Loading...
175 Laurel Brook Ln (2) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 RrUJ4 B 7 0 1 ce(,-C -I Tax Account led To: Waters&McGuire Building Co. lt( � SubdivPIN/EH ionn o: Lau el Brook Lo Billed #4-1A 'Reference Name: N;II Wew 0OW) Location/Address: Griffith Road-27006 + .-)posed Facility: Residence Property Size: see map ATC Number: 2915 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 ONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: l Date: 7`�/ CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Coa ion shall indicate the system a 'bed on Improvement/Operation Permit has been installed in compliance wi Section.1900"Sewage Treatment and Disposal Systems,"but shall in NO Y betalc at the system will function satisfactorily for any given period of time. r� Septic System Installed By: 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 IMPROVEMENT/OPERATION PERMIT Account M 990001776 Tax PIN/EH M 5863-57-1695wm Billed To: Waters&McGuire Building Co. Subdivision Info: Laurel Brook Lot#4-1A Reference Name: Location/Address: Griffith Road-27006 Proposed Facility: Residence Property Size: see map ATC N bFr. 2915 **NOTE** its 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 � #People_� #Bedrooms _ #Baths , Dishwasher;/ Garbage Disposal Washing Machine Basement w/PlumbingP?11'- Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: Lot Size Type Water Supply Ae// Design Wastewater Flow(GPD) Site: New. Repair System Specifications: Tank Size/ Dj1 GAL. Pump Tank GAL. Trench WidthcS� Rock Depth 1.2 'Linear Ft�� Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6«BELOW FINISHED GRADE. ****NOTICE: Contact a representa ' e C.OIth Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:3 a v of installation. Telephone#is(336)751-8760.**** !el Pei) CIO, I�� 1 •lac,, �\ �. i= � U Environmental Health Specialist's Signature: i — Date: DCHD 05/99(nevi CATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC Davie County Health Department JUL " 5 ZOOI Environmenta/Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 ENVIRONMENTAL HEALTH (336)751-8760 DAVIE COUNTY ***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 L �\ ontact Person a L Mailing Address 0 � Home Phone City/State/ZIP ` /O/ Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address city/state/zip '-r-, A" 3. Application For: ❑ Site E aluation "-- rovement Permit/ATC ❑ Both 4. system to Service: Ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People OI # Bedrooms�� 3 # Bathrooms of 5 PLIfi hwrasher ❑ Garbage Disposal asking Machine " Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage ons per day) 7. Type of water supply: ❑ County/City Well ❑ Community s. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 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: � n n,� X 3. I J / Qi bEE�IRECT ONOS(from ocksvilille)to PROPERTY: Tax Office PIN: # �69k F ! t� 4 r� Property Address: Road Name ' t City/ziP L\- k La V\to t\-\( ��� U�; r, VCL\��O' If in a Subdivision provide information,as follows: Name: ' �rL'Aj() C)Nrn: I e. s Section: Block: Lot: Date Property Flagged: �C-(=b oZ r�cS' C\Cf Vl° O RQj�� 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 D7vie County Health Department