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111 Stone Wood Rd Lot 2 Davie County,NC Tax Parcel Report Friday,December 30, 2016 CP �. 4 7 QRD Rp 0�4� I 0. \O 115 208 A I � O t r� ,•'� 127 � Ov �. 30 110 f' � 1 of � tf 139 r 7 f WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: M4050B0002 Township: Jerusalem NCPIN Number: 5736502452 Municipality: Account Number: 82515801 Census Tract: 37059-807 Listed Owner 1: DONALDSON ROBERT PAUL Voting Precinct: COOLEEMEE Mailing Address 1: 111 STONEWOOD DRIVE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAME COUNTY R-A State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-5503 Voluntary Ag.District: No Legal Description: LOT 2 GLADSTONE WOODS Fire Response District: COOLEEMEE Assessed Acreage: 0.68 Elementary School Zone: COOLEEMEE Deed Date: 11/2000 Middle School Zone: SOUTH DAVIE Deed Book/Page: 003520691 Soil Types: GnB2,CeB2 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 or fitness for a particular use.All users of Davie County*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 �Obt344 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 '3;°` P.O.Boa 848/210 Hospital Street /c °a Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000787 Tax PIN/EH#: 5736-50-6147.02 Billed To: Southern Showcase Subdivision Info: Gladstone Woods Lot#2 Reference Name: Keith Bolick Location/Address: Stonewood Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2173 **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 Im• "(DrAr #People 3 #Bedrooms 3 #Baths 2 Dishwasher: fff'� Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industriall Waste: 13Lot Size Type Water Supply WVord 17 E Design Wastewater Flow(GPD) Site: New Repair❑ System Specifications: Tank Size VCO GAL. Pump Tank GAL. Trench Width--2�d Rock Depth e' Linear Ft.300' Other: .� S'f(Z�)ToQ Required Site Modifications/Conditions: 't�LA— c),J 6'6f OTyoe P �' p�-F �. I�D►v1� IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS)IF 6°°BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie 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 the day of installation. Telephone#is(336)751-8760.**** I t, NDt4e loo, 8 'L Lc,T 3 � Q Environmental Health Specialist's Signature: Date: v! DCHD 05/99(Revised) a ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028. (336)751-8760 Account #: 990000787 Tax PIN/EH#: 5736-50-6147.02 Billed To: Southern Showcase Subdivision Info: Gladstone Woods Lot#2 Reference Name: Keith Bolick Location/Address: Stonewood Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2173 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 WASTEWA C TIO S VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature( Date: /J/27 CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit has been installed in compliance with Article 11 of G.S.Chapter 130A,Section.1900"Sewage Treatment and Disposal Systems,"but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of time. -TA rtk Z>sT6 to•'7 =tv,,., fGa4Mg� � I8 Septic System Installed By: t.-4211 Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC Davie County Health Department $E� 5 I Envimnmenhd Health Sectfon P.O. Box 848/210 Hospital Street Mooksviile, NC 21028 (336)751-8760 ***Iwt7 vmv** %%Is "PLICATION mmm AB momm muss ALL %W MQM= iNfOIt WION is PROVIDIM. Refer to the n6Ol11MION BULLETIN for instrJ dductionsl. 1. wave to be Willed L U i` e�n /S 11�w/,��G"/ Contact "coon �P.I 1 Nailing hrese Irl US )qk/L,��� �/ �/ som *lace. City/state/a:' 1406kfy,*1/G IL ?02 susineas *riom. �.�aJ351'?a. !lens as assn/M if Different than above rH G 60ts4,e ,6")GI,sG Wiling hddeess City/state/sip s. Application fort 0 Site ivaluation AImprovement Permit/ATC 0 Bath s. cyst" to servioss 0 House KHabile Some 0 Business 0 Industry 0 Other a. If Residenoe: i people 3 _ ! Bedrooms L e Bathrooms �- )<Dishwsher O Garbage Disposal Xwashing Machine O easement/Plumbing O saaeaent/Ho Plumbing i. tf ausiness/Industry/Others specify type I People I sinks 0 coaaodss 1 shouers I urinals water coolers It NUMS&MCB: # Seats Istimated !tater Usage (gallons per day) 7. Type of water supply: XCounty/City 0 well 0 Community s. Do you anticipate additions or expansions of the tacWty,this system Is Intended to serve? 