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122 Oak Leaf Ct Lot 13 DAVIE COUNTY HEALTH DEPARTMENT '� + Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900063 Tax PIN/EH#: 5708-06-7210.13 Billed To: Larry McDaniel Subdivision Info: Oak Crest Sec.2 Lot#13 Reference Name: Janice McDaniel Location/Address: Davie Academy Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2536 **NOTE** This Improvement/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 HO osz #People a #Bedrooms Z — #Baths 2- Dishwasher: 12�' Garbage Disposal: ❑ Washing Machine: 2f Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size p. Type Water SupplDesign Wastewater Flow(GPD)3-0(J Site: New Cid" Repair❑ System Specifications: Tank Size ICMGAL. Pump Tank GAL. Trench Width -3t-,.Rock Depth IZ" Linear Ft.3C(:� Other: I 01STa%3JTt0,�l w)C Required Site Modifications/Conditions: 1"�SS'TALLI Of-) Cz)-Z`ro0Q 14--7`P,5 � ©� 1e- Id e)(T-A&- IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT 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 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** I �2)i 1 3 Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) VU • + + DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section y . P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 989900063 Tax PIN/EH M 5708-06-7210.13 Billed To: Larry McDaniel Subdivision Info: Oak Crest Sec.2 Lot#13 Reference Name: Janice McDaniel Location/Address: Davie Academy Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2536 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 WASTEW C RU ON I ALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatu e: Date: 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. Qv �, N o u s; �n Septic System Installed By: Environmental Health Specialist's Signature: Dat • DCHD 05/99(Revised) 1 • •APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT do ATC Davie County Health Department Envfianmei Pftf HwIth Sactfan' P.O. Bos 949/210 Bondtal Street AUS 2 2 2 00 Mtookoviile, NC 27029 (336)7'51-9760 ' ENVIR�ti�GE�j�A��ALTH 9 ***IWgR=NV** THIS IIPPLICUItiMT CAM= BS FROWSW X88 ALL I= UQUtRiII'—~-- ---� IMll7O52MIM 18 PRtIiV M. Refer to the IHl+OA MICR BULUTIMi for iast=Gtiona. n , 1. Nene to be au ed, n J1 contact person n 1 U)c-MC-Ch lwto JV Ira 14 addressKTFmor phone �o• Qq lS- 4U 3a citt/atate/S= NVlrr M6Ile . tiL 5310- -15 t- g0aa s. News on pesait/hsC u Different thm above 1�a rry h CIS n i o.0 guilde-rs nc . �lailinq address PDX 51 -1 eitt/erste/:ip �(�K�UI l l�. >\1C a70:�R 3. t MUcation Icor: p Site ivaluation Improvem at Permit/ATC 13 Both 4. atstea to ser hoe: /tj House O Mobile Home o Basiaeas O Iadustsy 13 other S. u Residence: i People ! Bedrooms _ • Bathroom T(A�her O oarbage Disposal Ant""* Machine a masment/PluMAW O ma.eaent/No plvia AW G. sf alieiaeee/Iadwtrt/other: speoift two People h tiara 0 Cawood" f shover. # urinals I Nater coolers I! YMSXMCH: # Seats _ estimated Water Usage tvalloos per day) 7. Type of water supply: )<Founty/City 0 Well 13 Community s. Do you aatkipate additloot or e:pausioas of the facility this system is Intended to serve? D Yes 0 No If yes,what type? ***IMPORTANT"**CLIF.MI'S UMT COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MGSTBESUBMITTED by the dint with THIS APPLICATION. Property Dimesslons: S Pee l WRITE DIRECTIONS(fres