to enter upon above described property located in Davie County and owned by r p r✓ to conduct all testing procedures as necessary to determine the site suite ' i DATE 15'C�\ 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 Datc(s): Client Notification Date: EHS: Account No. -76 J/ Revised DCHD(07/99) Invoice No. --� IP ' Oc. N74*13'3 (� 4* O,QFF` N74,13 3g"� 433•g5 ge �- 3= 1 NPS IP Z W i 0'40'35�"E 90.25' \ W�M �2j 0.25 \ 2 cV ildo NPS I z N21.39'34"W �40.60' TRACT i TRACT 2 INC. NPS N5339'09"W AREA = 5.365 ACRES - 38.30' PART 0 FLO 3184 PB 7 AREA = 5:310 ACRES 147 23'27"E NPS DB 318 899 PART OF TAX BLOCK ' 106 PART OF LOT 4 PS 7 PG 16 f 32.82' NPS 4 OT PART OF TAX BLOCK 87010B 351'04"W NIP w 59.31 V i x N53*51'14"E 41.26'x/ NPS ,� ff �� I 141"W NPS C/ N30-20' VE NPS t 56.7 $ PROPERTY LINE BE GINS.FO' 0 NG CENTERLINE OF CREEK AT T I w EIP NIP NPS DINT .E 2 N n t d O RA DER S r t NsB IP G.S. �S99�S W NFW ; fi I DAVID M. HANES CONTRACTING INC. N68�\��NF c= I DB 159 PC 229 3 635,• v h i DB 92 PG 540 Op {y DB 51 PC; 245 y 1�Tr Op• = Q l' I TAD BLOCK B7 LOT 40 • ,,� 6'36 53•K, EIP EIP S ►P EIP nAvn AA unKrrl _ - Davie CountyWealth Department Environmental,7Yealth Section PO Box 848/210 Hospital Street Mocksville,NC 27028 Phone: (336)751-8760 May 30,2001 Grace Draman Re: Erik Blankenship 431 Riverbend Drive Bermuda Run,NC 27006 Re: Site Evaluation- Laurel Brook Lot 4-1A/5.365 Acres Tax PIN#: 5863-57-1695 Dear Ms. Draman: As requested, a representative from this office visited the above site on May 29, 2001. Based on the information provided on the Application for Site Evaluation and after the evaluation was completed,the site was found to be provisionally suitable for the installation of an oversized, modified on-site sewage disposal system. Due to shallow soil depths and poor soil characteristics on the site, we will require that the septic system be sized at approximately 200 linear feet per bedroom, or 800 linear feet for a four-bedroom residence. This is subject to change as actual design and dimensions of the septic system will be determined at the time a permit is issued. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization 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. Please have the preliminary clearing and grading completed prior to making the request for the permit. If you have any questions, feel free to contact this office. Sincerely, Jeff G. eauchamp, R.S. Environmental Health Section Enc(s) •. .{a a V LICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC Davie County Health Department Eni rvnmenta/Hea/thSection MpV 6 P.O. Box 848/210 Hospital Street Mocksville, NC 27028 E�v`RONM�CO�rAL�N (336)751-8760 ** MI�ORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. ' Refer to tithe INFORMATION BULLETIN for instructions. fi � 1. Name to be Billed r; k n81,q,kQ{1s th f? Contact Person &I Mailing Address Q. 1 1 S 7 Home Phone ' city/state/ZIP MDC�5V i 1U) 1'V/�`- 2'70'Z$ Business Phone 33G 2. Name on Permit/ATC if Different than Above Gr-acA- -' Dratnna.Y-y' Mailing Address y3141,i(ey eQ� �)r, City/State/Zip &rYnU c/Q I/),l Nle Z7b�1, 3. Application For*Site Evaluation improvement Permit/ATC Both 4. system to Service: House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 1 S. If Residence: # People # Bedrooms '7 # Bathrooms y P/bishwasher OKCaLrbage Disposal ' "ashing Machine "asement/Plumbing ❑ 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. Type of water supply: ❑ County/City fell ❑ Community s. