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504 Peoples Creek Rd ' . . . � - ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section r.o.sog sasnio x�P�r�i sr��t . Mocksville,NC 27028 ! (336)751-8760 � � 4 � Account #: 990003056 Tax PIN/EH#: 5789-91-3014 Bilied To: Homes by Jonathan Lee,lnc. Subdivision Info: �"ay Reference Name: Location/Address: Peoples Creek Rd.-27006 � ATC Number: 4353 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 fireatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: /�Q���a''��l. Date: (f CERTIFICATE OF COMPLETION **NOTE** T'he issuance ofthis Certificate of Completion ' ate the system described on ImprovemendOperation Permit has been installed in compliance with Article 11 of G.S.Chap OA,Section.1900"Sewage Treatment and Disposal Systems,"but shall in NO WAY be ta cen rantee that system will function satisfactorily for any given period of time. /�a ���.� � �3 �!� �/ C���� � �u � � � Septic System Installed By: ���N cJ,P D /J�C Environmental Health Specialist's Signature:____�� /,� Date: DC�ID OS/99(Revised) , DAVIE COUNTY HEALTH DEPARTMENT , • ' _ Environmental Health Section ' ' ` � P.O.Boa 848/210 Hospital Street Mceksville,NC 27028 �. � (33G)751-87C►0 \� . IMPROVEMENT/OPERATION PERMIT 3\�� . Account #: 990003056 Tax PIN/EH#: 5789-91-3014 Billed To: Homes by Jonathan Lee,lnc. Subdivision Info: Reference Name: Location/Address: Peoples Creek Rd.-27006 Proposed Facility: Residence Property Size: 13.65 Acres **NO`���*�s7mpro4ement/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 �i� Dishwasher: � Garbage Disposal: � Washing Machine: � Basement w/Plumbin� Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply � Design Wastewater Flow(GPD) �� Site: New��Repair❑ ��vGAL. Pum Tank�.e�l�i GAL. Trench Width �� �� � System Specifications: Tank Siz p �� Rock Depth /� Linear Ft. �;-l�� Other: Required Site Modifications/Conditions: 11�9PROVE111ENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S) IF G"BELOW FINISHED GRADE. ****NOTICE: Contact a representative ofthe Davie County Health Department for final inspection ofthis system between 8:30 a.m.to 9:30 a.m. or 1:00 p.m.to 1:30 p. ifE�day of installation. Telephone#is(33C)751-87(0.**** � � �����p� �� �, �1 a,�.24t� 15 �� .y�� �� �@ � � �6�'�� ��� _ � � � � Environmental Health Specialist's Signature: r� Date: ` y �6 DCHD OS/99(Revised) � ; Mar 17 06 02:36p davie county envhealth 336 751 8786 p.2 . . , i . ' � � APPI,ICATION FOR SITE EVALUATION/IM t'ROVEMENT PERMIT&ATC , � ;� Davie County Iiealth Dc:partment Environmental Nealth Section � l�n, Q � P.O.Box 848J210 Hospit:►t Street ��'����"" ' Mocksville,NC 27�ii28 (a (33�751-8760/Fax(33�'151-8786 �� � � Applica4on For. �1 Site Evaluation!(rc;�rovement Permit 7 Authorizition To Conswct(A'fC) oth � '/3� �.` � ' •"IMPORTA/VT"`*THIS APPLIC.'.TION CANNOT BEPROCESSED 1.1?JLESS ALL OF TIIE REQUIRED O 1NFORMA7'ION IS PROVIDED. Refer to the INFORMATION�3ULLE l'IN for instrucHons. APPLICANT INFORMATION �S'� Name to be Billect �OJ���3Y�/�N/}'Tj/q.�/ L�L�l� Cuntact Yerson �N 'r LEG �S Billing Address22_3S-C L��y)SV/L/�CL�l�i+d�:� }lea�e-Pl+one S— 4� 3 � �99 O City/State/7_IP L In S�6 /YG 2?o» /`�B�,isiness Phone��(�•- 77/5 ? � Name on PermiUATC if Differer�!than Above �fi �GO � v Mailing Address _ City/�zte/Zip � 9G/�F ��� —� - F �r 6 PROPERTY 1NFORMATION , c�G�'�yy� NOTE: A survcy plat or site plam m�st accompany this application. � (Pcmut is valid for 60 month>with site plan,no expiration w� ccimplete plat) Street Address_T'/�+�C�L 2 8 City_�.