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169 Stone Wood Rd Lot 7 Davie County,NC Tax Parcel Report Friday,December 30, 2016 i i I 151 159 169 r r ' 175 RD 1 -� ee r` + ' 174 j WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: M4050B0007 Township: Jerusalem NCPIN Number: 5736509107 Municipality: Account Number: 182515056 Census Tract: 37059-807 Listed Owner 1: SHELL BARRY W JR Voting Precinct: COOLEEMEE Mailing Address 1: 169 STONE WOOD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-5503 Voluntary Ag.District: No Legal Description: LOT 7 GLADSTONE WOODS Fire Response District: COOLEEMEE Assessed Acreage: 0.70 Elementary School Zone: COOLEEMEE Deed Date: 4/2007 Middle School Zone: SOUTH DAVIE Deed Book/Page: 007090278 Soil Types: GnB2 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: 161 All data Is provided as Is without warranty or guarantee of any kind 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 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 #: 990000787 Tax PIN/EH M 5736-50-6147.07 Billed To: Southern Showcase Subdivision Info: Gladstone Woods Lot#7 Reference Name: Paul E. Swires Location/Address: Stonewood Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2175 **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 R. NC>Mt5 #People 3- #Bedrooms `4 #Baths 12— Dishwasher: Dishwasher: 0?*- Garbage Disposal: ❑ Washing Machine: 0 Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply Design Wastewater Flow(GPD) t.}as Site: New GT Repair❑ GAL. Pump Tank GAL. Trench Width:s� Rock Depth Linear Ft.�fl� System Specifications: Tank Sizel Other: _ (✓{-{�,M( '"�QztJC�-1 S�ST� -icC�2L��3,�� 1�4� F�O�MEOt�� r=t Required Site Modifications/Conditions: �rJS1�L` O-J C-Z>,j-0t)Q - �� b3-:S; IF U.J IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS)IF 6 K 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.**** L', JOS - �¢.M 1,�1 \ °4i Co,`1T(L D,G'Se�2 1tM7`JT "F3 V rL 29 �4 lTQLL SgST—.-� NCODQ. l� rro Environmental Health Specialist's Sign e: DCHD 05/99(Revised) \ I DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street Mockisville,NC 27028 (336)751-8760 Account #: 990000787 Tax PIN/EH M 5736-50-6147.07 Billed To: Southem Showcase Subdivision Info: Gladstone Woods Lot#7 Reference Name: Paul E. Swires Location/Address: Stonewood Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2175 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.190 Sewage Tr tment and Disposal Systems). THIS AUTHORIZATION FOR WASTEW C NIS, IS AMID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signa e: �. Date: 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. 1 F"1 sL�'(Z^-�Q J Ssb cdo, S4 �LZ VV\-vt Septic System Installed By: I J 4K—I/ 6p-'a"D I"i Environmental Health Specialist's Signa dez,-� Date: h11V1qq DCHD 05/99(Revised) • 15 � � OV15 APPUC47ION FOR SRE EVAWATION IMPROVEMENT PERMtT&ATC D Davie County Health Department SEP 1 5.1999 Envfimtmentd Hml&Smffon P.O. Box 868/210 Hospital Street Nbaksville, NC 27028 (336)751-8760 ***nV0R=KV** THIS RIPLICUICH OUMT BZ PROC&SSED =MOB RLL Tile RaQUIMM 11=VM 21216 18 PROVIDID. Rates to to the Z2i> UM 1011 SULLITIN tat instructions. 1. Maas to be billed �7 DLtle,-^ �hOwGlrt�. Contact parsec /) uailinq address / 70 S US YwY• 601 aa.. shone r �l�a' 7t3 —�a�9 City/state/alt /-70(/6-y- L 2`70.2e^ basks. lame 31.2-SS) 7 a. maio on pessit/ase /risss Le Disntthan above hit! G �t�✓,IGS kailiaq address 372' 044,6 lW,0Pr, 1"�OJ city/state/sip s. Anlication toss 0 Bite Rvaluation Ximpsovem mt Ve=Lt/RTC 0 Both a. systes to sesvioes 0 House KKabile Home 0 Business 0 Industry O other a. It Residences I people -3-00 1 Bedrooms ! Bathrooms --2- _ '6Disbwsbes O Garbage Disposal )(lhsuw uscune O sas*ssnt/pimibiaq O basesent/xo pluebiaq s. Zt bwiaess/=ad"try/other, specify type Q people a sinks a Commodes I showsrs a urinals 4 hater coolers I! 1'00 09MCS: # Seats llstimated Batas Usage l a tme per day) 7. Type of water supply$ County/City 0 well 0 Cammuaity a. no you anticipate additions or expansions of the facWty this system Is intended to serve? 