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes W-No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPLICATION. Property Dimensions: .$;3/os aGI WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: #_ 519L; - 57- /G 9 5 11 D - sw-,y - Property Address: Road Name Q r of ffi-i-�-� ��. Ya J k)y) Va.A,P tet City/Zip cl rX11 A--,L If in a SubQ`ivision provide information,as follows: m;o Name: I b 1-0o A� Section: Block: Lot: A Date Property Flagged: ' ` 0 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 by to conduct all testing procedures as necessary to determine the site suitability. 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): C n � Client Notification Date: EHS• 1 C-- Account No. Revised DCHD(07/99) Invoice No. v.,� \ I E IP N�A�38 Do- IP O E N IP Q � o 9 i c� O A}}95 W \ Of C9�FT- NC35 5A 8 E �� OT ' w � o ps;, NPS / IP i ro --Oiled cr + Y lav be WIe. N •^.e N20'40'35"E I z 90.25' NPS N21'39'34"W TRACT 1 TRACT 2 40.60' AREA - 5.310 ACRES V N53'39'09"W AREA - 318 gggCRES DB 318 899 HANES CONTRACTING INC. MRS PART OF LOT 4 PS 7 PC 106 318 PG 899 38.30• PART OF LOT 4 PB 7 PO 106 PART OF TAX BLOCK 870108 LOT 4 OF PB 7 PG 106 N47'23'27"E� NPS PART OF TAX BLOCK B7010B LOT 4 'CK B7010B LOT 3 32.82• NPS NIP N35'21'04"W 59.31' N54.26" NPS O/( OF NPS ST MTCAI i N18'47'41"W-, 38,55' N30'20'29"E NPS PROPERTY LINE BEGINS FOLLOWING 56.77 'CENTERLINE OF CREEK AT THIS POINT WIN o g 3 EIP NIP NPS 2 2 ti N71-O�D"E 39.07'(T) 7 EIP 01 n HIS PLAT WAS DRAWN UNDER N��� EY MADE UNDER NY 3 .DED IN DEED BOOK 318. A'@e IP ry SURVEYED ARE SHOWN AS 'ION FOUND IN DEEDS AS7$9 AS CALCULATED IS B) -D IN ACCORDANCE WITH G.S. 3$• D N DAVID M. HANES CONTRACTING INC. ,HIS 4th DAY OF MAY 2001. OB 159 PG 229 08 92 PG 540 ___ _ DB 51 PC 245 N7636' uND SURVEYOR TAX BLOCK B7 LOT 40 / 5.3- S S'J:? EIP EIP Sc 6p•08 WI / NIP /' 600 EIP 6 40 35"W LANG SURVEYOR, DAVID M. HANTS CONTRACTING INC. / -E FCLLOWINO DB 183 PG 694 -A, CREATES A SUS- / TAX BLOCK 97 LOT 49 OF A COUNTY C2 ',TA- RECU;AT_S I C-.f-ziq / NUHBEF I NOTES 1 RAW ERROR OF CLOSURE 1:10.000+. MISCLOSI�RE WAS DISTRIBUTED BY COMPASS RULE. 2 AREA DETERMINED BY COORDINATE COMPUTATIONS I 3 DASHED LINES REPRESENT INFORMATION TAXEN FROM DEED OR PUT DISTANCES SHOWN ARE HORIZONTAL GROUND DISTANCES UNLESS NOTED OTHERWISE 10.498 Acres w m2 / 3 tiry i 40.40'00"E 91.88' 5 51.56'40"E 75.63' \t", G S 436'05-'E-.L4.70' yb \ 51 4 A °+lo S 17.56'15"W 87.32' -' c l a P S 38.51'25"E 70.95' �I 1 O vPi a a. pS43.40'20"W 33.11' 3 P 34,P8' CS 36°49'35"E 61.03' 10.840 Acres o o' 09"Ea 88.98' S 25.22'35"W 124.63' I <v 9 10'50"E 71.27 I t54.6T P x PZ g d , Nw S 79"46'15"W 39.07' UP 6a,�§i25"w / 3 6. S N '3.z`7 30', •zp„w 0p' N h I _ 6p'00' a ' S �6:3p S 78�36L40 I 64ofSe a 4Cce B 6,36 40,W I Parcel49 I S 1323'20'1 1 ' David M. Hanes I O I I I s, Owner : David M. Hanes oni 01 coni Advance n � n� N1 A� 38 6 .0 • O,c, A33'g9 S'\0.� (� lc,y w NPS i IP --.