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151 Stone Wood Rd Lot 5 Davie County,NC Tax Parcel Report Friday, December 30, 2016 111 rr 127 r t t r S r� f �© +r 139 r'{ O� ,'r 151 1591 169 --- 126 69 ---126 175 r r r rj i -- r 1401 ------ !— ti r' 174 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: M4050B0005 Township: Jerusalem NCPIN Number: 5736506241 Municipality: Account Number: 82516538 Census Tract: 37059-807 Listed Owner 1: SPILLMAN ROGER P Voting Precinct: COOLEEMEE Mailing Address 1: PO BOX 738 Planning Jurisdiction: Davie County City: COOLEEMEE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27014-0000 Voluntary Ag.District: No Legal Description: LOT 5 GLADSTONE WOODS Fire Response District: COOLEEMEE Assessed Acreage: 0.74 Elementary School Zone: COOLEEMEE Deed Date: 7/2008 Middle School Zone: SOUTH DAVIE Deed Book/Page: 007650870 Soil Types: GnB2 Plat Book: 0007 Flood Zone: Plat Page: 073 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding 8r Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9t�1� 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'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 NCor arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT 11 3t' Environmental Health Section J�21'G0 P.O.Boa 848/210 Hospital Street a Mocksville,NC 27028 (336)751-8760 IMPROVEMENT(OPERATION PERMIT Account #: 990000942 Tax PIN/EH#: 5736-50-6147.05 Billed To: Terry Simmons Subdivision Info: Gladstone Woods Lot#5 Reference Name: Terry Simmons Location/Address: Stonewood Road-27028 Proposed Facility: Residence Property Size: .748 Acre **N 14 iiss prov2e9m9ent/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 il1'1.ot)MG #People #Bedrooms 3 #Baths 2- Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type / #People #People/Shift #Seats Industriall 11Waste: Lot Size a-74% �-L+c� Type Water Supply l�Ot4TY Design Wastewater Flow(GPD)_:�C ,_ pD Site: New� Repair 11 System Specifications: Tank Size_k OQ GAL. Pump Tank GAL. Trench Width St,"Rock Depth I Z" Linear Ft.'- mc"' Other: �-2 -D1ST0..IRu- O-3 Lpx-aS, 6.3sp\u- Li I1 O .L. M10. Required Site Modifications/Conditions: tJ S l t_ J 'e- S O OJ =P pe'D 6,3'6, 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 em 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.**** A RIPecoe., rip, -}7' P. a•.1 �o�• j los' EnAronm tal Health Specialist's Signature: Datl: Z/ 40 DC A05/99 ised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990000942 Tax PIN/EH#: 5736-50-6147.05 Billed To: Terry Simmons Subdivision Info: Gladstone Woods Lot#5 Reference Name: Terry Simmons Location/Address: Stonewood Road-27028 Proposed Facility: Residence Property Size: .748 Acre ATC Number: 2299 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 WASTEWATER CONSTRUCTI S VAL FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: / Z� 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. S0 �o n� SO' go' 13 FQo � g. rvrn �4 Septic System Installed By: ,Sh1 014 r TA Environmental Health Specialist's Signature: Date: 2 17 o DCHD 05/99(Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&AT V Davie County Health Department JAN I 12000 EnWi vnmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***IIMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be BilledU Contact Person s7o, j q Mailing Address Home Phone City/state/ZIP Business Phone 3 3 2. Name on Permit/ATC if Different than Above n Mailing Address /2) 5wt�e e& city//sstate/zip (� 3. Application For: ❑ Site Evaluation q4mprovement Permit/ATC ❑ Both 4. System to Service: ❑ House i%obile Home ❑ Business ❑ Industry ❑ Other S. If Residence: # People # Bedrooms # Bathrooms ❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks _y # Commodes # Showers ! # Urinals _ # Water Coolers IF FOODSERVICE: # Seats Estimated WaterUsage (gallons per day) 7. Type of water supply: ❑ County/City —YFTi ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? t1 I41 ❑Yes ❑No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLANMU(A/14c) WRITE T BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: P( �r7 1 DIRECTIONS(from Mocksville)to PROPER TS Y: Tax Office PIN: # � Property Address: Road Name City/Zip �` l�1111JL11� 1 If in a Subdivision provide information,as follows: �Y/We S� Name: ��� �fa�AV—, Wk J i Section: Block: Lot: Date Property Flagged: 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 