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174 Stone Wood Rd Lot 9 Davie County,NC Tax Parcel Report Friday, December 30, 2016 f' 151 159 ` ' r , 169-�ti_ f 175 K,00, i w 140- -----r--�5 1 t , 174 �. 148 4; 156 164 i - r r a 170 JAL FARE--1 LN w � z U 0 a � WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: M4050B0009 Township: Jerusalem NCPIN Number: 5735690955 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 9 GLADSTONE WOODS Fire Response District: COOLEEMEE Assessed Acreage: 0.84 Elementary School Zone: COOLEEMEE Deed Date: 4/2014 Middle School Zone: SOUTH DAVIE Deed Book/Page: 009560384 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: 9 t1E 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 Oa ah 8-10 �- Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002068 Tax PIN/EH#: 5135-69-0953 Billed To: Iris Roldan Subdivision Info: Gladstone Woods Lot#9 Reference Name: Location/Address: Nolley Road-27028 Proposed Facility: Residence Property Size: see map ATC Number: 3020 **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 4,�6 #Bedrooms #Baths _ Dishwasher: E� Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type /J #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply ( d Design Wastewater Flow(GPD) Site: New Repair❑ System Specifications: Tank Size/ AD0 GAL. Pump Tank GAL. Trench Width—?�" Rock Depth/ ' Linear Ft Other: Required Site Modifications/Conditions: 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.**** r 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 M 990002068 Tax PIN/EH#: 5135-69-0953 Billed To: Iris Roldan Subdivision Info: Gladstone Woods Lot#9 Reference Name: Location/Address: Nolley Road-27028 Pro osed Facility: Residence Property Size: see ma ATC Number: 3020 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 NS UCTION IS VALID O A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: 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. Septic System Installed By: _J��Oovs� Environmental Health Specialist's Signature: Date: 2 DCHD 05/99(Revised) . 4 PLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC Davie County Health Department D r 4 2001 Environmental Health Section prcC P.O. Box 848/210 Hospital Street Mocksville, NC 27028 RONMpLHEALTM (336)751-8760 �1V1 EC00\r(`t TFIPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be BilledContact Person MailingAddress �9 C( n+� "1 �� Home Phone V,,) City/State/ZIP 34 S ',9 7,0 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation ;(Improvement Permit/ATC ❑ Both 4. System to Service: D� House Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms _ # Bathrooms �2,— W Dishwasher ❑ Garbage Disposal F Washing Machine LI Basement/Plumbing LI Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. pipe of water supply: ❑ County/City ('Well U Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ,JJr No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a/PLAT ,or SITE PLAN MUST RESUBMITTED by the client with THIS APPLICATION. .Property Dimensions: WRITE DIRECTIONS(from Mocl svillc)to PROPE.IO ': Tax Office PIN: # fS:-/3 s-6%—Q �S3 �Q. D � 'C'�!> 4-0 ZQ-X 5.J-0 /L,-- Property Address: Road Name P o f l City/Zip n� r✓--- If in a Subdivision provide information,as follows: Name: UJ dOdS Section: Block: Lot: _ Date Property Flagged: z'' J / Lo 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 1 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 owned by to conduct all testing procedures as necessary to determine the site suitability. DATE / /O / SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge f" Datc(s): Client Notification Date: PAccount No. _o Revised DCHD(07/99) 7 Invoice No. C� 1. - t 1� ar.'::•e o! ev:•m r<, :<:.: er�•� .,r4:;] L til-�a-�[.7� a n!�� f 1 a I =n r r:y;'�,r�a �,are •a w-:!.'.C.a..., tJi �.. •:r C.:1s-N_. L C=.� C. . ci:•Cc R:ai s:a!-a.t5f:a or!..., C'' - L < ---L,4-74�{I �_ S ] 10 :,'J /a'�` `•1.] a. .21.:i 'c :•:: ''a aL 5:� 177tt•� +' '•' / •a-.`(a C} 1.55.:3 ?77a 5'. '�:i Uaa 71 11 J' CS :5Ja' S•)C. C!.!/ S:.i) 35.53 at.i5 a).73 22 J) n•t• �. 57 s) 4•.57 25, (J. :.) _i 7�. -L\ ..CJ a:: ::)' 557 7a 7i^J J• 7a '7 I} 13 i ..i. Ct (3:i• :] ,i 5) 5 ?JJa'±a• - LOT W4 _ �� •� � o is •'. �l <<.r�,f:- r-)„ ��. 1.01' #5 LOT #f :i. `i:. LOT I: �-- '''- - Lr,1. la � ��,` - `s/ � x.•,,.11 U;(�'i U.N. PG.206 './10 7' = I 1 OT ;i S�OP,LEY JONES I 0.8.66 PO.206 i:`:•: I G,LA B S�� APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT C Q �g f Davie County Health Department Environmental Health Section 1998 P.O.Box 848 JUL - 2 Mocksville,NC 27028 (704)634-8760 Eryy�RONMENTAL HEALTH DAVIE COUNTY ****IMPORTANT**** TIM APPLICATION CANNOT BE PROCESSED 1 ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed Contact Person Mailing Address -` V o 1"�) SHome Phone 3 a d ? City/StateMp oC1c;-".0\U \�j C- Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For. O' Site Evaluation (3 Improvement Permit&ATC O Both 4. System to Serve: a—House (3'--Mobile Home O Business ❑ Industry O Other 5. If Residence: # People # Bedrooms _ # Bathrooms dishwasher O Garbage Disposal 0'Washing Machine O Basement/Plumbing O 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: a--county/City ❑ Well O Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? O Yes Ek-No If yes,what type? PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions:500x '733,5.2 X %6.S)x SO9.g X '7)L7 f? 1 WRITE DIRECTIONS(from 1 Mocksville)TO PROPERTY Tax office PIN: # „� 7 3(� - �o _ �t t-( '1 1 ll Property Address: Road Name �� lZ�NQ) 1 City0p \�o c_ 0-,,A\-e \�j C_ 1 \ 1 AcJ StwC, `� c 1 If in Subdivision provide information,as follows: J 1 Name: 1 1 Section: IS X\r:R e Lot #: 1 1 As 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 alsifred or changed.I,also,understand that I am responsible for all charges incurred from this application.I,hereby,give consent to re Authorized Representative of the Davie County Health Department toenterupon above described property located in Davie County d owned by '2 P, ce �� �u �� -�r� d /"1 lZZ A C&OF/--to conduct all testing procedures necessary to determine the site suitability. iXE / �- 7 SIGNATURE evised DCHD(06-96) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_LOT, Soil/Site Evaluation APPLICANT'S NAME 0 c/ DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE ` SUBDIVISION ROAD NAME �.f Water Supply: On-Site Well Community Public 2/ Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH ' Y" Texture groupCL Consistence Structure Mineralogy HORIZON Il DEPTH « Y Texture EroupG 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 SITE CLASSIFICATION: EVALUATION BY: C/ LONG-TERM ACCEPTANCE RATE: 7 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)