1794-1804 Hwy 801N✓' DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
ti Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
OPERATION PERMIT
Account #: 990004409 Tax PIN/EH #: 5853-31-2262.02
Billed To: Tim Snyder Subdivision Info:
Reference Name: Location/Address: NC HWY 801 N.-27028
Proposed Facility: Residence Property Size: 6.2007 acres
ATC Number: 4742
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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.
y System Type: S.T. Manufacturer Tank Date Z- 27 ank Size l CJ0
Pump Tank Size_
System In stalledBy:K Wje haYheS E.H. Specialist: r Date: S /e ar
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DCHD 11/06 (Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
I
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990004409 Tax PIN/EH #: 5853-31-2262.02
Billed To: Tim Snyder Subdivision Info:
Reference Name: Location/Address: NC HWY 801 N.-27028
Proposed Facility: Residence Property Size: 6.2007 acres
ATC Number: 4742 /
Site Type: 2New ❑Repair ❑Expansion
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900'Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms # Bathrooms # People 2 BasementL9'Basement plumbing E4
Non -;Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size 13 - y Type of Water Supply: CCounty/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow (GPD)CQD Tank Size GAL. Pump TankGAL.
Trench Width Max. Trench Depth 3 O ' Rock Depth /Z Linear Ft. / d
Site Modifications/Conditions/Other: As stated in 15A NCA,C 18A.1.969 5
vcgcptedSystems fr.e use
Contact the Davie County Environmental Health.Section for final ection of this system between
8:30 — 9:30a.m. on the da of installation. Tele' hone # 751-8760.
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Environmental Health Specialist A Date: 9-31 _ -7
OOV 00.r
DCHD 11106 (Revised)
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751=876,0/ Fax (336)751-8786
IMPROVEMENT PERMIT
Account #: 990004409 Tax PIN/EH M 5853-31-2262.02
Billed To: Tim Snyder Subdivision Info:
Address: 2335 Almond Street Location/Address: NC HWY 801 N.-27028
City: Winston-Salem Property Size: 6.2007 acres
Reference Name:
Proposed Facility: Residence
**NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from this office prior to the
construction/installation of a wastewater system or the issuance of a building permit(in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to
revocation if site plans, plat or the intended use change.
Permit Type: aNew ❑Repair ❑Expansion Permit Valid for: W5 Years ❑No Expiration
Residential Specifications: # Bedrooms— # Bathrooms "�_ # People '�l—Basementtl�'Basement plumbingg"
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD): t3' Type of Water Supply: 916ounty/City ❑Well ❑Community Well
Site Modifications/Permit Conditions: As stated in 15A NCAC 18A.1969(5)
-acc@ptF d Systems mayalso
Environmental Health SpecialistD ate R — 3? —G%
Lp.11-06
acc ,
oIN
T -A LICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC
Davie County Environmental Health
3 P.O. Boz 848/210 Hospital Street Mocksville, NC 27028 "
,ZOO' �_ (336)751-8760/ Fax (336)751-8786
U 1
Applicati n For: Site Evaluation/Improvemen Authorization To Construct(ATC) Both
T pplicatio . ew Syste Repair to Existing System Expansion/Modification of Existing System or Facility
1.
v`RGNSltF�;O�` �y***/ ANT'** THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED
ppV�� ORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
P
I Name to be Billed I f �l Contact Person I YYI _ S Irl �{
r r,a Billing Address Home Phone rT 8 8 - 0-110
City/State/ZIP - Business Phone LIl 3 - 0109-1 - Ptll - u 4"
,q Name on Permit/ATC ifDierent than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION *Date House/Facili C Flagged Z
&7
NOTE: A survey plat or site plan must accompany this application. Included: ite Plan Plat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat
Owner's Name Joe- 4 Sd Phone umber7O
Owner's Address A02> i City/State/Zip _ S c� GSV i L p . VlC 2-U-1 )
Property Address WJ �01 N. City UJ2C5L5V i --
Lot Size 25- Q Gets Tax PIN#_ tj �S �, 3 1 2 2 ti
APPLICANT INFORMATION
Account #: 990004409
Billed To: Tim Snyder
Reference Name:
Proposed Facility:. Residence
DAVIE COUNTY HEALW,,DEPARTMENT
r
Environmental Health Section
Soil/Site Evaluation
PROPERTY INFORMATION
Tax PIN/EH #: 5853-31-2262.02
Subdivision Info:
Location/Address: NC HWY 801 N.-27028
Property Size: 6.2007 acres Date Evaluated: 5i — t -0 -7
Water Supply: ' On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
t�
Slope %
HORIZON I DEPTH
4
Texture group
e G
Consistence
tr,xrj
Structure
1((
Mineralogy
s
HORIZON H DEPTH
Texture group-�
Consistence
Q
Structure
iSt L
Mineralogy
l.' (. M ;x
HORIZON III DEPTH
Texture group
Consistence
Structure
rall
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
,
SITE CLASSIFICATION: /'/dV 5(-4J A EVALUATION BY: TIQG� -Ale! la
LONG-TERM ACCEPTANCE RATE:y''2 17 OTHER(S) PRESENT: ', Cv
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
Moist _
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
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
Mineralog
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 05/05 (Reviced)
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i I �1I9�9 PROCEEDINGS BOOK 10, PG. 503
F, 4. WHICH APPEARS ON RECORD IN r
THE CLERK OF SUPERIOR COURT
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D.B. 130, PG. 47
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PRELIMINAR Y MAP
I, -,RADY L TUTTEROW,=ERTIF`r" THAT UNDER
MY CIRECTION .4+D SUPEFNISION, THS 'GAAP
WAS DRAWN FROM AN 4CTI;AL FIELD SURVEY
MADE BY TUTTEROW SURVEYING COMPANY
FROFESSICNIAL LAND SURVEYOR L-2527
TUTTEROW SURVEYING COMPANY
107 NORTH 'SALISBUR'Y ST.
27023
PLAT OF SURVEY FOR, TIMO THY AIARK SSV Y DER
REID JAMES SNYDER, Jr.
REVISIONS SCALE, 1 = tj0 APPROVED BY, DRAWN BY,TILE HAZE, SN"—TIM
DATE-
DATE, aUG-3-2007 3.L. TU-TEROW J HORR ,w►EN/EB15E01 -c.1
BEING --71.303 AC. TAKEN FROM THE JOE K. 'NOOC'NARC PROPERTY
D.B. 144, PG. 545) LYING IN THE r,APMiNGTON-GWNSHIP
DA'',,lE COUNTY, NORTH :ARC;-iNA
DRAWINZ NUMBER,
TA,d "AFD P 77-J_ ����-