Loading...
214 Chal Smith Rd0 • 0 DAVIE COUNTY HEALTH DEPARTMENT � Environmental Health Section �' P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)75]-87(0 Account #: 989900137 Billed To: Scott Hillard Reference Name: Proposed Facility: Residence IMPROVEMENT/OPERATION PERMIT 1 . ,�( /��-- ! ( �/� y / �� ✓ Tax PIN/EH #: 5850-35-2362.sh Subdivision Info: Location/Address: Chal Smith Road-27028 Property Size: see map ATC Number: 2975 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction ofa septic tank system or any wastewater system. An AiTTHOWZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department priar 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 STI`E PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type _�'%,� #People � #Bedrooms � #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 e// Design Wastewater Flow (GPD) Site: New ❑ Repair ❑ System Specifications: Tank Size,�� GAL. Pump Tank GAL. Trench Width ��Rock Depth L�� Linear Ft.� � Other: Required Site Modifications/Conditions: I1�'IPROVEI�IENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6" BELOW FINISHED CRADE. ****NOTICE: Contact a representative ofthe Davie County Health Department for final inspection ofthis system between 830 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (33C)751-8760.**** Environmental Health Specialist's Signature: DCHD OS/99 (Revised) Date: �,���—'� � �, I � ' Account #: 989900137 Billed To: Scott Hillard Reference Name: ATC Number: 2975 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/Z10 Hospital Street Mocksville, NC 27028 (33G)751-8760 Tax PIN/EH #: 5850-35-2362.sh Subdivision Info: Location/Address: Cha! Smith Road-2702$ r AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction ML1ST BE ISSUED 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 WASTEWATER CONSTRUCTION IS VALID FOR A PEWOD OF FIVE YEARS. Environmental Health SpecialisYs Signature: _�,� Date: - CERTIFTCATE OF COMPLETION �**NOTE** The issuance of this Certificate of Completion shall indicate the system described on ImprovemendOperation Permit I 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: Environmental Health Specialist's Signature DCHD OS/99 (Revised) Z��O�� Date: ��7 r D � � .�. ��a� � DC � S� l 3 2�01 __�� .��-41 LICATlON fOR SITC EVALUATION/IMYROVFJ�tENT P[RM19IT & AT '�� Davie County Health Department � �� � �� Environmenta/Hea/th Seci�ion � � \ � P.O. Box 848/210 Hospital Street � l� ��� � Mocksville, NC 27028 �.i � Cs (336)751-8760 (� L..�IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL TH� R�QUIR�D INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. �— 1. Name to'be Billed ��d7T ���r��j/�i Contact Person �/�rlS"}r'�T ��E C�� Mailinq Address � � �n /�'�, �/����''% jfid• ' Home Phone �� / �" � ^,� City/State/ZIP �,�/Qn� � �Cj.