�A/L� Taa YIN# S 7� �30� . Subdivision Name Section/Lot# Lot Size ''. 1'o S /�G Directions To Site: � � O � l.� QN SECv/�D L GS C O � c7�. l /?�/t-E oN �.���r-r <a. ; [.�c f , Date House/Facility C;omers Flug;�ed 3 0!v If the answer to any of the following qiiestions is 'yes",supporting documciiiarion st be attaclied. Are there any existing wastaHater systenu on the site? Q'''es�y Does the site contain jurisdi:;tionai wetlands? U"'es 91Qo Are there any easements or right-of-ways on the site? V"ts�y Is the site subject to approval by anather pubtic agenc}r? ❑'.`es 8No/ Will wastewater other th:vt c umestic sewage be generated? ❑"es B7Qo IF RESIDENCE FILL OUT'fFI:E BOX BELOW #People #Bedrooms �athroon:s Gard�n Tub/whirlpool es IJNo _ IIasement: . es DNo Aasement Plumbing: es ONo IF NON-RESD�ENCE FILL OUT THE BOX BELOW Type of Facility!Business . Total Square Fo�tage of Buiiding_ #Peoplc #Sinks #Commode:t H Showers #Urinals Estimated Water Usage(gallons�;er day) (Attach dc r.umentation of similar facility water consumption) FOODSERVICT:ONLY: #Seat: Type systcm requcstexl: onvcnticlal OAceepted Olnnovative OAltemative OOther WaterSupplyTy�u:'. ounty/City'JJuter U New Wetl ❑i.xisting Well f Community Well Do you anticipau additions or expat�sions of the facility this system is inti aded to serve?U Ye� L'Fo if yes,what type? _. .. This is to certify that the infocmation provided on this application is�ue<.nd coneet to the best of my knowledge. I understand that any pemtit(s)or.4TC(s)issued hcreafter are subject to suspension or rev�:��ation if the site is altered,lhe uitended use changes,or if lhe informarion submittcd in this ap�:lication is falsified or changed /umlersland thut 1 am recponsi6le for n!f charges incurre�t jront this application. I hereby grarc right otentry to the Authorized Repeesentative of the Da�ie County Health Departmcnt to conduct necessazy icupections to de�,:mtine compli�nce with applicable 1,:�Hs and rules on the above described property located in Davic County and owned by CI�Fr'�ST/��J� f��i!i(���(.,(�� �'CRS 1�8Y�tC� ��' v'�n�/�lT�/1/ �LZ�C� �i►+'C �. /��lJw�- Site Revisit Charge Pro eriy owner's or owner's legal r.�presentative signature Date(s):. Da� G � (� Client NoGfication Date: � EHS:_ Sign givcn OYcs ONo Account il ��(J� Revised 2/06 Invoice# : . � DAVIE COUNTY HEALTH DEPARTMENT " ` � ' ' ` � Environmental Health Section , Soil/Site Evaluation � '" APPLICANT INFORMATION PROPERTY INFORMATION" Account #: 990003056 Tax PIN/EH#: 5789-91-3014 Billed To: Homes by Jonathan Lee,lnc. Subdivision Info: • Reference Name: Location/Address: Peoples Creek Rd.-27 06 Proposed Facility: Residence Property Size: 13.65 Acres Date Evaluated:����/�� Water Supply: On-Site Well Community Public _� Evaluation By: Auger Boring � Pit Cut FACTORS 1 2 3 4 5 6 7 Landsca e osition L..., ,C,., Slo e % ?