MoclovWe)to PROPERTY: Tax Office PIN: 8 I"-35? PI YT-4 6109- o6" rip-1 0 .13 f ISL Property Address: Road Nalne TTU c+ymp14- ft 194 Ar\1�960- AZadb A' Q-21 If in a subdivision provide Imformadou,as fellows: CO&yUQ ox, .11.1, Name: rlkP-,3 L04- -k n-I,S (7-A Y 1 Q-Q-) Secdous a Blocks _ Lots Date Property Fagged: �- o This Is to certify that the information provided Is correct to the best of my knowledip. I understand that any permits) land hereafter are subject to suspension or revocation,U the site platy or intended use change,or U the laformmtion submitted in this appllcadoo is falsified or changed 1,also,andmiand that I an raposulbk for a0 ekoges hwurrtdfrom Ibis appika'toa. I,hereby,give consent to the Authorized Representative of the Dqk County Heal pmrtment to enter upon above described property located in Davie County and owned by S nC. to conduct all tee ft procedures as necessary to determine the site suitability. DATE OL SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the fallowing: Ezls ft and proposed property lines and dimensions, structures, setbacks, and septic Iocadon4 Moa lJ' -' Site Revolt Charge Date(s): 1a-•��' Client Nodficadon Date: y. -V ERS• JAccount No. 3 Revised DCSD(07/99) ,3�- Invoke No. .subject to an easements.rwrt–of-rays. "04K CREST" CALL TABLE Davis Aco nents.N any.as the some nay appear of Phase 1 /SR 1 of the Register of Deeds Clerk at Court. COURSE BEARING DISTANCE No tfwY got Ir/ Orrice or rddeh may have bean acquired by PB 7 O PG 82 L-1 S 88°46'03"W 23.72'Chord Radius: 30' c ° ullsurvey is subject is any facts that may �- 1 2" EIR L-2 S 88°46'03"W 39.53'Chord Radius: 50' SII and oeeurab title search,NOT furnished ��� / - L-3 N 45°09'51"E 34.73'Chord Radius: 50' .q and any accompanying N 7g 22 ,ished to the persan(s).named 04, T79 . srations or use by others authorize!by 1/2" EIR V 06 ;ng Co ation. +� t N 13 Vicinity Map (Nc Z 0.689 Acres +/- J W I 14 ° N � 12 „Op aye I aa.ar a "OAK CREST' Q� 1,V ProposedHousPhase II t9 ro � I iA00 E at ,�uttnrhrffr,, 1� a N CARO< UR a r J I •F• � •�te / � I 5'Utility Easement E + � "OAK CREST' 1111���� _ I / s��n . 20 00 , Phase 11 1/2"EIR �� 1? 1 2'E7'/2"EIR 1/2" EIRTypical 1/2a EIR � ( o P®Fft I" db -0 tV L-31 ¢:W: 4,7 66.91' S 65°29'02'V 175.00' S 65°29'02'W Tie Line 3 Jr •_ Q •�� Oak Leaf Court vi "OAK CREST" 50' Public R/W 20' Pavement ti Phase II — — — — ID � S'Utility Easement 0 I LEGEND a Typical I y CL-tet r�° 17 18 I 19 epeby EP–Edge of Pavement O O O FC–Faced Curb invent PP–Power Pole Lot 13 t 1/z^ VN- nt�ol°e "OAK CREST' "OAK CREST" "OAK CREST' "OAK CREST' Phase II :� hyo-=ode'tame Phase 11 Phase II Phase II Plat Book 7 O PG 121 Part,naetipPipe• e_�a Easement 0.689 Acres +/- by coordinate computation Boundary Pipe P8–Plat Book Survey for: s TOWNSWP STATE DA iastic Pfpa ce–Catch n es FTs_ �el�,�t 1" = 50' Calahan Davie North Carolina 8- Boc– of Curb o 50 100 150 SuRErED: Stone Land Surveying Company ,io, Larry K. McDaniel MT.MS George Robert Stops PLS L-3182 S5 MAPPED: 113 Drum Lane Phone(336)998-4733 M/ ALC — FEET GRS Mocksville.N.C. 27028 S5 Im APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATCDavie County Health DepartmentEnwfivamenta/Mealth Section P.O. Bos 848/210 Hospital street Mockeville, NC 27028 (336)751-8760 ***nIwORT7"** TRIS APPLICATION CAMM = mommy malls TILL ?Ric REQUIRED IMFMMTIOM