The URL can be used to link to this page

109 Marchmont Dr Lot 17 AUTHORIZATION NO: ,11 9 6 DAVIE COUNTY HEALTH DEPARTMENT .. Environmental Health Section PROPERTY INFORMATION Permittee's P.O.Box 848 Name: Mocksville,NC 27028 Subdivision Name: j +^ Jiv1� Phone#:704-634-8760 tM Directions to property: 1. Section: Lot: .AUTHORIZATION FOR .+� WASTEWATER Tax Office PIN:#—Cr SYSTEM CONSTRUCTION Road Name: E'd. eS 6 3etip: **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits.This Fonn/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) k.11 ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALIDFOR A PERIOD OF FIVE YEARS.ENVIRONMENL EALT SPECIALIST DATE ISSUED ' .yam . ir y'". '�:F..i F-. f»F ... ..-♦ _ .. .. ._ ,. 1196 DAVIE COUNTY HEALTH DEPARTMENT ^� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION - )'. Name: 'r Subdivision Name: Directions to property:' Section: Lot: - IMPROVEMENT PERMIT Tax Office PIN:# Road Name: /c,4 desi � E:� ►1P � r 4("6�v f **NOTE**This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system.An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the constructionlmstallation 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) ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER ENVIRONMENTAL IMALTh SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE. INSTALLING TIRE SYSTEM. RESIDENTIAL SPECIFICATION:BUILDING TYPE // #BEDROOMS?#BATHS r #OCCUPANTS 2 GARBAGE DISPOS .Yes r No COMMERCIAL SPECIFICATION: FACILITY TYPE/J #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZE 7112 TYPE WATER SUPPLY / DESIGN WASTEWATER FLOW(GPD) tri O NEW SITE L� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ' LINEAR FT.'1 OTHER REQUIRED SITE MODIFICATIONS/CONDMONS: IMPROVEMENT PERMIT LAYOUT IA44 "CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-8760. OPERATION PERMIT +� SYS M INS: ED BY: ` JAA) ATL= P,cx�c.►-t 72-3 S� Y. N AUTHORIZATION NO. OPERATION PERM Y• DATE: 2 "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE TH SYSTEM SCRIBED A O 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. DCHD 05/96(Revised) APPLICATION FOR SITE EVALUATIONAMPROVEMENT PER • Davie County Health Department 0 Environmental Health Sectio l 0 / P.O. Box 848 7� 6/ JAN 16 1998 9 Mocksville,NC 27028 G ( 0�> (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED LESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed RAHARD PRESSLEY Contact Person SAME Mailing Address 7905 BARKLEY ROAD Home Phone 704-483-8748 City/State/Zip SHERRILLS FORD, NC 28673 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: [ ] Site Evaluation [ ]Improvement Permit&ATC M Both 4. System to Serve: [x]House [ ]Mobile Home [ ]Business [ ]Industry [ ] Other 5. If Residence: #People 2 #Bedrooms_3 #Bathrooms'_ M Dishwasher kd Garbage Disposal M Washing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing 6. If Business/Other:Specify type Air hangar garage #People #Sinks 1 #Commodes_1 #Showers #Urinals #Water Coolers If Foodservice:#Seats Estimated Water Usage(gallons per day) 7. Type of water supply: [mss]County/City [ ]Well [ ]Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes N No If yes,what type? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED:***IMPORTANT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: App. 170 x 450 WRITE DIRECTIONS(from Mocksville)TO PROPERTY: Tax Office PIN: # G _ 9 _ 22 158 East to 801 Property Address: Roads ame People's Creek 801 South to People's Creek City/Zip/Zi Advance 27006 Lot located at intersections of � If in Subdivision provide information,as follows: People's Creek Road and Marchmont Name: Marchmont ; Section: Lot#• 17 ' 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 Jerry A. Hauser o nduct all testing pr e e as n essary to determine the site suitability. DATE A SIGNATURE Revised DCHD(06-96) THIS AREA MAY $E USED FOR DRAWING YOUR SITE PLAN: See attached •S. 4 .� � 1 ,2 3 - >; ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME - le"m DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE SUBDIVISION / /SZT�i h��' ROAD NAME Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe% HORIZON I DEPTH �� Texture groupS G' L L Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure /C S/f/l Mineralogyf 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: EVALUATION BY: � 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 I 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(O1-90)