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1551 Farmington RdDAVIE COUNTY HEALTH DEPARTMENT f Environmental Health Section P. O. Boz 848/210 Hospital Street ' Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900241 Billed To: Craig Carter Builders, Inc. Reference Name: Proposed Facility: Residence Tax PIN/EH #: 5842-63-3119.02 p Subdivision Info: 1551 Fwrmioghn 2u+ Location/Address: Farmington Rd -27028 Property Size: 100 + acres **NO I * IIs 1g provement/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 C #People �% _ #Bedrooms -�7 #Baths 2_ 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 /4Design Wastewater Flow (GPD) 2W Site: New Z"O' Repair ❑ System Specifications: Tank Size AM GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width Rock Depth Linear FtYPV 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.**** se oec? E:::n Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900241 Billed To: Craig Carter Builders, Inc. Reference Name: Proposed Facility: Residence ATC Number: 2547 Tax PIN/EH #: 5842-63-3119.02 Subdivision Info: Location/Address: Farmington Rd -27028 Property Size: 100 + acres 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 WASTEWAT,PA CONSTRUCTION IS VALID FOR A PERIOD OF FIVEE� YEARS. Environmental Health Specialist's Signature:0&e2dir", p Date: O '-)- �v 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. / St L 3 Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: 1� — Z-1 -ZD APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mockoville, NC 27028 (336) 751-8760 AM - 7 2000 ENVIRONNIENTAL HEALTH DAVIE COUNTY ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED . INFORMATION IS PROVIDED. Refer to the P52EE10H BULLETIN for instructions. 1. Name to be Billed Mailing Address City/State/ZIP Contact Person Homo Phone 1-/ Business Phone 4/0 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Lip 3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC �!(Both s. system to Service: �ouse ❑ Mo/hie Home ❑Business ❑ Irrn7�dustry ❑ Other 5. If sidence: f People —/ i Bedrooms .C. t Bathrooms washer �4&ge Disposal C Zhing Machine �C.�[sement/Plumbing O Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks t# Commodes #f Showers f Urinals f water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: CSgnnty/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes VNO If yes, what type? I***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: / (/ V 1411 i J Tax Office PIN: # �-19 Property Address: Road Namef City/Zip �C/mss '//le If In a Subdivision provide information, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (fro Mocksville)�to P //, fcf / 6 4-7loo--- 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 l am responsible for all c rge c fn this application. I, hereby, giv onsent to the Authorized Representative of the Davie Co p t to enter upon above d fg rX property located In Davie County and owned by to conduct all testipI P0 ocA ,iii cessary to determine the site su1tabilib0 I - . - P1l-�/�S ' t ' IrldwdS "r 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 1 tions). J Revised DCHD (07/99) Dater): Account No. -) y/ Invoice No. v t 239.4 N g8 1094.28 161.70 � 326 132' 339. N 95 i 01�14o Ac 96 (2.1 Ac) '� 507 54 13.05 AC �" 350 688.38 �\ (10.2 Ac) IA63.88 101.-83Cn u5 H- 206 147.9 5.58 410 707. 8 TO 5Ac_ 94 99 �, _ 55.54 Ac � � �� 00 4 Ac L' 7.29Ac-r-I 'a2 5s4 � �? 8,D C 396 9th 1. '34 339.30 (342) p — —4135 a300 N c �2'.02Ac h 88'. Ul 81 N 324.0 \�O 330 365,6 tj 2 1432 -98 C 4 -- — I?56.98 ' S 1 �g86 2 6 85 4.02 84 (6.2 Ac) a1.41Ac: 30� s 73 Ac ' Un 8v X1.734 — — — – — --- — -- -- -- , 396 501 W 61 360 211 L 10 07 (1) 261 (LOT 60) (33.92 Act) Ln $' a ro 2E 4:08 Ac 7, I. ?4 2F o (18)-30 2155.0 i5' 415L m — --(395 _ r(20) C V- LOT 19) f (66.2 Ac) \ / 72 \ K 134.40 Ac 45.72 i O O _ 04 - 1 12 A1702 `�' , Y (LOT 59) c' �m !`J Ac � (28.x, pc 00 � f OD 0 �v \ 6 g MU-) DAVIE COUNTY HEALTH DEPARTMENT A Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900241 Tax PIN/EH #: 5842-63-3119 Billed To: Craig Carter Builders, Inc. Subdivision Info: Reference Name: Location/Address: Farmington Road -27g28 / Proposed Facility: Residence Property Size: 100 + acres Date Evaluated: �l02/ ho Water Supply: Evaluation By: On -Site Well Community Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH Texture group 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 ' SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION BY: %iG l OTHER(S) PRESENT: 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 05/99 (Revised) ■■■■■■■■■ ■■MME■■M■ ■■MM■■M■■ ■■■M■■M■■ ■M■■■M■M■ ■■■■M■M■■ ■■M■■■ME■ ■■■ME■■E■ ■■M■ME■■■ ■M■■ME■■■ ■M■■ME■■■ ■O■■ME■■■ ■E■■■E■■■ ■■■■■■ ■■■■■■ ■MME■■M■■ ■■ME■■E■■ ■■MM■■■■■ ■■■■■■M■■ ■■■■■■■■■ ■■■■■■■■■ ■■■■■■■■■ ■■■■MEMO■ ■■■M■■■■■ ■■■M■■■■■ No ■■■■■■■■M■ ■■■■■■■■■■ ■■M■■■■■■■ ■■E■■M■■E■ ■■■E■■■■■■ OMEN ■■■■ ■1■■ moon MONO NONE ■■■■ OMEN No no ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■M■M■N■ ■■■■■EOE■■ ■E■■■EM■E■ ■E■■■ME■E■ ■E■■■■MME■ ■E■■M■■ME■ MEMMOMMEEM ■■■■■■■■■■ ■■HOMO■M■■ ■■■■■■■■■■ ■ ■ ■E■■ ■■■■ SEEM ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■.