� �/�, ,�. � � � IIusinoss Phone � ��" / �� ���_�_ _ 2. Name on Permit/ATC if Different than Above M-�;ling Address 3. 1lpplication For: ❑ Site Evaluation City/State/Zip �Improvement Permit/ATC I i Doth 4. system to service: ❑ House �1 Mobile ome ❑ Business I_l Indust L:I Other 5. If Residence : # People � � q #► Bathrooms 2- �Dishxasher LI Garbaqe Disposal i� Washinq Machine ll Basement/Plumbing II IIasement-/No Plumbing �. 6. If Business/Industry/Other: Specify typo # Peopla N Sinks M Commodas }i Showers # Urinals Ii Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City � Well IJ Community a. Do you anticipatc additions or expnnsiuns of tl�c facility this systcm is intcndcd to scrvc? Ifycs, wt►at typc? 17 Ycs I"I No ***Ih1PORTANT*** CLIENTS 1VlUSTCO6IPLETETH� RLQUIXGD PROPLILTY INI�OIt1�9A'I'!ON RLQUI,S'1'L:D i3ELOW. Eithcr a PLAT or S1TE PLAIY MUSTI3ESUBh1I77ED by thc clicnt with TII1S APPL.ICA7'ION. I'roperty Uimcnsions: y� `c��� Tax Of[icc PI1Y: #�� S o- 3- s o�- 3� Z Propccty Address: Road Namc _��"�''�— c��""f� �•' c�cyiz;P �� v �—b� If in a Subdivision providc information, as follows: Namc: Scction: Block: Lot: WKI'I'L UIRGCI'IONS (from Mocl:svillc) to PltOPGIt'fl': 1 s� - y� zS � ,�,4��- .� � Q�,�a ss C� �_ c� -�� � �L�.. � ��,� ,�o�.� n � �� �. 5�,.�� �� , `� �r- Z s--�' Datc Property Flaggcd: �� / �� This is to ccrtify that thc informatioa providcd is correct to tl�c bcst of my Icnowlcdgc. I undcrstan�l tlint :�ny permil(s) issucd hcrcaftcr are subjcct to sus�cnsion or rcvucation, if tl�c sitc pl�us ur intcndcd usc cl►angc, or if llic inl'urmation submitted in tl�is application is falsificd or cl�angccl. I, nJso, «�rdersla�rd 1/ra1 I uut respollsiGle jur a// c/rurges rncrrrrcrlJrun� 11ris applicalio�i. 1, I�creby, givc conscnt to tlic Authorized Rc�rescntativc of tl�e Davic County IlcaltB llcp:�rtmcnt to cntcr upon abovc dcscribcd property locatcd in Davic�County and o�vncd by __ __4_ to conduct all testing proccdures as ncccssary to dctcrminc tlic sitc suitability. DATE �'" �� — `�� SIGNATUI2� _ � ,�„1�.� '�. �P�c�� THIS AREA MAY BE US�D FOR DRAWING YOUR SIT� PLAN (Includc all of tl�c following: �xisting und proposcd property lincs and dimcnsions, structures, sctbacks, and scptic locations). � � � Sitc Rcvisit Char�;c � Datc(s): �� � � � � Clicnt Notification Datc: � �HS: Rcviscd DCHD (07/99) �. D /`�-- _/ �( � �� � Account No. � � � Invoicc No. �' �. ,� APPLICA ON FOR SITE EVALUATION/IMPROVEMEM PERMIT & � . ������ (� �� , b ,� � Dav�e County Health Departmer�t °� ,�' En✓ironmenta/ Hea/th Section � �� / , � �' L� ��P.O. Box 848/210 iiospital Street � �� � � ) e�;� � Mocksville, NC 27028 J � . V � � J � (336) 751-8760 � � � � � � AUG - 61998 *** Il�ORTANT*** THI3 APPLICATION CANNOT HE PROC�SSED UPiLE3S ALL THE REQUIRED INFORL�TION IS PROVIYlED. Re.