0 Ya 0 No If yes,what type? ***IMPORTANT***CLMM UWCOMPIETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE S[1BJIt IM 41 the Went with THIS APPLICATION. Property Dlmewtonsi `3WRITE DIRECTIONS(from Moelavllle)to PROPER TY: Tax 081ce PIN: Property Address% Road Name , <4*nr, �lD�� d tr�i�t/f�+,r �� 11/n Ile e✓ cityalp /�4GKfLy'�lG 9 0 .al �,6 U In a Subdivision provide Information,as follows% Lo f 7 , Names ����r,I Sf�� L►/ooG�s Section: Blocks Lot: Date Property Flagged: 9 This is to certify that the Information provided Is correct to the best of my knowledge. I understand that any permtt(s) Issued hereafter are subject to suspension or revocation,it the site plans or intended use cbang%or It the information submitted In this application Is(shifted or changed. 1,also,understand that I am responsible for all charges Incurred from this appllcadon. I,bereby,give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located In Davie County and awned by to conduct aD(testing procedures as necessary to determine the site sultabW . DATE�/1s� -- SIGNATtURS, THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include ail of the following: Existing and proposed property Ilea and dimensions, structures, setbaclu, and septic locatlous). Site Rablt Charge Date(s)% Client Notification Date: EHS: Account No. Revised DCHD(07/99) Invoice No. • • APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&A Davie County Health Department Environmental Health Section P.O.Box 848 JUL - 2 1998 Mocksville,NC 27028 (704)634-8760 ENVIRONMENTAL STHDAONTY ****EVIPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UN ALL THE REQUIRED INFORMATION IS PROVIDED. '( 1. Name to be Billed l )t(!e_ Z), Contact Person Mailing Address U a!�� S V fe. Home Phone 3 a a City/StateMp c, -% �\\C� Q- Business Phone 7 5 Lcd d a 3 K-Lao? 2. Name on PermitIATC 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 U�-Mobile Home ❑ Business O Industry ❑ Other 5. If Residence: # People # Bedrooms „� # Bathrooms 'a'Dishwasher O Garbage Disposal O-Washing Machine O 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: 13 County/City ❑ Well O Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? O Yes ©"No If yes,what type? PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions:500A '233 X 905,Z)9 SU�i,F� J� 927, L? 1 WRITE DIRECTIONS(from i Mocksville)TO PROPERTY: Tax Office PIN: # 7 3 - S-1z) - G k4 f) 1 Property Address: Road Name �` •� �l��`J 1 1 -Eon.► City/Zip 1IJ c— 1 \ 1 If in Subdivision provide information,as follows: 1 Name: � d S ko 1 Section: Lot #: 7 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 revocation,if the site plans or intended use change,or if the information submitted in this application is falsi`.ed 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 Dane County Health Department to enter upon above described property located in Davie County d ovine`by ee �� �u.���-tom d /1 o conduct all testing procedures necessary to determine the site suitability. ATE /'�- SIGNATURE evised DCHD(06-96) • • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION / LOT- Soil/Site Evaluation APPLICANT'S NAME b DATE EVALUATED 1G7� PROPOSED FACILITY PROPERTY SIZE ,�d A/, . SUBDIVISION U� I v� 9 ROAD NAME I" Water Supply: On-Site Well Community Publicy Evaluation By: Auger Boring Pit C/ Cut FACTORS 1 2 3 4 5 6 7 Landsca a position Z T Sloe% HORIZON I DEPTH -t It V,/ Texture group 12 L' G 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 i SITE CLASSIFICATION: 0K 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 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)