Is PROVIDED. Refer to the nVOMMIM BU=TIN for instructions. I.. Maas to be Billed, /irra ffanieJAINdcls IhC,-• Contact Parsons i r- m -(_1.c M 1 o KailbV Address �nEaen-i-i some Phone 33(-0-- Qq GO- 4 LD 3a City/state/ZzP Mff y'56Ile_. NCS a l(Y" $ business Phone —D(D- 151- 9ODLa s. Mar on Permit/ATC if Different than Above L arra McLani o 0 gu i Ide rs Inc. railing Address Po a( `�1 City/state/Zip M 0 ISSUU lf.. NC c9-7�2$ 3. Application ror: Asite Rvaluation 0 Improvement Permit/ATC 0 Both e. system to service: - House D Mobile Home 0 Business 0 Industry 0 Other rr11 S. If Residence: # people # Bedrooms —_ # Bathrooms d- Mshwasher a Garbage Disposal AWashing Iaohine O basasrsnt/Plnabinv O baseasnt/no PlisbinQ 6. ZZ susinsss/Industry/otherr specify type # People # sinks # Commodes # showers # Urinals # Yater Coolers Ir rOODSERVIC3: # seats Zstimated Nater Usage gamont par day) 7. Type of Water supply: County/City 0 Well 0 Community e. Do you anticipate additions or expansions of the facWty this system is intended to serve? 0 Yes 0 No If yes,what type? ***IMPORTANT"**CLIENTS MUST CbWUMTHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: S e4:nl b(�,Oj� WRITE DIRECTIONS(from Moekaviile)to PROPERTY: Tai OMce PIN% # 300 RLI 1 26 Q(0— r1a.l Property Address: Road W16u i e N dent City/Zip_r(b( Y ,I IZ ftO 164 e If in a Subdivision provide information,as follows: A+ Name: DILL I.X)+ 4, fl-6 cTA rr-Q_QJ Section: 02 Block: Lots Date Property Flagged: This Is to certify that the Information provided is correct to the best of my knowledge. I undersbud that so petvd4s) 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 falsilled 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 Dayie County Heat0hpartment to enter upon above described property located in Davie County and owned by S Y1C to conduct all testing procedures as necessary to determine the site sal y DATE `�"oQ-`Inq SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(In de aR of owing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: 53� Y EAS: ` ! Account No. Revised DCHD(07/99) 3 Invoice No. r•_ Tax Lot 38 6.4 Acres +/— Angle Iron Stake Found Total 000 35x•34 3 • /,O �'W N 36.34 02 222,34 1pp.000 1/2" EIR 00 M1 4 '" O �O ~ 30,000 SF + N 30.000 SF + ;0 ^ h � o �' 17 l k 30,000 SF + o 30,000 SF + W 41 � � �•��•. ,y 34.73 �>''I•' 212.98 _ o, g � N 3.� �•g6 1 o u �n c h0 . N N 53.00' 39.53' ~ 13 1 B 23.72 23.72' � 30,000 SF + ;-- ttQ�� m x 30,000 SF + `O 12" ap to V snt N 18.40'28"W 172.68' 15.00' N 23.5423'W 192.35' 04 }- 19a 12 :♦ N g 30,000 SF + 30,000 SF + o � N i2 to N V) 116.82' 35.69 112 EIR 50.00' — ---'� — — ---- — —' � 102.50 30.54' S 22026#21"E S2302 •+ IRS 30.02' _�_ --- 291.95' p 96. + Davie Academy 1 RR Spike Found ` DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900063 Tax PIN/EH#: 5708-06-7210.13 Billed To: Larry McDaniel Subdivision Info: Oak Crest Sec.2 Lot#13 Reference Name: Janice McDaniel Location/Address: Davie Academy Roa -2702 Proposed Facility: Residence Property Size: See Map Date Evaluated: d� 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 Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC Consistence , Structure .0KIA /9 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: 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 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)