£er to the INEORt�TION BULLETIN for instructions. 1. Name to be Billed �C (� ��, 1 G��J Contact Person �i(}`` `` \ � Mailing Address �� �� r'(1'�" , U� ((�Q %1 ► \��1 . Ho�e Phon City/state/ZIP \ � (7 (� �' � � (� (1�-� ��C . � �(�Business Phone �3 v� `- � 5 � — � �� � 2. Name on Permit/ATC if Different than Abwe , Ha311ng Address 3. P.pplication For: ❑ S].'te Evaluation City/State/Zip ❑ Isaprovement Perm:i.t/ATC � Both 4. system to service: ❑ House � Mobile Home ❑ Business ❑ Industry ❑ Other 5. af ;�esidence: � PeoRale � # Hedrooms 3 # Bathrooms �. �i:�i3h.washer � Garbage Dlsposal �Washing Machine O Basement/Plumbing ❑ Sasement/No Plumbing 6. xi Business/Industry/Oc.1er: Specify type � Peaple # Sinks M Com�.;c,:�::, # Shower:3 # Urinals � Water Coolers IE' FOOJ�x:^VICE: # Seats Estimated Water Usage (gaiions per day) �. rype of water suop.�y: 0 County/City � Well ❑ Community e. Do you anticipate w:dditions or eapansions of the facility this system is intended to serve? ❑ Yes ❑ No ***IMPORTAN7J°** CLIENTS �IfUST COriPLETE THE REQUIRED PROPERTY INFORMATION iZEQUESTED B�LOW. Either a i'�.Y.AT or SITE Pl.pll�i hiUST BE SUBJIITTED by the client with THIS APPLICATION. Propert�� Dimensions: �'F ���� "� �7 � i � Tax Office PIN: # J$.5 d� 35 - a 3�� Property A�dreea�: Road Namc ��q I I G c�t.��z�n �_c�c (�S Ui � l� � �o�p' k� in ;� ::. ;_�. :_�•r►3ior� ��:-�ryWide info�-:nation, as follows: Name: � ♦ VaA.ii�:�� ._ `.���c l� wicaY�: uruc��iii�i�� (irom iYioc'ics��iie) to PROP�RiY: ��✓h l � �D �� �'crrr�,`-����n %� �l , ��Grc�55,- (' � aU� G�' c�/i r, � d� e �J� �� ����� c�� +h� _ ;�,hf �' h� L S w►,� �� �i cl This is to certify that the information provitied is correct to the best of my kno�vledge. I understand that any permit(s) issued hereafter are subject to suspension or re��ocation, if the site plans or intended use c6ange, or it the informat3on submitted in thcs application is falsified or c6anged. I, a[so, understand that I am responsible jor all charges incurr��nd from this application. I, hereby, give consent to t6e Authorized Representati��e oi the Davie County Health Department to enter upon abo�•e described property located in Dacie Count� and oRned b.- �'•JIr1Q Il �� j� to conduct all testing procedures as necessary to determine the site suitabitity. � DATE � S --� �/y SIGNATURE TH1S AREA MAY BE USED FOR DRAWING YOUR SITE PLAN: l� ' iQevised IDCHI) (�7i�8) ��inl`� NO. � � IIIVOICC NO. £ . . � . • ..: %�i ��. . F E � �d a� k�+'9 : i� �, d� ' `�gq'r� „ ��.jl • !