` J co r, d 20'40'35 E O ' z z 90.25" NPS N21'39'34"W CT 1 40.60' AREA 5.365 ACRES .NG INC. NPS N53'39'09"W DB 318 899 \/ 38.30' PART OF LOT 4 P8 7 PG 106 N47'23'27"ENPS PART OF TAX BLOCK B701 LOT 4 3 32.82' NPS NIP N35'21'04"W 59.31'1� , N54126' NPS NPS y 8'47'41"W s 38.55' � � 4, c La N30'20'29"E NPS PROPERTY LINE BEGI S F OWING 56.77') CENTERLINE OF CREEK THIS POINT w/ o EIP NIP NPS 2 z N '19.07p E 39.07'(1) 7 0 0 WN UNDER dY ( 318. N6e \ IP 6 IOWN AS `DS AS S9 9� W FI : WITH G.S. DAVID M. HANES CONTRACTING INC. 3 VIAY 2001. DB 159 PG 229 \Q DB 92 PG 540 DB 51 PG 245 TAX BLOCK 87 LOT 40 YOR, DAVID M. HANES CONTRACTING INC. ` DB 183 PG 694 SUB- TAX BLOCK 67 LOT 49 r OR ATES NOTES: 1. RAW ERROR OF CLOSURE 1:10.000+. MISCLOSURE WAS DISTRIBUTED BY COMPASS RULE. 'L. AREA DETERMINED BY COORDINATE COMPUTATIONS. 3. DASHED LINES REPRESENT INFORMATION TAKEN FROM DEED OR PLAT. 4 DISTANCES SHOWN ARE HORIZONTAL GROUND DISTANCES 2 UNLESS OTHERWISE NOTED) UNLESS NOTED OTHERWISE.. t REFERENCES 2 UNLESS biHF:RWIS,E ru)rI-U) I I'I.AT ENTITLED "I.AIIREL BROOK" RECORDED NOVEMBER. 1999 1 IN MAI' HOOK 7. PAGE IOH DAVIE UOUN'rY REGISTRY 2 PB 6 PG 147 ENTITLED "RIVER BEND TRAILS" 3. ALL DEEDS AND MAPS SHOWN HEREON. 1 10.498 Acres Ln 26 • O �^ 40'0O"E 91.88' �n 51056'40"E 75.63' �O E\P a i� 32.89 S41"36'@5�L4.70' EOw 672.89 25 4° as as O a U�° ��6U. e / iS 171,56'15"W 87.32' c CP �S 38051'25'E 70.95' h' z)P S 43040'20"W 33.11' �- �S 36°49'35"E 61.03' 10.640 Acres o N S 25°22'35"W 124.63' N 1.27 m N vj o P n P S 79°46'15"W 39.07' / °Q EIP N 68Op 6" 3• /3p1"IS' 20 ''K. pp" N h T! pp, NiP P 23 S76-361 2�@80„E. 60 448 . V Se c .4 .oo• a P, cess 7 cti arce/ 49 ' 453.13” S �avi� IU, vanes S 13°23.20 08°S5,2S/,w 60.78. 'W / I O60.00• t / 1 / I Po Owner : David M. Hanes Contracting, Inc SCA1E 301 Hanes Trail 1 Advance, N.C. 27006 SURVEYE 'res by d.m. d. CRC MAPPED: -, CRC DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ' Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990001751 Tax PIN/EH#: 5863-57-1695 Billed To: Erik Blankenship Subdivision Info: Laurel Brook Lot#4-1a Reference Name: Location/Address: Griffith Road-27006 Proposed Facility: Residence Property Size: 5.365 acres Date Evaluated: Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% HORIZON I DEPTH O 12 - _7/0 Texture group CL Consistence - -r Structure UL Mineralogy + ; HORIZON II DEPTH -Z ?�U t7✓ �S Texture groupC✓ Consistence ` Structure [� Mineralogy -,c c—,_n, 7 0G� ` HORIZON III DEPTH 20 Texture group C. Consistence ; Structure v- My— Mineralogy I HORIZON IV DEPTH 4- Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S S-C LONG-TERM ACCEPTANCE RATE 0.7- SITE .7- SITE CLASSIFICATION: PS EVALUATION BY: WAJ LONG-TERM ACCEPTANCE RATE. OTHER(S)PRESENT: �"",Y-- 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 05/99(Revised) ■■■■■■ee■e■■■■■e■e■■■s■■■ecce■■ee■■■se■s■■■■■■■■■e■■■■■■■■ss■s■■s■ ■ecce■■■■■s■e■■■■e■■sss■■■■■■■s■�s■■■■ee■■■■■ss■■s■■■■■s■sese■ess ■■es■■ss■■s■ss■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ssess■■■■■s■■ss■■ss■ ■■■■■■■e■■■■■■■■■■es■ecce■se■■■■■■■■e■eeeees■■s■■e■s■■sess■sse■e■■ ■■■s■■s■sees■�eess■e■■sees■s■e■■s■■■■■■■s■■s■■■e■se■se■ss■■■■■■■s■ ■■■■s■■■■■■ssss■■■■■e■s■s■■■■■■■■■■■■■■ss■■ss■s■■■■■■■■■e■■s■ess■■ ■■■■■■■■sss■■■s■■■■■■■■■■■s■■s■el�■■■■■■■■■■■■■■■■e■■■■■■■■■■■■ee■ ■see■s■■■s■se■■s■s■■■■s■■e■■see■ ■■■■s■e■ssses■■■s■ss■■esesssees■ ■ss■■see■■■■■■■■■■■■s■■■es■■■■■■■■■■■■■■■■■■■■■■■■s■■■e■■sss■es■■■ ■■■s■■■s■s■■■s■■■■■■■■■■e■s■■ss■es■■■■■■e■■s■■■ses■ss■■■■■see■es■■ ■■■s■■■■e■■■■s■■■e■■■■■■e■■e■■se■■e■■■■■■e■ess■■■■■■s■■■■e■■■■s■■■ ■■■■■sees■■■■■■■e■■■■e■■■■■■es■■■■■■■■■■■■■■■■■■■■■■■ee■■■■■■■■■■■ ■■■■■s■■■ssessssss■■■s■■es■■s■■ss������es■■■ss■■■■■■sss■■■■ssn■■■r ■■■■■■■■■■■■■■s■■s■■■■■■■■■■gee■■■■■■■■■■ss■■��■■■■■■■■■■■■■■■■■r,■ ■■■e■■■■■■■■■■see■■e■e■■■ee■//■■■ese■■■■■■e■■■■■►\■■e■■■e■■e■■■■■n■ ■sss■■sss■■e■■ss■s■■■sss■■■■i■■■■esr.■■s■■��■■■■e■■■►■■■s■■■■sns■er�■ ■ssss■■■■■seas■■■■■■■■■ee■■■�■■■■�1\�■ss■s■s■se■s■■■s■a■■■■ai►�►as■s■■■ ■ss■s■■■■■■■■■■■■■■■■■■■■sees■■■ ■■■■■■s■■■■■a■■■■■es■slr�■s■■■rye■ ■■s■sss■■■s■■ss■sss■■■■■■■■■►�s■■s■s►�■■■■■■sss■s■sss■ses■■■er�■■su■■ ■s■s■■■■■■■■sss■es■■■e■■ssss■sse�aess■■s►e■■■e■■■■■isseess■r�ss■sss■ ■■■■■■■■■■■■sage■■■■■s■■s■■s■■■■I�Ie■■s��as■e.-a■■■►s■■■■e■re■■u■■e■ ■■■■■■■■■■e■�a■■�::::aeeesoeeeeee•■■■■■see■■■spa■■■■■■■/�■e■■■ie■■■e ■■■■■■■■■■■■ss■e■■■■■■e■■■■■■■■■■■■■■■■a:e■■■■■r.�eeo•�■n■I�r,►■r►■■■se a■seas■■■■■■■■■■■■■s■■■■■ae■■s■■■■■■■■■■■■■ss■■■■s■■■rw■seer■■ssr■ MENNENMENNEN �iiiiie ' EREAME iiiiiiEmmmum iiii`■irli�I ■■■■■■■■■■■w■■s■■■■■■s■■■i■■■■■e��vetaftir�■■■■■i■■■■■■■s■cas■■■u■■■ea:a ■■■■■■■■■■�:�■■■■■■■■■■■■■IIs■■e����■■■■■■■■■1■■■■■��■■■■■■■�■Ic�a■■■e ■sss■■■■■■■■■■■■es■■■■■■■11■es■■■■■s■■■■■■■■i■■■e■■■■■■■■re■ue■e■s■■ ■■■■■■■■■■■■■■■■s■■e■e�1■J■■■X11■■�■■■■■■■■■■■■■■■■■■■I■■■■■■■■■■■■ ■■■■■s■■■■■■■■s■■■■a■scsss■■■■ie■■■■r■s■■■■■■■■■■■■■s■■■■■ssss■■■■■ ■■■s■s■ss■■■■see■■■■■r■■■■■■■■rssr:■;r►tut■■■■■■■■■■■e.■■s■■■■■■■■■■■s■ ■■■■■s■■■■■■■■u■■■■■t3■■■■■■■e■I■7'11■;il'i■1�■■ee■ee■eGe■e■■■e■■■■■■■■■■■ ■■■■■■■■■■■■■I.■■■■■re■■■■■■■,■■Ile s■■■■11■■■■■■■►%■■\■■■■■■■■■■■■e■■■ ■■■■■■■■■■e■d'/■■e■i.�r��Jl�■■■■11■I■L�ny�C:a■■■■■ee■■eC!��1■■■■e■■■■■■■■■■ ■■■■■■■■■■■■tee■■■■ssss■e■■ifl■■■■�■■■■■■■■■■■■■■■\!/■■■■■■■■■■■■■■■ ■■■■■■sss■■■■■■■s■■s■■■■■■s■■■■s■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■■■■ ■■s■■■ee■■■ees■■e■e■■■■s■■s■ses■ ■■■s■■■■■ss■■■■■■■■■■■■sss■■■■■■ ■■s■■s■e■s■■ee■sss■■■■s■■■■■■■■■■■■■■■■■■■s■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■ss■■■■ss■sss■■■sss■s■■■■■■1�1■eee■e■e■s■■s■■■■■■ss■■■■■■■■■s■ ■■■■■■see■■■■■■■■gee■■■■■s■ss■■■ ■■■■■■s■■ss■ss■■■■■es■■e■■s■■■■■ ■■ss■■■ss■s■ss■s■se■s■s■■s■■■■■■■s■■s■■■ssss■■ss■■■■■se■■■■ssss■■■ ■■s■ss■■■■ess■sews■■■■■■■■■■e■■■■■■■■■■■■■■■■■■s■s■■ss■■■s■■■■e■■ ■e■sees■■■■ecce■■■eeee■■■■■■■■■■■■■■■■■■■■■■■e■■ee■■■■■■■■■■■■ee■■ ■■■■■■■ss■ess■ssss■s■s■■■■■■■s■■ ■a■s■■■se■es■■■e■■■■■■■■■■■■■■s■ NONE ■■ssss■■seesee■■■■■■■■s■s■■see■sr�iis■■seas■see■■■■■■e■■■■■■■■■■■■s■ { APPLICATION FOR SITE EVAWATION/IMPROVEMFM PERMR&ATC D Davie County Health Department NOV , 9 1999 Environmental Health Sectfon P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336)751-8760 ***IDPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Milled 'ZOV10 M JJRNC- contact "coca Vi flU1Q "AW6 Nailing Address �'.�Ol �,1�+�t'S rG� w Mom Phone Q9�• 577 city/state/zsP OVc•v%Ce.ot*,I. C.. .2-700C, Messiness Phone 19gT-54 q k rt%. 