Loading...
255 Baileys Chapel Rd (2) DAVIE COUNTY HEALTH DEPARTMENT -� � . _' Environmental Health Section � � - �' P.O.Boz 848/210 Hospital Street 1 � ' Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000889 Tax PIN/EH#: 5779-241794.b2 Billed To: Cherie Yarbrough Subdivision Info: Reference Name: Cherie Yarbrough Location/Address: Bailey's Chapel Road-27006 Proposed Facility: Residence Property Size: See Map ATC Number: 2994 **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 PERMTT 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 rT #People� #Bedrooms `J #Baths� Dishwasher:� Garbage Disposal: ❑ Washing Machine:� Basement w/Plumbing� Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size �� Type Water Supply �a Design Wastewater Flow(GPD)—C� Site: New� Repair❑ System Specifications: Tank Size�GAL. Pump Tank GAL. Trench Width ����Rock Depth��Linear Ft�aU Other: Required Site Modifications/Conditions: 11�1PROVEMENT/OPERATION PERMIT LAYOUT- APPROV EFFLUENT FILTER. RISER(S) IF 6`�BELOW FINISHED GRADE. ****NOTICE: Contact a representative ft vie County Health Department for final inspection ofthis system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m. o he a f installation. Telephone#is(33G)751-87G0.**** � Environmental Health Specialist's Signature: Date: ��-�/'"� � DCHD OS/99(Revised) • � DAVIE COUNTY HEALTH DEPARTMENT � � Environmental Health Section P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (33G)751-87G0 Account #: 99q000889 Tax PIN/EH#: 5779-241794.Q2 Billed To: Cherie Yarbrough Subdivision Info: Reference Name: Cherie Yarbrough Location/Address: Bailey's Chapel Road-27006 Pro osed Facilit : Residence Property Size: See Map ATC Number: 2994 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MiJST BE ISSLTED by the Davie County Environmental Health Section prior to issuance of any building permit(s). T'his 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 WASTEWAT CONST CTION IS V LID A PERIOD OF FIVE YEARS. �' Environmental Health Specialist's Signature: � Date: �j j�f �� CERTIFICATE OF COMPLETION **NOTE** The issuance ofthis Certificate of Complet' n s all in icate the system described on Improvement/Operation Permit has been installed in compliance with Art' le of .Chapter 130A,Section .1900"Sewage Treatment and Disposal Systems,"but shall in NO WA be ken a guarantee that the system will function satisfactorily for any given period of time. s��� � �,� i� �v� , � � . �����y� ��� _� �' �= ��.. � � Septic System Installed By: ;~ � �; � �� Environmental Health Specialist's Signature:�—T�� Date: p2��`�� , DCHD OS/99(Revised) � �t'ei',::�:�'ia5'+uz�.