0 Ya 0 No If yes,what type? ***IMPORTANP**CGT6TMUWTCOMPLEMTHE REQUIRED PROPERTY INFORMATION REQUESTED BELDW. Either a PIAT or SITE PLAN U11STBESt1BMiTrIED by the client with THIS APPWCATION. Propa:rty Dlmewlonst D Z X Lis X 14, `'WRITE DIRECTIONS(from Moclerllle)to PROPERTY: Tax C,g ase PINI N J ��(ri 7 �CiG��70`1 L �Q Q l�- ' Property Address: Road Name �S�o�G 1,✓oo�A 4 � ./t�11 Y eel Citylzlp 100t4sto'i'L XJJeY &V o _KGf If In a Subdivision provide information,as follows: Loi Z Name: 1(-)GOls A126 C "'o d< 21 Section: Blockt Lott Date Property Maggedt This Is to eerHtyr that the Information provided Is correct to the bat of my knowledge. I understand that any permit(s) Issued hereafter are subject to suspension or revocation,if the site pians or intended we change,or It the Information submitted in this application is Melded or changed 1,abo,understand that 1 am responsible for aU charges incurred from this applicadoa I,hereby,give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures a necessary to determine the site saltability. DATE el !s /9� SIGNATURE THIS AREA MAYBE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposal property lines and dimensions, structures, setbacks, and septic locations) site Revisit Charge Date(s)t Client NotiBaltion Date: EHS: Account No. Revised DCHD(07199) Invoice Na 6 / / 22/ t! /60 P� / 4� NN / `Y / I i �4.,r i �93 / SARAH NOLLEY i D.B. 3B PG. 206 LOT 2v�e>3 . .E't:ENT •Op\ fir ' LOT 3 JT 1 \\ \\ OO \ \ LOT 4 OO 21000 396.00 51,o z O 0 5600's., •-r� 54..' /34.36 `a't`"'1\ LOT 5 p r fit• '�j. \ \ h O:At. 'Ts ry LOT 6 0 LOT 22 p q� h LOT 7 \ N CP:/,) p No cNa� LOT B N 0 i �p LOT 15 \0400\ s0 Jo 0.00— LOT 23 n O tD 100 DIT .00— o0 Z: m195.00 p V ` ,2Q oo A —g0 00 00 b. 0, �65.00 � o LOT 9 N ` 0 0� - - - LOT 14 p 0 h 0 0 O p v LOT 13LOT 12 N a LOT 11 N LOT 10 I 255.00//.93 /20.00 ��•N, /20.00 94- 09'Oq•• W /50.00 9/5.48 TOTAL 903.53 270.00 ( I � } APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT FONMENTAL sDavie County Health DepartmentEnvironmental Health Section P.O.Box 848 L - 2 1998Mocksville,NC 27028 (704)634-8760IOTY STH ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED ALL THE REQUIRED INFORMATION IS PROVIDED. I� 1. Name to be Billed ��iv S W vee. C'�oQ') Contact Person floc Mailing Address -` Home Phone 01 k 3 a a ? City/StateMp o '_S \\\e L- c� Business Phone 7 5 La a a a K XT20? 2. Name on Permit/ATC if Different than Above Mailing Address / City/State/Zip 3. Application For. M Site Evaluation ❑ Improvement Permit&ATC ❑ Both 4. System to Serve: a—House Mobile Home ❑ Business ❑ Industry O Other 5. If Residence: # People # Bedrooms # Bathrooms �- ql-D-ishwasher ❑ Garbage Disposal a'Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other. Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # SeatsEstimated Water Usage(gallons per day) 7. i),pe of watee su �pply: 8 County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes EV-No If yes,what type? PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions:-700X 7331"o X 9105,S,)!( 4^OS,Q Y 92L 7, L� 1 WRITE DIRECTIONS(from 1 Mocksvtlle)TO PROPERTY: Tax Office PIN: # � 7.3(0- - _5 O - _G k 4 '� 1 l 1 a •-�o Property Address: Road Name A�e-\ 1 -EoN City/Zip C— 1 1 If in Subdivision provide information,as follows: 1 Name: 1 Section: _ 1\c.'RP Lot #: Z 1 1 1 ' This is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter are subject to suspension or revocaticn,if the site plans or intended use change,or if the information submitted in this application is ;alsified or changed.I,also,understand that I am responsible for all charges incurred from this application.I,hereby,give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County id owned by �e �J � ���� ie- d /"Ivy ezz t o conduct all testing procedures necessary to determine the site suitability. ATE /`�- SIGNATURE c evised DCHD(06-96) ~� DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTIONLOT Soil/Site Evaluation APPLICANT'S NAME �Gt�? C�/MDQ � DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE SUBDIVISION l ROAD NAME Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH �- O Texture group .G Consistence Structure Mineralogy HORIZON 11 DEPTH Texture group Consistence Structure r 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: C LONG-TERM ACCEPTANCE RATE: t OTHER(S)PRESENT: 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 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(0I-90)