�W �d' � �; 2�.��HR �£ . �] i � ^4 ti'4� .at �\ <��' '¢bu � � ,.� � � �- �.� � .F.�': �y,oy� : `V3 ' ,�wr� M�+I ; .�� k/,� � � � �� i� � $ �'k � ��� � �.f 2� 1� r' �� � 54 a �i.. M ,* ssY�IM �� � 5•� {� �� �� ..�� � . �.II � Y � yk� : ,, Y� , �" � � � ( a , 6� ; 9 E � � � � .�' � �;. � � �' � r'y ' y 4+� � � MF �. s` r �� � '� �$ ,. �r� � p� �, � �r � i'���+M)t� ,�r• �'� .... I � �. „�.. �" ���. 3�•' �-, �; � �S;*' � �� > � � � '', � > : %an � °� � �� � fd q �� F I �+#,�. `,a #� �.��,�9� � "�' .�'� �<°� � '� \ � i��` . .!�`.J� ,� �`��. � �� ' � f � �, � `� "��� ar� y.�' .:: �, ,�`� � . � � � � ' � � ���/I1,�j �'q7� s �.;a., � � :� �i ' i J47 � .i"� i� .. ;.� � : f j� �� � s " ,y"�' 4� i:�Y k � � � �'`�„ �� �� ti�' k � � � � � � � , � �xV �� ��, Y �.. � �.�� �-� �" �" ��� �E�" �� ��. �� �i � � � � '�1� � „' kc �.! P ,` r� � �'&: i � � � . � �� � �� � � E �y { :3R� 1 'a�3%�.,r� � �`�` � 4 � r� S'� ."� .,� ,;�� :s� ,�" `� 1;� �1 y��K t ��xPa� ,�' '��� '(�� � ' �rs/ � < � �u 's ,' �`i° y � c' . _ r�� . ����(l} ��� � � �^fl x ;s �� � \ �� � � �� �� -. . � # � � . � _ ��' � , i '� �-- . - �a ';. �sy • � � � � � ,. .. � i � �; "A�S°'i � � „�� �sa . „ �:: � ' .. _��. �',� .'v g �� � � � : � "� n � � � , q,.:� & � i�'� � �,. �._ �. . . �� .� d� A1 -. • .,, .. L � M � .� � ��r 1 . . � ... . � .il �' � ��� � \ �•� �Y � � �'t��,. � � � ��. � ' '� � a i * ,�� RA � �y F � � � �� . {� :? �, ��y 'S�: a � y<�, `•t.. Vr �.1 jlit '�.� sd - �� �.. � � - , k. �� � F �..` ._ ` �� �� ... h i' � � �.�1`�'.�,s'z . ' �3 � . �� , - s � � � ��� y: �.,�� �'�, x � , , .�� a � i _.�' �sk � �3 :�.. �` � . � � 966.Fr ,s � . �i � y�M�� � � �� � ,�," Z&�`Yffi , ' � � C ,'��,��r,y}1��( K i' 6'1 � �,. �Aa ' ���. � � �� / � tc �'% - ��„ � � � � L.•7i Mn� x �' ; �� ��,s � a�'� � �� � ;� �„ r .� v�' "' . , � � j'' �•. _ a3 � _ �r � " V � �� � �i,�. �� � ���� �i i � .� � ��i'. � $ ��4 9 �; � � �' �� � +� 4a 3 i � �` '�., ` ��� y� � ,� �` �'' �v3' � - .� � -�aK ,� py..(� .w iR" � t,� � � er �%. . ;� y. �'�R a, �v � � . � � .� y �, � -.3 . r„ � � , 3� � � � : .� �� ^*=r z�, �. .�� '.. � �l'4,� �x��s ��� " �g h x 3 .Y k ,i, fi 3?i. ea: 6' a .�f' ,�;a�' ,Pa°" � �' � :£S�' � x � � � � _�, . k �.. ! !� �'. K � �. "4Y � �+ �r r .. �� _ x . �� � '�90 � � �� � i[a .� � ' � s s� � � � �` t �i. .-W-. � �f � ; <, fi�'�� � � � �a � s .� r � �I �, � �" t � �, �" �"� � ' a�� � . �rIM,�, ° :r. �.�i a . ,y'�" �' y� �,.�"� �.. � _ „�r. 3�" �� � k ; �`� .� � . ;.���' • o �� � �� � 3 ��r' ' �• �� a � �` � k� x � � : , '` �„ � " < �. � , ,,. , � •; �" `�' ` '"��,1 ``� _ �,�„u s� �;� ;•;. � '�� �' �':� ��" � � ` , � y" � < «t � , ° s; x,,; . -,�.