<c'�..S,P�'_.. ..�.,._.._.. . . - { ���,a�c�srrE t�►�n�s�a�t��°��xr�������C � � � � n �` ! .� � . _ _., ;R �� � �>�S-�. C�`� Da,►s�G���r�t�►H��itn oe�:r�xr�sne � �- --�__--_ .�._ _ � , � "#a � ��rr�tmer�tl Nbs/dt�'�'� ��� , { �°' � �/ p.o. eos �it/�io Hospital atrw� �,i, DEC - z i..::-, . �� � � �� � �. . ltcck�vill�, �C Z7026 • - �r, r.. .. �' . . (338�7�Si�A76� EtdV�t,o,a r ���:�'i ',.;�� �.. � D��lIE COU�JIY '�.': �;� �r+# 'P�IS 11ppI.IC��OQ� C1lN�!' � pR�'8� UL�.TeZ88 7lLTe '1'�i RZQqJZR=D ,�' ZBt�'�I+�l�30dA IS pR0�1I"ii�. R��ss to t� �IGl� BULLZlIN !os iastrncti0as. �,: � �. �. � �. � C erie ar-E�t�� �,� � �4rnctd (-��5e� � �� �... Zo�4 �t�-�t_,�rnn ' V ' �r". �.�. �C33�n) �7(.�(��- Z,1 l�5 ��i���,��� -S NC 2'71 D� ���. �.�3��� '�(..�(.�-� 5�1�� �. �... m �c/�.re s�e Dstt.r.at taaa �,bo.. ( c.�►�-- G�!� � �s rc..�� lOailioq adds+��s CitZ/�tab/=ip " /E�?-�d-� �. I►pplicstion�tor: Sit� =valnstioa 0 Isprov�at/s�t/11sC O SotL s. ��..: �a �.s i��� I 8ons� . � Mobil� So�. C Bnrin�sa C ias�strg ❑ �tb�r s. I! R�sid�ao�: i P�opl� T i S�dsOOas � t 8atbrooss � �Di�hKatb�s �Oasbaq� Di�posal �ttaahiaq 11aa�ia� �iu�nt/plm�iaq 0 �a���nt/1to pl�sbiaq 6. _! swin���/sAQu�ts=/ot�r: �D�7[ ti7rP� • ?�apl� i siA1u � coaod.� t s!►oMar� i vrivai� E waR�r cool�r� I! ��OODBl,RVICl: # S�ats =stiaut�d 11at�r Ossq� t�uo�s. par ea�t) �. syp� o! xat�r �upQlp: �Couatp/City 0 N�11 0 Co�suaity e. Do yoa antieipate sddiNoe�or ezp�ndau of the iseWty tkN rystem b tnteaded to arvet O Ya �No ura,�.w�t�i *�'IMPORTAM"**CUF.Kf3 M[�S1'C�OMPL�TB'THE J�'QUI1tF.D PROPERTY INFORMATION REQU�'.4'fED BEIAW. Ei�er s PI.AT a�SITE PLAN MllST BES�I7ED t�e elkat wh�THIS APPLlCA110N. property Di�pensipns: s e� a�ached m a.� �y��DIREG110N8(irrom ModaviUe)to PROPF.iCfY: Tu081a PII�: � 5 7 �9 - z� -��1 g ►v�� Trave L ��l �"�st -� �r,� ���kl�r.,/ ��� , �acLe _'S �1 �f• ZLY'Y! ���� DI'� �vl�'�. �3�y�� �d. Property Addrae. Rosd Name ,y � T � � City/Zip A�IV f1�� IV�Ci TGC.Y'!�l l�C �1� D l'1 �a�Ce� s C'G�c�,p��� /CU� � 2?L�b�.o U 1��8abdtvbion prwWe informstlo�,u fol : �ro P�r-fz,� w o r1 cor h�r o-� Name: � ��'�i P `g a�LC� 's Cho��1 `C�C�. -� �1� Sch�l P , s�: s� � n.a r��►�a= �z��� 11b b to ardt�that ttie l�formsdon provided M corrat b tLe bat ot ay keo�►lcd�e. I m�dersts�d t�at aa�'Permit(�) b�ned 6eraBer aro sabjat to�nslon or revocstioe,litre dbe pi�w or tnhirded�ee chaa�e,or If t6e tnformsHon sabmltted ia t�it spplkadon M�bi8ed or c.han=ed l,elso,a�deeatand tA�I oni nspo�ulb/e jor op c�aaes lncamd fi+nar thls applkadon. y 6ereby,ttve eooseot to�he Amborhsa Repe�aeaativss ot We l�iivie Comt�►Hadt6 Dep�rtme�t to enhr apoa abave daer[bed ptnperty located Ia Davk Co�t�aad vwssd b��,1 o h n T. + C w u n n e. L. 1�/i�e r5 c��a�.n taa.