9 gT-1110 2. Nage on Pernit/ATC if Different than 1►bove I %eey$v- 770-g i31 Nailing Address City/state/zip 3. Application For: 041te Evaluation ❑ Improvement Permit/ATC ❑Both 4. system to se"Loes "Ouse ❑ Mobile Home ❑ Business ❑ industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms O Dishwasher O Garbage Disposal O Washing Machine O basement/Plumbing O Basement/No Plussbing 6. Ie Muuine•s/industry/Others specify type # People # sinks # c # showers # urinals # Water cooler•. r IF FOODSERVICE: II Seats Estimated Yater Usage (gallons per day) z. . Type of Water supply: ❑ County/City U4e11 ❑ Community a. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑Yes ❑No If yes,what type? ***IMPORTANT***CWENTS MUSTCIOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESLTBMI77ED by the client with THIS APPLICATION. Property Dimensions: 10,0i6Nc, WRITE DIRECPIONS(from Mocksville)to PROPERTY: Tax O®ce PIN: # G3' 1--t Property Address: Road Name G 1�F i 4l. PO CityrLip A0V4nCE 27006, If in a Subdivision provide information,as follows: Name: L G. A E•) Q Aoa K . Section: �a1 Block. �_ Lot: L_ 'Date Property Flagged: I Al Ll k 4 G 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 ant responsible for all charges incurred from this appiicadom 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 b c.•+cto r-. Ot-%e s Cc yliu-Ji to conduct all testing procedures as necessary to determine the site suitability. , DATE 1 I-(!� 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): f--(p Client Notification Date: EHS: • w kiw 11 0C s LaV-L&ybC., �vrij�S 1.4 a Q y _ 1 Lai a3 �;vtr4z.,� �S .D S Ao C. Pt{ RJ Tax MOP B-7 Nrginia G. Walker River Bend Hills D.B. 075-153 - \ P.B. 6• P. 162 ,jOp /David M. Hanes p N N 89.45'15"E 00 r $ d, D `!6 1392.97' Pe C? o\e4 14 '„'j0�. .0✓ 1.'n to 1'�`J• 312,$ 0 -16 19 P53.01 �N 70� �5 L-17 rL-18P 1'06 tb �' 390 •�* W 06 -, P642�R. n• 14.700 Acres . 202.54' tion ps75 0' S 1- 88°08'35"E P Z�c�O?bg� ,�p6• p ^dlb- ao aQeo rn / o / 1 .54' W p \Q 0.♦ A% n t s3 Y9 oy / F P n 4) rn s 10.498 Acres N 26 ro„ nar• o°la al tion. .. F S A0O',5 3 � ryv3 V y e / O \ 40640.00"E 91.88• N 1 a D.B.➢23933 9 /W. s POW 3o P 551°56'40"E 75.63' P n 5 4113665"E_ 14.70' 6j289 8g• .. t�• 5.105 Acres o O L WIN 672. s 2 ItIP 3p• �S w yN m ° 5.815 Acres +I.crop /s n°5615"w 6],32' / p pN' Z S•' by A� m,0 a olo P �S 38°51'25"E 70.95' u ? q uS a s 0 P „IP �S 55°20'00"E 134. 8' S 43°40'20"W 33.11' / O ` �S 36049'35"E 61.03' / 3 aF \ 10.640 cB kw S 53°13'O E 88.98 Acres Ib o S 25°22'35"W 124.63' / 0 0 !� 'on \ N 89 10'50"E 77.27 / N e a ° „ L 154.67' P 'w s 79•46 ,s'w 39.07 P ° / Z OP -- w 5.014 Acres 1 m v N P � I 6809. 6. S13°?,1 G 150• access easement7i /30•,w .on .20 ,I)p ,60, N / P 30• P " •0 60 ^ ` P 86°48.29..E P �_� I S 00. y L 1 / 117 L-2 L 3 L/ �to 36.40„`t, p S 76036'40 E 32.81' 369.2555!' g / 7 so,�^ g e pBcce S 83°39'50"W 402.06' e a a P 76 36'40" arcel ,r / 539--- 9 I / David U.HOnes S 3.2J'20' I O Owner : David M. Hanes Cont 301 Han Advance Total Area ► DAVIE COUNTY HEALTH DEPARTMENT . _ Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900641 Tax PIN/EH#: 5863-48-3164.04 Billed To: David M. Hanes Contracting Inc. Subdivision Info: Laurel Brook Sec. B Lot#4 Reference Name: David Hanes Location/Address: Griffith Road-27006 Proposed Facility: Residence Property Size: 10.640 Acres Date Evaluated: 7 Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit � Cut FACTORS 1 2 3 4 5 6 7 Landscape position L_ Slope% HORIZON I DEPTH ©' Texture grou &L L Consistence !