revocation,if the site plans or intended use change,or if the information submitted in this application is falsified 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 and o to conduct all testing procedures as necessary to determine the site su' bili DATE /— ib -U d SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Inliude all of following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge .0 Date(s): ! Client Notification Date: EHS: JP! � g L, Account No. / 177 Revised DC (07/ ) ��, •'`�� Invoice No. S N 31'32'44' 72.77 ✓83 +�5�� a /I�XtECiOR OF MANNING N 44.46.46• E tr 2B.43 O � N N 4460.OI)o' E /�+��4`�Ql Q C4 13'24' ,y s� Z \ LOT # Z s60oSARAH NOLLEY , .89oh,° YS�gJ (0.778 AC:.) 4. 64•S4 'r D.B.38 PG.206 CURVE DELTA h.. J` �S �p V /S1 q$. 1C� Cl 2.52'44' \/J 00 3q F C2 IT55'08' 497. 497 \C p� 52 \ C3 10"56'08' 497 c'!ty c'r�J� L \� y'j 02• y C4 42'50'00" 25. �• os S �, C5 70'53'34" c, o \ LOT #3 cs 5°. `•'„ 48'04'26" 50. `✓ '��� \ \ (0.720 AC.) ;:/!i a r` /Ot OO C7 53.22'07' 50. S.ACCEESS�i� �» r \ r p :'� C8 93'19'54' 50. EASEMENT i 2 Pte' C9 42.50'00" 2 y 8323'4 c�r1r /O .`rt,�l��` r C110 8'07'20' 557, LOT #1r�S S39 ,•l �t,p C12 1320'18' 557. (0.960 AC.) 03 ,,� L�., 22h �� g \ 's ss \ LOT #4 (l/ 132 v0 rc,�°S s' \/,' (0,724 AC.) 4j�Oh (196 . 00 80.42.5' Vo �9 J 1yC07199 `�a \ UTIUrr 2 LOT #5 OO Z `► CASEMENT (0.748 AC,) 'j o / l \r c r,i' LOT #g `lam 66100 LOT 22 r.. ��6•�L /� '4 �UBDIYISION I- , ��,0 ,�L� ti (0.6190 Ac.) ti �=- � '9 I PG.1 I ' ; '� ��- fy v.y/ _ LOT ##7 o«� LOT ##15 `r \ \ �c v (0.698 AC.) Sao 21 � r �' 1.133i I � � �! l C� •� r ( AC.) �r / •1 C `'OJ f,> C 22 0 oa f 2e2 _LOT 23 _ ,� :::,:T:L:r, i< or4c� '�5 00 �Ic'.3 LOT ##3 ti ; EA_t:MCrri N $— :"i `� CIO S 76. '6'a9. (0.730 Ac.) •� 3� J W y i r q '2>3 49'56• t•; 56" v C C5 LOT ' /n r LZ F `P�' 5 " 4 24Iz0.00 X22.3; r a ►`'' g rr �' ,� ti�,b LOT14 Orq�� N aQ•1a n4. 1_ Q'r/:' (1.299 AC.) ~�S,OQ.- C9 v^ 1`.rs.ria LOT }113 ca (0.758 Ac.) W LUT r # 12 LOT o: (0.762 AC.) W J, '� # 25 ,:.�° o r o a LO' ;11 1 �� LOT 0 / ' � n (0.-136 Ar• (0.845 AC.) L , r 1• r 1 ; ni 2 I - in :Rpy Ploc 951 a tIST1rrG u:nry ;,iFE ' r n l0. 4 :.C.) " T• =10rrf 236.19 L VT '126 I 120.00 1 I L 04'1 i' ti 14 v1q- rnYnty5. T(ITA ` A APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT& RR Davie County Health Department Environmental Health Section P.O.Box 848 JUL - 2 1998 Mocksville,NC 27028 (704)634-8760 ENVIRONMENTAL HEALTH ****IWORTANT**** THIS APPLICATION CANNOT BE PROCESSED DAVIE COUNTY ALL THE REQUIRED INFORMATION IS PROVIDED. [� 1. Name to be Billed t S w\C P, Contact Person Mailing Address RSIA V o N S V f e, Home Phone 2 d City/StateMpJ �`\e C— c� a Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For. O" Site Evaluation ❑ Improvement Permit&ATC ❑ Both 4. System to Serve: B—House Mobile Home ❑ Business (3 Industry ❑ Other 5. If Residence: # People # Bedrooms _ # Bathrooms Dishwasher ❑ Garbage Disposal O—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 wager supply: 3--county/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes EI—No If yes,what type? PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: X 905.'S:)k SOS,Q I( 27, L? 1WRITE DIRECTIONS(from Tax Office PIN: #: ��7.3 _ ) _ G k t( '� i Mocksville)TO PROPERTY: Property Address: Road Name1 ` City/Zip ky o'0 C— 1 1 If in Subdivision provide information,as follows: 1 Name: 1 Sectiop: 15 N c.Q Lot #: -� 1 1 1 This is to certify thr`.the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter are sutject to suspension or revocation,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 e Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County d owned by ee ad �u Ie-�1C d /"1c 1 o conduct all testing procedures necessary to determine the site suitability. ATE L o' SIGNATURE ` o c evised DCHD(06-96) • '� DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOT S Soil/Site Evaluation APPLICANT'S NAME 7? e e©d eo') DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE - SUBDIVISION � i -�S 'l��-" _ ROAD NAME Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit L/ Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH " Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence I r 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: 0, EVALUATION BY: LONG-TERM ACCEPTANCE RATE: 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 I 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)