�:�`. . � .� � �? $ '�`� � �E :. i �- )% aV p., ���k"f i`i ���r a.�� � s � 4 .!4f K� - '�i F . ,.� '�,;� � � _ :1 ', � , � ,� r „ ` � �. .. �.t � .� . .,� �i[1 .y� �� � � � � � ����.. � , _ 3 � • � t1 ` 'o-..,. � " "y � � � •� � �' �. ,i?.. � �. m,� J O !�. . t �. , ns m �. � GF� �^ � � ,. C �`�c�, R � �;:.h %� � ��;� �. ;, � �. � `� . �.. � '�j ••� 5 r��S� �;; ` � , `� �` , "• + , , . 't7' �7i�i ��`� �- � , '" � '.` � � "� : , �" �k� � "x � � ,4 � � ��e i-� * A� � � . ;�� i � �. � , � � +.+r�^ . � � � �F ,� � ��. N� s,� � � � � � � I �•�: .... � � $ E �c. � � �fi� :fy � ; �H , g � :��`r �II du+,. �,� .. ��� � � a'�•9�-.'.;,� I y •� �r Y+.. � a . � � '�� .. .. . . 9� � g � .. t ��Y � �,. .h � ��� I .. .f .Eh, . . . . � o � I dY ,�, ..�u .. �' xL � �9 � . . ,n . � �..., . . ., . , . ¢.� . . .- . � �'?:-� , I . . . � ;,+aF' ���i r,',. a .. �`JY .. Y� � . ��y . .. �� . k . tY �u ��'�� ��i, . . a�f'� ... ... ..� � . �. . L, :.1"z':h� I e • . . •���^ - �'����� .y� , °� �y"}Al�"L "°��Ex � "�Sfi ��.' . '�%,. . . - � ..:3 3l �,�� .q� �� � ;( 'f'Wy� ..��. . . � �rfu� I � � � �'� �'.. � � t�a��.� . �Y � �� � ��9NC �� ' . . . a � / . s �$ H .b.. .. .. /�\ , .£�'-..�. ,� e . >''S` 6 . . < . ''�,,` . �r �, a . � �'�. . . :-���:. . d�" �-�'�' . 3. % . ��V � � � � �.-s. d&,,.,-.�Ak e �3,4 �.� ,n� ,a. . .fi,w's i 'ri�, � tt� �'y`,- �` �' ... . . i . .ax " � � Iri ;� , s ,. . . .. .a , , � � � ,. . � . . ,. , �a. ��- � .��. � ..� � ..� �gy� ��x � • � � � " � � ' .: ° x $d ,�g.t.,, 9N:.����� b YH`, `'!R , . � � � � � � � � �. �¢ . . v� s "�' � �a>,,,'� a ���s �� r z �b#' - �w ,. * � �-.��> � • . '"� p � ��` �d` t � .t, a � - "� '� � '� � � �.. � �' �-s: �i .. . � � 'Gk�� t�� � 4��� . . � • t y_.r . . . � $' . . . , . . . a�.'. . � . . . �9-c :1� . " r . . M ' kw �y, :': ' � � � � V � ;'� „ � � � ^ 6 A` ;� � i � i' , . 6 ��� 4 � � � r4 , �"� 7� � . I � F A� ' � � . . �ry �� A� 5' '' � y ;� c � �Y.idx�_ � . � ��� s >�� ���"�" �g a� �;' �,� �' s� #� �,x � . , ,,_. . , , - ,. , ` �ii r+ , � , - . �' I��iN .� � �'€� ny�z,. '4�''P � t � ,3, Y`,,� ti �'�.a�. �. . � �f` �` � �., e, .. � �°` . . � . U�`il . h �s .c-.:: r �' 4 . .. . . . ., ., � o�m,. •�St . , . . . ., �. ._ � � ,' .. •s , �„ .�. �, _ ,. � �• : s,- . 4`: s� �.'__"- . .. .__.— . ....:;�., . . '.�- .�,.. ,..,i .h�'� y.�.t�� _e�'��� �..;.� . � C� x't. � *, �!i . . .. - 1 , � � . , DAVIE COUNTY HEALTH DEPARTMENT � �` Environmental Health Section SECTION LOT SoiUSite Evaluation APPLICANT' S NAME ��� �l Q! r DATE EVALUATED _ U/.