� Structure c Mineralogyy- HORIZON II DEPTH I I - 3c) -3 Texture group Consistence F S P Structure Mineralogy ► r 1 HORIZON III DEPTH Texture groupC� Consistence i 5V MyJ Structure 5 POIC Mineralogy HORIZON IV DEPTH 3fc -42, Texture group Consistence r r-.SS S Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 5 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: PS EVALUATION BY: -14- LONG-TERM ACCEPTANCE RATE: O, OTHER(S)PRESENT: _ &lk. w, tD I-II 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 05/99(Revised) l Davie GountOYealth Department Environmental)Yealth Section PO Box 848/210 Hospital Street Mockwille,NC 27028 Phone. (336)751-8760 May 30, 2001 Grace Draman Re: Erik Blankenship 431 Riverbend Drive Bermuda Run,NC 27006 Re: Site Evaluation- Laurel Brook Lot 4-lA/5.365 Acres Tax PIN#: 5863-57-1695 Dear Ms. Draman: As requested, a representative from this office visited the above site on May 29, 2001. Based on the information provided on the Application for Site Evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an oversized, modified on-site sewage disposal system. Due to shallow soil depths and poor soil characteristics on the site, we will require that the septic system be sized at approximately 200 linear feet per bedroom, or 800 linear feet for a four-bedroom residence. This is subject to change as actual design and dimensions of the septic system will be determined at the time a permit is issued. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization 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. Please have the preliminary clearing and grading completed prior to making the request for the permit. If you have any questions, feel free to contact this office. Sincerely, Jeff G. eauchamp, �R.S. Environmental Health Section Enc(s) fAPPLICATION FOR SffE EVAWATION/IMPROVEMENT PERMfi&ATC IF Davie County Health Department Environmental Health5e0. on OV f 91999 P.O. Box 848/210 Hospital Street Mockaville, 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. Hama to be trilled��faUl 0 M J JR NC:S r.J 1�dCt�Vey-SAI' Contact Parson )A U�A C A IJ CS i Mailing Address 3 ck IA4V%Bi k r4-�% h Hose Phone Rq$' S 7 b 7 city/state/zxP 6 0\/C.v"GE.t'J. C.. .2-700(o Business Phone 1I9?-5bq1 m, a IJT-110 2. Mase on Permit/ATC if Different than Above Nailing Address City/state/Sip 3. Application For: 4411te Evaluation ❑ Improvement Permit/ATC ❑ Both s. system to services "Ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms ❑ Dishwasher O Garbage Disposal O Washing machine ❑ Basement/Plumbing O Basemant/No Plumbing G. If Business/Industry/Others specify type # People # sinks # commodes # showers # Urinala # Water coolers. Ir FOODSERVICE: it Seats Estimated Water Usage (gallons per day) 7. Type of Water supply: ❑ County/City ell ❑ 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 BESUBAR77ED by the client with THIS APPLICATION. Property Dimensions: �_.