►illi■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■M■■■■■ ■■M■M■■■M■M■■ ■■■■■■■■■■■■■ ■■M■■■■■EM■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■M■■■■■ ■■■■■■■■■■■■■ ■■MEMO■■M■■■■ Iieft Side of House APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 EI -71 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. name to be Billed Craig Carter Builder, Inc. Contact Person Craig Carter 119 Hwy 801 South Mailing Address Home Phone city/state/=L, Advance NC 27001 Business Phone 3 3 6 940-2341 2. Name on Permit/ATC if Different than Above Jeff Harrison Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Bl Improvement Permit/ATC ❑ Both 4. System to service: C$ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People 4 # Bedrooms 2 # Bathrooms 2 Dishwasher rl Garbage Disposal O Washing Machine ❑ Basement/Plumbing O Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Co—odea # Showers # urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: Acreage WRITE DIPXCT!ONS (from Mocksville) to PROPERTY: Tax Office PIN: # 5842-63-3119 �a Property Address: Road Name Farmington Road i! City/Zip Mocksville 27028 If in a Subdivision provide information, as follows: Name: 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 owned to conduct all testing edur as necessary to determine the site suita fO DATE �! 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 Date(s): Client Notification Date: EHS: Account No. Z:� I Revised DCHD (07/99) Invoice No. DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900241 Tax PIN/EH #: 5842-63-3119.01 Billed To: Craig Carter Builders, Inc. Subdivision Info: /Kt Reference Name: Location/Address: Farmington Road -27028 Proposed Facility: Residence Property Size: 100 + acres ATC mbf ** r. 2546 NOTE** is mprovement/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 TF'us #People #Bedrooms s #Baths Dishwasher: 7r Garbage Disposal: Washing Machine: ;3"'0' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size �� 0 Type Water Supply � Design Wastewater Flow (GPD). _ Site: NewO"'Repair ❑ /,2V0 11 System Specifications: Tank SizeGAL. Pump Tank GAL. Trench Width -?-/"'Rock Depth Linear Ft. d Other: x,// 44 Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PER T - FFLUENT FILTER RISER(S) 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::0j0 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** �a sC y� h < p �� ►� jr- Environmental Health Specialist's Signature: Date: tr'j % DCHD 05/99 (Revised) 4 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900241 Billed To: Craig Carter Builders, Inc. Reference Name: Tax PIN/EH #: 5842-63-3119.01 Subdivision Info: Location/Address: Farmington Road -27028 Proposed radiity: Kesioence Property Size: 100 + acres ATC Number: 2546 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 WASTEWATE STRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: -,gp 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. r� I r Septic System Installed By: Environmental Health Specialist's Signature: �(/y G�� Date: AQ -- / -&41) DCHD 05/99 (Revised) Rqht side of house APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Craig Carter Builder, Inc. Mailing Address 119 Hwy 801 South city/state/zIP Advance NC 27006 Contact Person Craig Carter Home Phone Business Phone 336 940-2341 2. Name on Permit/ATC if Different than Above Jeff Harrison Mailing Address 3. Application For: ❑ Site Evaluation 4. system to Service: N House ❑ Mobile Home S. If Residence: 4 Dishwasher # People 4 City/State/Zip [XImprovement Permit/ATC ❑ Both ❑ Business ❑ Industry ❑ Other # Bedrooms `� # Bathrooms 4 K Garbage Disposal LN Washing Machine 11Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: ## Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 19 County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Acreage Tax Office PIN: # 5842-63-3119 .u1 Property Address: Road Name Farmington Rd. wpiT—v DIRECTIONS (from Mocksville) to PROPERTY: I-40 east Left on Farmington Rd. City/Zip Mocksville NC 27028 Turn left on gravel drive beside If in a Subdivision provide information, as follows: Name: Section: Block: Lot: Davie Dance Academy. (Across from Farmington.Family Practice. 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 Denartment to enter upon above described pro rty located in Davie County and owned by to conduct all testis %edurs/nec'essary to determine the site suitabi DATE 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). x Revised DCHD (07/99) Site Revisit Charge Date(s): Client Notification Date: EHS• Account No. Invoice No.