��/� �3 PROPOSED FACILITY r%%� PROPERTY SIZE ���"Q" SUBDIVISION ROAD NAME ( ��� � � Water Supply: On-Site Well ''--'" Community Public Evaluation By: Auger Boring L� Pit Cut_ HORIZON II DEPTH Texture group ('nnciciPnrP SITE CLASSIFICATION: �J ��J , ►�iG'� LONG-TERM ACCEPTANCE RATE: � OTHER(S) PRESENT: REMARKS: 6v,�� s"rz,��� ���1�-J �G� 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 f 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 fll - 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 - gaUday/ft2 DCHD (01 •90) . ■��■ ■�■■ ■�■■ ■�■■ ■�■■ ■�■■ ■�■■ ■ ■■ ■■ �■ ■■ ■��■■■��■������■■■ ■��■��■■�■�■■■■■�■ ■■��■�■■�■�■�■���■ ■�■■■�■■��������■■ ■�■�■■�■■�����■�■■ ■�■■■�■■�■■����■■■ ■■���■�■■�■���■�■■ ■����■■�■�■■■�■�■■ ■■��■■■�■�■��■■�■■ ■■�■t■��■���w�■�■■ ■��■������■■■■■�■■ ■��■����■��■■�■�■■ ■�■■��■��■■■��■�■■ �iiiiii�iiiiiii�i ■���■■■■����■■�■�■ ■�■�■■�■����■■�■�■ ■■��■■�■�����■�■�■ ■■���■����■�■■���■ ■�■■���■■�■■■����■ ■■■��■�■■■■�����■■ ■��■��■�■■■■����■■ ■■■���■�■■■■����■■ ■■■���■�■■■■■���■■ ■�■■��■�■�■■��■�■■ ■��■■�■■����■�N■■ ■�■■■■■■����■■■■■■ ■���■■■■�����■�■■■ ■■■�■■■���■■■■���■ ■���■■�■■�■��■��■■ ■■�■�■�■■�■��■�■�■ ■■�■���■■�■�■■���■ ■����■��■�■��■���■ ■��■��■�■■■�■�■�■■ ■■����■�■■■�■�■�■■ ■■�■��■�■■■�■����■ ■��■��■�■■�■■�■�■■ ■■■■■�■■�■�■■�■■■■ ■�■■■■�■�■�■�■�■■■ ■�■�■■���■■■■■■■�■ ■■�����■■�■��■�■�■ ■��■■■�■�����■�■�■ ■■■�■■�■��■��■��■�■�■�■■�■■■■���■■�■■■' ■■■��■�■■�■■■■ ■■��■■�■������■����■�■ ■■���■�■■�■■■��■■��■■�■■�■�■��������� ■■�■�■■�■�■■■�■��■�■�■�■■����■�■��■��■ ■������■■�■■■�■■�■\��■����■�■■�■�■■��■ ■■����■�■■■■■�■■�■■��■��■��■���■��■�■■ ■�■■■�■�■■��■��■�■■■�■■�■����■�■■�■��■ ■�■�■��■■■�■■�■■�■■■■■���■���■��■�■��■ ■�■■��■�■■��■■�■�■■�■■��■■�■■�����■��■ ■�■■■�■■■■��■■�■�■■■�■����■�■■�■�■�■■ ■�■■■�■�■■���■ ■�■■■����■�■����■�■�■■ ■�■�■�■��■���■�■■�■���■�������■������■ ■�■�■�■■�■���■�■■�■■■�■■�■�■��■����■■■ ■�■�■■■■�■�■���■r���■����■■�■���■■�■�■ ■■■�■■�■�■■���■�■■�■■■�■■�■�■��■■■■��■ ■■��■■�■��■■��■��■�■�■�■■�■�■��■�■■��■ ■��■���■■�■■■�■�■■���■��■�■�e■�■■■■��■ ■■■■���■■�■■■���■���■�■■�■�■■�■■■■��■ ■■■■�■�■■�■■■■ ■■■■�■■�■���■■�■■�■��■ ■����■��■���■��■�■■��■����■�■■��■�■��■ ■��■■■■�����■��■��■���■��■�■����■�■■�■ ■�����■��■���■�■■�■■■�■�������■�■�■■■■ ■�■�■�■■■■���■��■��■■�■■�■■■��■�■■�■■■ ■�■�■■�■�■���■���������■�■■��■■�■��■�■ ■■��■■�■��■��■��■���■■�■�■■�■�■��■�■■■ ■■�����■�■■��■��■���■�■��■�■�■�■��■■■ ■■�����■�■���■ ����■■�■�■�■■�■■�■�■■■ �����■�■��■�■■■�i����■�■��■�■�■■�■��■■ ►������■��■■��■��■�■■■�■��■�■�■■�■���■ ■��■�■■�■�■■■�■■�■■��■�■■�■�■��■�■���■ ■■a■�■��■■■■��■■�■■■�■��■�■�■■�■�■■�■■ ■�a���■�■■��■■■■�■■���■�■���■■�■■�■��■ ■������■■■■��■■�■■�■■�■■��■���■�■■�■�■■ ■�����■�■■���■ ■�■■��■��■����■�■����■ ■��■r�■■■�■��■■�i��■■■�■■�■�■��■�■�■■�■ ■�■���■■■���■�■�■■�■■■������■������■■■■ ■�■����■■�■■��■�■■�■■■��■�■■■�■■�■��■■■ ■�����■■�■�t�■��■�■�■■■■�■�■�■■�■��■�■ ■■�����■�■�������■_:�■■�■�������■�■■�■■■ ■■■��■�■�■■��.