/ a � HORIZON I DEPTH �/�' �� Texture grou ..fCL SC L Consistence �� ,, Structure � Mineralo HORIZON II DEPTH � '� 3 �� Texture rou G Consistence / � Structure �� S' I�, Mineralo HORIZON III DEPTH L �� �`� Texture rou "' Consistence Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE � � SITE CLASSIFICATION: �� EVALUATION BY: � �- � c� LONG-TERM ACCEPTANCE RATE: � OTHER(S)PRESENT: REMARKS: LEGEND L�ndscape Position R-Ridge S -Shoulder L-Lineaz slope FS -Foot slope N-Nose slope CC-Concave slope CV-Convex slope T-Terrace FP-Flood plain H-Head slope Tsx�urg 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 ('ONSI�T .N F, MQlst 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 SYT11f�liLg SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic � Mineraloev __.-------''�'_^ 1:1,2:1,Mixed �`�'�" Li�tes 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 OS/OS(Revised) ■■���\����■■■�■��■�■�■�■���■��������■����■■■■■�■���■■■■�■■�■�■�■�■ 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VeriSedbY:.......................................................................County on lhe ................daY of........................,........;.:.......:............, 19....;....... . . by .......................................................:.............:...........................................................................................................:..:........:....................:......... , Map after recording to .....G&�1TEE..@...2k.34...PIlIPERNII...DR1oE.....WAI.DORF.�...�tD.....�Ob9.3.....................................:.................. .............................................................................................................................................................:.................................................................. Thie inatrumeut w.ia yrepared Uy. ..SAT.LY..W....SMITH._..MARTIN,,.VAN.110Y,,,�,..5?11TN, A'1TYS,..(�OGI(S.V.ILLE..,NC...,. .... Brief description for the Index NORTH CAROLINA G�NLI2AL �APPANTY D��D TFIIS DEED made this..�5...day of����9r' ,1�.��-,Ly and between GRANTOR GRANTEE JAMLS E. il1IEI.AN AND WIFE, JAMES TIMOTHY WHELAN (DIVORCID) F.DYTfIE S. WFIELAN • , Enter in apYrupdate hiock tor each Dar{y:name,sddress,and,It appropriale,cHaracler o(enUty,aq•curporaliml or pnriners2dp. � The des(gnation Grantor and Grantee as used herein shcill include said parties,thcir hoira,successors,and assigns, and' shall {nclude aingular, plural, masculine, feminine or neuter us reyuired by context. WITNESSETF�; that the Grantor, for a valuable consideratiun paid by the Grantee, the receipt oY which is hereLy acknowledged, has and by these presents does grant, Uargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of]aud siluated in the City tif.................. ................................._., .. ,..:...$iIAbY.GI[OGE. ... Townahip, _.DAVxE.................. . ...County,North Carulina uud morc parLiculurly descriLed as fullows: BEGINNING at an old iron in the northwest corner of the within-described tract common corner with Eeebles Property which iron is further located in the eastern portion of SR 1650 (Peoples Creek Road); thence £rom the BEGINNING running in said road North 42" 26' 28" East 249.13 feet to a new � iron pin in the northeast corner of said tract in the western margin ot said road common corner with Bowers Property; Chence with the Bowers line South 70° 31' .52" East 1028.25 feet to a new iron pin; thence South 64° 07' 00" East 1142.57 feet to a new iron pin in the southeast corner of. said tract common corner with Bowers Property and M.C. Benton in the Peebles 11ne; thence with the Peebles line North 85° 53' 05" West 1386.86 feet to an old iron in the Southwest corner o£ said tract; thence continua.ng with � the Peebles line North 35° 28' 05" West 462.15 feet to an 'old iron; thence with the Peebles line North 70° 31' S2" West 545.26 feet to the POINT AND. PLACE OF BEGINNING containing 13.65 acres as shown on a survey dated July 2, 1975, by Dermid and Clayton Engineers. Said tract being a portion of a 296.29 acre trac� of M.C. Benton found in Deed Hook. 77 at page 611, Davie County Registry. SWS/NTE . �..