=procedara u�ccea�ary to dehrmlae t�dte satbbWty. DATE__ L2/2 I 9 9 BIGNATURE � TH13 AREA MAY BE 11SED FOR DRAWQIG YOUR STPE PLAN(Inclnde sU of t6e foUowin�s E�W�and pr�opa�ed Property lina aad dimemio�, nroctara, utbaciu, a�d Kptk locadom� �� �„ '? 3, � . Sibe Revbit Crsr=e �--� � � ; Dace(�): � � � fV � c, -�.' Ciknt NotiBadoa Date: � � � I � � F.H3: � ;�hP C° 4a � r �. �,,���,rC�� �- , � �� = Aecoant Na N � R�evbed DCHD(07/99) ; Lvoiee Na G r '?�-C���J�• -'L�Yv�..� C�f��, a�'t . �s z,/� I `��_ � f � -�� ��� X�.. '�-(.��t,l�i;.. ��1"ti ir,`�,,. � l '� • j /�w��''�'`�`v � _� `� � c� i/ � . ..-'. `- -��....Tro�daMT.f�'tmfiryYrMa� ` � .� ,..�... _ G�M�t1tAA�TM:l:t6�72►M � - ._ � �tprtR7 � .._. .. . • i . . �.��CNOl�llq�t�i . '. .. . .. .._.-..._... ..__........ _...� . �- .. _ .�....._._ .. . � .Cwoqc..RlYy ..—i.��..._._...Wtl..1� ... .�I�1! 2T00o . � ^._i'r. .e4, � y . . � � pC � � �ei• / � ��� P t t.22A2 H�:F2? Or ACNE3 ���'' `1e o :� c�' Je LOfJ�:t E i:1'(tn ' •,��, � o �^�; b � c� N ?, � ' � N '!•ST 28`!Y�'� • ao .. : a ^'��, M �:E N N `� ryho. �o��e Jo�w y �9� � : •�33�•s .Be, a �� • N 6i�49'b1'W 30.uG' qti /... �r� � N �' . *3. N o O N .'1 �r � �^' 27 •ti3' � ,. � y � ' q A ..1��. u, �d o' m� �° " 1,�1 . �'OQ. tr a b a � .. �a,. 4 ,_ " � w � � ��yo �.w . ; o� A O � • C: N � � , � . l � } �@ . . (N7� �C � w `/ ' v �•�S.fj/.� �� C '� • h ` k `OJ• ry N P �RG�Y/"•��J � e9• ?S� "' :i W 10� �o n o� sa'w W W w A1� ^� �6. 29°J8 ACHF c� `1'F' A�� S ?)•y9,�+� p . 22.A� � �e f m 4 0• . . _ � � � a ai b ry a E ` N r2'JS'27• 1C.1(' o-b I 03. 1 7' S b6' I I' 01`E 619.24' g dq•�:��-' I , 1 WILLIAM E. MYERS I Furm MAP.1lA—'faTA 200Q fa Yf Mowr�Opb�f pMnu�Oy i f�mod�,ac.—t-IOG-RJiAADOE � � . � �' , � � ��1. � � � - �������� . �'�������`�.�-�`�� `�. ► - i� � .r_�� � ; +�- --, � � r����"'��r�� :;�A:��;,�.�.�.,�j; _������ �.�_���- ::��,..� .�. � � ���������� ' �, � �;.:- � .�.,,,,��- ��� �� � �y � �! '==;r.,� j;i��`�r; � r i.��'��,1 .;� . ..�. � � { � ��� '3 ;,.,'`.,� �� ", .+� � �*► ���i.'��,�'�...-�:.�. - ftru�� ��,�. � ��, � - - `�� �''i� ��� �� � -� ��� 1 � �� ��>�'' � � r' : �� '�' �. , � � :,�; `�a �.,, ,,, .�..,:.�!�� �k--+ai�,_. � ��:�'� t , a0,.l� ' /-•:`:�•,/� "�1�' ' � � ���,::;' ,,,�;, ����,y/ - : :� ��. ,�•�",,��,.�, �;� � � . .� ' ., � a (�. `� �i,' : �nr;+� �,�i�E''1`r .� - �.-_E• ,�. ����� ��- r�. � �+ t�l ''� :/. �� :!L `,i' • -►�"1� �` I .. •��.. . � .��� � m �� ;� . � . . �:! � �► :� _� , _ , i� , � , ,� ����.��"� . .�,��i��� � �� �`•����► � - }� „� �j�, � ► r�, � ����. ��'1�--'.'