��■����■�rr�i►,ri�■�■■�■��■■ ■■■�■■���■■■���■■■�■���r���■�■■�■��■■■■ iiiiii�iiiiii '�iiiiiiii�i�.r��i�i�iiiiiii ■■■■�1■■�■�■�I�■■����I��■�Ir�Lii1��■■■■■����■ ■■■■/1■■�■�����::ii��■■i�■■���■■■■��■�■ ■�■■n�■�����■�����■�■■■�■���■■■■��■■�■ ■■■■u�■����■■■������■�■■���■�■■�■��■�■ ■■■■i��■��■�■�■��■�■■■�■■�■�■�■■�■�■■■■ ■���i��■■�■�■���■■■■■■■�■�■����■�■■�■■■ ■������■�■■��■�■■���■�■�■■�■�■�■���■■ ■��t■��■�■���■ ■���■■�■�■��■�■�■■��■■ ■�■�,�����■■■�■�■■��■■■�■������■�■��■■■ ■���i■■�■�■■���■�■■■�■��■■�■�■����■��■■ ■�■t�A■�■■�����■■■■►�n���■■�■����■�■���■ ■■■i���r��■■�■■■�■■■■■�.a�■■■■�■�■��■��■��■ ■■�����■■i�l■�����■■ ■■■��■�■■��/�■����■■ ■�■■���■■■���■���■ ■■■■ ■�■���■�■■�■■ ■�■■�■��■���■�■■�■■ ■■�■������■�■��■�■■ ■■�■�■■�■■■�■��■�■■ ■ii:i■■!�������■��■ ■��■�■■��������■■�i ■■�■�■■����iw��■■�■ ■��■ ■������7A11�1�� i�■ ■■■■�■■�`■il�■���i■ ■�����■■�■■■����■�■ ■■��■��■�■�■�■■�■�■ ■■■�■��■�■�■��■■��■ ■■■�■■�■■■�■■�■���■ ■�■�■■�■■�����■��■■ ■■■�■■�■���■��■�■�■ ■�■■��■�■�■■■■■■■■ ■■■■ ■■■���■�����■ ■�■��■�■■���■■■�■■■ ■■�■�■��■���■�����■ ■����■��■���■�■■■■■ ■■�■�■■�����■�■���■ ■�■■�■■�■�■����■■■■ ■■�■�■■�■�■�■����■■ ■■�■�■��■■����■�■■ ■��■ ■�■������■■■■ ■■�■■�■■�����■■■■■■ ■ ■■��■■ ■���■■ ■���■■ ■��■■■ ■��■�■ ■�■��■ ■���■■ ■■��■■ ■��■■■ ■■��■■ ■■■�■■ ■�■�■■ ■■■■ ■■■■ ■�■■ ■�■■ ■■■■ ■�■■ ■��■ iiii ■■■■ . , . � � � . . ,- . • ; ry.�,..r;?..M .`'_....... ..F ..s�l��' �`i�U����� ��1���'�T., ."_... r a.t:.., Y�.,'��......_';, .._ . ._ ,.._ , _ ...:_ . m, ., , . ..,,.._. .�_. . :_.... _ �.... _....�..d ENVIRONMENTAL HEALTH SECTION P. O. Box 848/210 Hospita! Street Courier #09-40-06 _ . , Mocksville, NC 27028 , .. . .... .: .. ... .�: ... . ....� :7 ' Phone #;.:.�3$6)75�'�� 6Q .. . ._ �. ,_. �,.,. ___. . .�. ._ _ . .w�.. .�.. ... _.. ... �. ...r._., . . September 4,1998 Scott Hillard 1150 Mt. Vernon Rd. Woodleaf, NC 27054 Re: Site Evaluation Tax PIN: #5850-35-2362 Chal Smith Road Dear Client(s): As requested, a representative from this office visited the aforementioned site on August 31,1998. Based upon the information provided on the application for site evaluation and after an evaluation was completed, the site was found to be provisionally suitable for the installa6on of a modified, oversized on-site sewage disposal system. Before a representative of our office will revisit the site to issue an Improvement PermitlAuthorization to Construct the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, please feel free to contact this office. Sincerely, �a�!� � ��� . Robert B. Hall, Jr., R.S. Environmental Health Specialist RH/wd Enclosure(s)