(tib{O Ac. WRITE DIRECTIONS(from Mocknille)to PROPERTY: Tax Office PIN: 0 r c • r (r+ t� Property Address: Road Name Cnk 1 kC i EI R3 City/Zip Nowonu: 2-7006 If in a Subdivision provide Information,as follows: Name: Each&' Q Ann K Section: ?1 Block: 1 Lot: LA Date Property Flagged: I"'0 1 ' This is to certify that the Information provided is correct to the best of my knowledge. I understand that any permits) Issued hereafter are subject to suspension or revocation,if the site•plam 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. 1,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 C-,J:to A-%. to conduct all testing procedures as necessary to determine the site suitability. c � 1 DATE I�1 y "(� SIGNATURE C THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property linea and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): ��` / Client Notification Date: ERS: �, �_ d DAVIE COUNTY HEALTH DEPARTMENT t Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900641 Tax PIN/EH#: 5863-48-3164.04 Billed To: David M. Hanes Contracting Inc. Subdivision Info: Laurel Brook Sec. B Lot#4 Reference Name: David Hanes Location/Address: Griffith Road-27006 —/ Proposed Facility: Residence Property Size: 10.640 Acres Date Evaluated: -[�1�g Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% ? HORIZON I DEPTH O' Texture groupG L Consistence Cc h}S Structure Q. c Mineralogy � HORIZON II DEPTH l l - 3vZ4-3 Texture group Consistence Structure Mineralogy ' 1 HORIZON III DEPTH Z Texture group Consistence —i 5, r.-r N6?.1 Structure st Mineralogy /h t HORIZON IV DEPTH -�F$ Texture group , Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE n SITE CLASSIFICATION: 1' �> EVALUATION BY: LONG-TERM ACCEPTANCE RATE: O• OTHER(S)PRESENT: 12C)Lj j4U,, o1W i b � :1 REMARKS: Z •5U0QQtX , i' 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 oist 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 -KHD_05/99(Revised) Tax MOP B-7 \ Virginia G. Walker Trott 1, D.B. 075-153 1 River Bend Hills i'L�/may N 89°5 5"E P.S. 6. P ]62 0 0�y jc_j David M. Hanes$ P to 1392.97• ` en 0�A e 0 •� 6 .77 a�L=SOC. L��2� ��►� '°�o .6� �� �19 -16 Ln Pyr p1 'p cr L-17 P L-1890 pfi t� O o � o�, ^ ,Q 5 64•Z� N io ^ rn pyo' 0'Its c 3 Acres 28 °�•,�� 0�a N 14.700 �•� oy a e\ P 97,50, S 88 08 .35"E .o��g� 6.1 bR a�0 0 o 6 070'45,,W axe ou °ne � P 1 �'Sa r ' �� �b�o °y0 t^ / 0tp G�'( C', O N 27 o 7^7 —'\ v / 00 S Acres 498 10. / . 26 axle at atone • S 10 057. ;o!t comer ^ 03 ?6800'F h v 2 rn / 'o �S 40°40'00" 91.88 1 :! :os.s\ E ' - � I `ne P S 51°56'40"E 75.63' point 3p 5.105 Acres o o oaS\4-1-636-05"E_.1;4.70' 632•g96 ` 72 g9, 74° ? na J (2, 'v N g 30' Sy'° J° /•`�� � 0 s ]7°ss•]s"w 5.815 Acres 87.32• x qtr, CA h �' CP F / u o ala P S 38°51'25"E 70.95' ��a S 43°40'20"W 33.11 9 NIP NIP S 55'20'00"E 134. P 1.03 8' • �f- 50 e o o �S 36°49'35"E 6 ' °ati 1 1 ( - NIPS 53°13'0 "E 88.98• / 10.640 Acres o 1 w �C- Co Q, N 89 10'50"E 71.27 S 25°22'35"W 124.63 0 0 � =-`� a NI 154.67' P cn NIP ' S 79°46'15"W 39.07' /� I B P i 88 lid"w '• a y(1' 0 DID ICo \ / � 5.014 Acres ran 1 Sp access P ' 68,09 6. S ¢0'K P o on. 0, easement�� /`30��, �`�?0,, g0, C%, o !P 3 ° l P' P i 6°48.2p E P P v15 of ' 6000, I 1YV ti to 1 L-2 L-3 L�4 :ti / 6°J6, ll P S E 32.81' 369.25 m I 40 f s0 ate^ p S s'e•36-40- 'r S 83139'50"W 402-06' 00 ee p$ece