ..... .
R Commodes t Shovers i Urinals i Hater Cooluru
IF FOODSERVICE: # Seats Eatilpated )later Usage (Oalloaa por day)
a. Type of water eupplyt d County/City ❑ wall Q Coaoaunity
f. D;YOU antioipata additiOW or lXpansietia of Ilio faelllty.U>!s Sys(Ctn h intended(0 SWWJ❑Yrs - Nu
if)*es,what type!
aaal4fPORTAN2a••CLIENTS AII/3TCO;VP=-THE lttiQUllt,C,a 1111OPLIM INF'Oiu►ATION It(SQUXt i-W)
BELOW. rMilia•aPLAT orSITEPLAMMUSYISCSURAIMCDbythe client with MIS APPLICATION.
11rope:rty Dimcnslons:f00X 5OOX db.T X Y'n WRITE DIRECTIONS Orval Ma"Illel lu PIM111-300.,
Tatomccivi: u
Property Address: Road ti2mc/y/0 J7-..r€0JwI}
City/T.ip
Ithl a Subdivlstail provide taformatio7�n,as follows:
(;I-,4h3TPA"' .u1o0Us
Name.
Scellonl QST
Block. hat: O! Date hot7le earners Ragged• �6
of
Tlils is to certify shat the laformallon provided is correct to the best of my hnowicdge.I Unilmland[lint aety pennil(s)
issued hereafter are subject to suspension or revocation,lithe site plans or intended USo change,or if Ilea(nfurenailou
subinitted is tbts application is fiibtBed oGchaaged.I,also;understand float lam rGvpoosfble for oil dtarges incurred frum
r1th appikatlon 1.heraby,give tanwnt to M2 AHM"lud$eprmcaiativc oft4c D I County l( al(h l) Tart ucnI
(a enter upon above described propeilylocated'hi Davie County andamn(ed by /E�iyitWY �(� PE7QS
to conduct a0 testing/ptoecdures as.necessary'to determine Glee site SURM "}...
DATE 3//a STCI�IA,TIJ
i
TRIS AREA MAY RZ USED l OR DRAtiVJNG YOUR SITE PLAN(L(cludo ull of Mo ton lvl((g:Lshtiug and propustd
property lines and dimensions,structures,sctbacico,and septic locations).
SiteRcYislt Charge
ClldutNatiIIcatIanDalc:
/�f _ Q Sign given Atcoant Pio. !T
(J Ul k Revised DCIID(05/03 lnrotco No. 44,1 l S
z7 RMS TZ AafLLMdO MOSLLSC£ YV.d ZZ:LT Gam 6002/1£/£o
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£00/coo ALMS TZ AHrUNHD 6Z609119C£ XVd £Z:11 OHM 600Z/T£/£0
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT&ATC
5
Davie County Health Department D
Environmental Health Section
P 0.Box 848 JUL — 2 1998
Mocksville,NC 27028
(704)634-8760
ENVIRONMENTAL
OUNTY
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLES
c ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed J Contact Person
Mailing Address Q- U Home Phone J
City/State/Zip ��` uC '. '�`\L ��L- V Business Phone
2. Name on Permit/ATC if Different than Above
• Mailing Address City/State/Zip
3. Application For: 0-'site Evaluation ❑ Improvement Permit&ATC ❑ Both
4.. System to Serve: El_House El Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms T� # Bathrooms
�0 Dishwasher ❑ Garbage Disposal El-Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other. Specify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage(gallons per day)
7. Type of water supply: O County/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 9—No
If yes,what type?
PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions:-00A '73) `'� X 9CS7 f,1 k` y U S .l% L S 3 1 WRITE DIRECTIONS(from
i Mocksville)TO PROPERTY:
Tax Office PIN: # !j._ ? � �_ - `� U - ���� � I
,
Property Address: Road Name
r 1 Cy
'tuhJ .0
city/Zip IV` .We �"'J C_ �
If in Subdivision provide information,as follows: 1
Name: r o 1
1
Section: R Lot #: 1
1
1
is is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter
subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is
sifted or changed.I,also,understand that I am responsible for all charges incurred from this application.I,hereby,give consent to
e Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County
d owned by I c.0 < ;d � lP S-tee- r F hoc , .tit-� to conduct all testing procedures
necessary to determine the site suitability.
ATE / �- ` '� SIGNATURE e•.
evised DCHD(06-96)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION_/—LOT/
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION �j'f ��� ROAD NAME /
Water Supply: On-Site Well Community Public l/
Evaluation By: Auger Boring Pit 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 ell L
Consistence i
Structure C
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 n
SITE CLASSIFICATION: /✓1 EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT:
REMARKS: %d ��
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
Moist
VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm
Wet
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
Mineralogy
1:1,2:1,Mixed
Notes
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(01.90)