�.._.._��:>:..,rii�l C".....,. . .��1is.��- �,��.�1sm-+e� N.C.Nar A��uc.F��r�n Nu.3'C)1976.Re�'iud IG1 1977...�unn wnenn.�Co..iM..no.13).YaJkimili..N.C.3]055' L'�'•{" . . .Pr�niw��irnarrmen�wi��tMN.C.Ba�Rwc.—�98� . �i�••••.��.... J•; � . . . . . . . . . . . ._ . J . . . .. . . . . . � . . . � � . � � . . . . � . . , . . � . . _ , . . � .. . . . . . _ .. . . . . . . ; �. . � � - . . � � � . � . . � . � . . 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C�e ��., i , ,�.�, � ��� i tk lR�ti r'N� � � � / � � I � � � � ��� ' � � �� , ���y''�" S >0•31,3j� � � � � �, �r � � I �}/� � 1— ::�' PnvcD 234 34 f�� // �� �• � �+� � � 1Y I I l�`i %/C-Jft"Ci� ��d--�� 'CL`� �� � f;;. / `.� �� � �� v I •B � �� N 5*S `\ i ��-� `' "R�N;�c •a �. r5 I �',30��,� ' � 4� r / ;,� � S' _ � ,`= ', � o ar kl .A � � .�1 s�, y `` � �09 8j �a31 3j��6 // _ � ��a i G 533 � � ` ` ` ` ' ± 'X�s f ��2 � � � � � � � �0�� / /R���NC S3,39 W� � � � � � \ � �/ � � � � ` � ` �k/ NG )1 1 I \ � CNT' 6 I `' ) � � � �k����i^�r � i ` � � i - � � � �' � � / A�_ ' i � � t �`r,9�,. � � ExiSt�r;; \ ! � IRON ' MT. SINAI A. � r � I � M.E. C;�RC8 �. F.�,S. _ _ D.B. 1�'8, PG. 7:3r3 � 'Roti'fNc � — " -- — -- — — — — D.B. 54, PG. 4;�: TOT,q � p.q —1 � AREA= 13.654 AC. S 6 �� I UL GARLAIVD y, My,�Rs f ti ��,� �.R ,� Rrr __ 4°''oo?60 � �8 � �� EDITH a!}'ERS { `�s.p�'� 3,9 e� � �9, p A''��, D.B. 9 6, P G. 4 8 5 I `�'-`�� '9 i G 3s ' . p> . ' . . . . . I y � � I ' N O,� I � %ooti r,�,, �; v�i� f � o.. I y L _ _ _ _ _ _ _ _ _ _ _ , � � � _ - - _ - -- - -- - -... _, _. ._ , I� SI�'.�,3 _ ___ _ _ _ --- - -_ _ _ --- -- - --- - -- ---- --- -----~-~� -- - - _ - - ------ - -- - ----- --- ------ - - - - - -- --- _ . - - - - -- ---- ----- -- - - - - -- - - - - --- --- ---- --. - ---- _ _ -- --- -- ------__ _- -- --- _ _ __----- -- - - -- - - - - - - - - `�, ._ k��a� _. � - `,�ay��e tls�e ���,``��'�a��4`J��i � O�°� �;G.S.SjQ��•���ri✓ 23$7,01 � ?'�Q�O y9��:� �. - N 85'S3'00' 4 � ' .�L�,�;� ;�:.� L-2�27 � � ! /e�,—Sn— _'- - - - - - - ,�.yy o?'�,� 1 ��ry N� ;9�"'�S�-1R�� � O` ' .,� r`:.......���� .. �� � ,. � ,����+r���e�oe��� CLIFTQIY �. P��PLES III RUT}� J 10HN E. WOLTZ Jr. MY DI REC T I ON ANII SUPER I S Ij�N, TH I S MADP R DULl"�. et Ql ( ��8� 3�8' ��"' 431 � D'B• �BJ�, PG. �Z14 WAS DRAWN �ROM AN ACTUAL FIELD SURVEY MADE BY TUTTER�W SURVEYING COMPANY, � � � —�� � ; � ---- -- - '- -------------- � PROF"ESS C] L LA b SURVEYpR L-2527 � TUTTER011 SURVEYING COMPANY y" �>. 107 NORTH SALISBURY ST, � "' `�;; MOCKSVILLE, N, C, 27028 �' (336) 751-5616 �� ,�(/�t � ��`1� �S�/�}- PLAT OF SURVEY FOR, CHRISTIAN SPEAS �,A 1t�1�'.HELLE SPEAS RE�t t s iows �„ , t" � 100' �D �� �� � Fi� w►►� K5-GD00 � bEC-12-2001 GL.TUTTEROW JOSHUA , a �, PAUB04VER-28 1OO SO O IOO 2OO 3OO BEING 13.654 AC. TAKEN FROM THE JAMES T. WHEIAN PROPERTY (D.B. 162. PG. 189) LYING IN THE SHADY GROVE TdWNSHIP � DAV(E COUNTY, NORTH CAROLWA " � SCALE I N FEE iT nwwir�c ,�m TAX REF.: H-9, PARCEL� 28 33601=4 ...., ,.�,.