�� .�'-'�' 1 ; 1` � '' ` �i; ��� �..-.. .�'.r��" !�'�• .+ ;.���1�. .�.1,;� , �' ;t�-�`�� � �'"� `��� � � _ -f � � �� .� � .._.. F' � __����: � .��.�.������ �� ..� ��''� , ' ���, �� � .��•: W~��� ' � , ,r �t , .,,t. ��� �I�, � ... ` +��., ��i�� �.:�.��:rl��i`� ,�.--.`. � � ;�,. � . o� • � . . � � �. l�� .J� . � '1 1 � �� / . � ., DAVIE COUNTY HEALTH DEPARTMENT ' � ' Environmental Health Section •� � Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990000889 Tax PIN/EH#: 5779-241794.02 Billed To: Cherie Yarbrough Subdivision Info: Reference Name: Cherie Yarbrough Location/Address: Bailey's Chapel Road-27006 Proposed Facility: Residence Property Size: See Map Date Evaluated: ��� Water Supply: On-Site Well Community Public d�� Evaluation By: Auger Boring `� Pit Cut FACTORS 1 2 3 4 5 6 7 Landsca e osition �C... Slo e% ` HORIZON I DEPTH Texture rou Consistence ( Structure Mineralo HORIZON II DEPTH ( �' C � Texture rou C' Consistence Structure /L �% Mineralo HORIZON III DEPTH Texture rou Consistence Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: /'� EVALUATION BY: ��C� 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 Mineraloev 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 OS/99(Revised) ■��■���■������■��������■��■�����■���■�■������������■�■■��■���■ !�■ ■�����■■■���■■■�����■���■���■■��■���■�■��■��■�■���■�■���■■�■����■■ ■�������■�■■�■�■����■�■■■■■��������■■■■■■■■��■�■����■�����u����■ ■�������■����■�■��■��■■■■■■����■ ■�■■■���■■�■■■�����■�■�����■■��■ ■����������■����■�■���■■■�i���■�■■����■������■���8�■■■�■�■�■■�■��■ ■����■■��■������■��■�������■�■�■■��■■�■��■■■■■■�■��■■■■���■����■�■ ■��■�■�■■�■�■�■�■��■�■��■■■■■�■�■■��■�■��■■■�■0�■�■oOv■�■����■■■�■ ■�����e���■�■���e���■�■��■��■����■■�■■■��■■�■■�■■��■��■�■■�■■■���■ ■■��■�■����■■�o■����■■■��■����■�■■���■������■■��■��■���■����■■���■ ■����■■■���■���■�■�e■■■■�■��■�■��■��■�■��■■����■■�����■■■■��■���■■ ■■��■���■��■■��■������■��■�■■�■�����■■�■■�t�■�■■�■■��■■��������■■ ■�����■■���■��■■�■��■■■■�■■�■�■■ ■�■■■■■■■■■����■���■��������■�■■ ■�■������■���■����■��■�■�■�s��■��■■�■■�■�■�t���■■■�■���■��■�����■■ ■�■�■�■��■��■■��■��■■��■■�■������■■�������������■����■■■��■�����■■ ■������■■■■�■�■��■�■�■�■■��■�■�■������■■��■��■��■�������■■■��■�■�■ ■��■��■■■�■■■��■�■�����������■�����■���������■■���■��w��■■���■�■�■ ■��■������■■����■�■�■�■�■���■���■��■����■�■�����■����■■������■■■�■ ■■���■��■��■■■■�■�■���■■�■t■■���■�■■�■�■■�■■�■e�������■���■■�■■��■ ■����■�����■�■■�■���■�■■�����■���■■�■�■■�■■�■■���■■�■■���■■��■■�■ ■■������■■�■■�■�■�■�■�■■�■��■��■ ■■■■�■■��■�■�■��■■�■■���■■■�■■�■ ■�■��■�■■■��■�■�■�■����■�■��■����■��■■����■■�■�■��■■�������■■��■�■ ■����■�■■■■■■���■�■����■■■■�■�■�■■��■■�■�����■���t■■�■■�����■�■�■■ ■�■��■����■■�■�■�■�■�■�■��■�■�■��■�■■■■■■��■�■��■�■■�■■�������■��■ ■����■■���■■�■�■�■�■�■�■■■■���■■�■�■■�■���■■■��■��■■■■■�����■■��■■ ■����■■����■■■�■�■�■�■��■�■■�■■■�■�■■�■�■■�■�■■�■��■��■��■���■■■�■ ■����■■■���■■������■■■■�■��■�■�■����■■■�■■�■■■■■■■�■��■�����■■■■�■ ■■����■�■■�■�■����■���■�■�■■�■���■���■��■�■■�■�����■��������■■��■ ■��■��■■■■�■�■��■�■�■�■�■■�■�■�■ ■���■��■�■■���■���■■�■�����■���■ ■■�■��■��■�■�■■�■�■�■�■��■�■���■��■���■■����■�■■�■��■■�■�����■■■�■ ■■�■�■������■�■�■��■■��■�■������■�■�■�■■�■����■���■�■■■■�■����■��■ ■����■�■■■■�■�■�■�■■�■�■�■■�■■■���n■�����■��■■■���■��■■■■�■����■�■ ■�■�■■�■■�■����■■��■�■�■�■■�■■■�■r���i��■��■�������■����■���������■ ■�■�■�������■��■�■�■�■�■��■���■�■■��s�■�■■�■��■�■■�■���■■■■■■■����■ ■�■��������■■��■�����■�����■��■�■��■■■■�■��■���■■���■������■■���■■ ■�■���■�■■■■�■�■�■�■�■■���■■�■■����■■■�■��■■���■■��■��■�������■�■ ■■■�■�■����■���■■��■■■■����■���■ ■�o�■����■�����■�■■■■■�����■■■■■ ■■■���■■■■�■���■■�■■■■■���■■�■�■������■����■■���■■��■■■����■■■��■■ ■■�■���■■■�■�■�■■�■■��■�■��■��■■��■�■■■■���■■■■�■■��■■■����■■■■�■■ ■■�■��■�■�■■■��e�����■■�■������■�������■■■��■�■�■■��■■������■■���■ ■�■■���■■������■����■�■�■��■�■�■���������■■�■�■��■■�■■■■��■�■■■��■ ■�■�■■��■■�■�■�■�■��■�■�■■�■■■�■��■���■■�■■�■�■■�■■��■�����■�■■��■ ■�■��■��■■�■�■�■�■■�■����■n■����■�■■��._�a■��■�■■�■����■■■■����■�■ �iiiiii�iiiiiii�iiiiiii�iiiiiiii '�iiiiiii��iiiiii�iiiiiii�iiiiiii� ■����■���■�■�■�■�■■���■■�■�i�■���■��■���■■i�■��■�■■■■■■�■�■■■■����■■ ■t■■���■■■�■■��■�■��■�■��■���■�■�■��■■■�■■i�■■����■��■■�����■■■■���■ ■�■■■■��■■�■�■�■��■�■�■■�■�i���■�■��■■��■■�■■����■■�■■������■■■■■�e ■��■�■��■■�■�■����■�■�s■■■�i�■■■�■■��■���■��■■�■��■�■■■■���������■■ ■�■■�����■�■■■��e■■��������i�■■■�����������■■■■■■�■■�■■■■■■■���■■■■ ■�■�����■■�■■■■■��■������■�i��■■■��■�■■■�����■■■■��■��■�■■■■■■�■■�■ ■■■��■■■�■■��■��■�■����■�■��■�■_==-- ■�■��■�■■�■�■���■■���■■■■■■��■■■ ■■��■■■■■■■�����■���■��■■o���■���i■�■�■■����������■���■■■■■�����■■ ■■��■�■■��■���■■■�v■�■����■■o■o■�■■��■■■�■�����■■��■��■■■■■����■�■ ■■■���■���■���■�■�oe�■�■■��■�■�■���i���■■�■■�■■�■■�■������■■■�■���■ ■■■�■■■�����■���■��■�■��■�■■���■�■i.����■�����■��■■■■�■■�■■■■■�■■�■ ■�■�■�����■�■�■■■��■�■�■■����■�■���■�■�■■�■��■■�■■�■■�■��������■■■ ■�■�������■�■�■�■■�■�■��■��■�■�■■�■■���■■�■������■�■■■�■��������■■ ■���■�■�����■�■�■■���■��■����■�■■�■■���■■��■��■��■�■■■■■�■■���■■■■ ■���■■�■����■�■��■���■��■�■■�����■■■■�■■��■������������■��������■ ■��■��■■������■�■■����■�■�■■���■ ■�����■��������■■�■■■■�������■■■ ■■�■■�■�����■�■�■■������■■■■■■��■�������■��■�■■��■■�■■■■�■���■■■■■ ■■�■■�■■����■��■�■�■��■�■■�■���■■��■�■■■■�■■■�■��■■����■��������■■ ■■■■■�■�■��������■■�■�■��������■■��■■■■■■�■■��������■������������■ ■■��■�����■■���■�■�■■�■�■■�■■�■■����■■�■■�����■��■■�■■�■■■■����■■■ ■■���■��■�■�■��■�■■�■�■��■■■■���■��������■�■��■■■�■�����■■■�����■■ ■■�■��■■■�■����■�■�■■■■■�■■��o����������������■■�■■��■■�■■■���■�■■ ■■�■■■■■■�■■�����■��■■■��■����■��■■■�■��■�■��■■��■��■��■■■�����■■ ■■������■��■■■■■�■■�■���■■�■■■■■ ■■■�■■■■■■■■■■�■■■��■�■■■�■�■�■■ ■�■■■■■��■�■���■�■��■■���■����������■�■■�����■■■�■■��■■���■■■��■■■ ■�■■���■■■�■�■�■■�■�■��■�■■�■�■��■■�■■■��■����■■■■■■�■■�■�■■■�■��■ ■�■����■■��■������■�■■■■������■��■����■�■■���■■■�■■■■■■■■■■■■�■��■ ■■■■����������������■■■■■■■■��■��■����■��■��■■■�■■■���■�■■■■■�■�■■ ■����■��■■�■■���■����■�■�■■�■�■■�■■���■■�■��■■��■�■■����■���■■���■ ■���������■���■�■�����■■■■■����■■�■���■■■■■■�■��■��■���������■���■ ■��■■■���■■■■■��■��■�����■����������■■���■�■■■�■��■�■■�■����■�■�■ ■■�■����■■■�■■��■��■��■��������■ ■�■��■��■�■■�■■■�■�■■���■■�■■■■■ �������n�■■�■��������■■■■■�■�■■■�■��■�■■■�■■■������■��■���������■ ■��■�■�■��■��■■�■■�■�■��■��■�■�■�■■��■�■��■�■■����■■■■■■■������■�■ ■■���■■■��■■■�■■■�■■�■■�■■��■■�■■■�■���■����■■���■�■�■■■■■�����■■■ ■��■■�����■�■�■�■��■��■��■■��■�■��■�■■�■��■■�■■■�■■■�■■■��■��■�■■■ ■����■����■■■■��������■��■■■������■��■�■��■�■�■■���■■■��■■■����■�■ ■���■�����■�■�■�■��■�■�■����■■�■�■■��■�■����■■■�■■■■�■■�■������■■■ ■���■�■���■■�■■����■�■��■�■■■■■■ ■■■■■■��■���■■■������■■■■■����■■ ■���■■■��■■���■�■■■■���■■��■�■���i�■����■■■�■����■■■�■�■���■■�■��■ ■■■������■■■�■■■����■■��■■■■■■■�����■■■■�■���■�■■■�����■�■��■�■�■■ .J �, D�1lI� �OUNTY�I�I.T�I D����T14i�NT Environmental Health Section P. O. Box 848/210 Hospital Street Courier 09-40-06 Mocksville, NC 27028 (336)751-8760 December 10, 1999 Cherie Yarbrough 204 Autumn View Drive Winston-Salem,NC 27103 Re: Site Evaluation Bailey's Chapel Road Tax Office PIN: #5779-24-1794.02 Dear Client(s): As requested, a representative from this offce visited the aforementioned site on, December 9, 1999. Based upon the information provided on the Application for Site Evaluation and after an evaluation was completed on the site, the site was found to be provisionally suitable for the installation of an on-site sewage system. Before an Improvement Permit/Authorization to Construct can be issued the appropriate application must be filled out and the house/mobile home location staked off. If you have any questions, please feel free to contact this office. Sincerely, /����•���' Robert B. Hall, Jr., R.S. Environmental Health Specialist RBH/msp Enclosure(s)