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181 Cecil Dr Lot 4 �Xa r - DAVIE COUNTY HEALTH DEPARTMENT 504,�) 7,. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'NOTE:Issued in Compliance With Article II of G.S.Chapter 130a Sanitary Sewage Systems Permit Number Name ::.\,� t � . �_ ` t� ` \ Date + �� (- NO_ 8196 Location� -� ry c fa 4 -_�� \� C+ y t�c�c > _ �� �`t—.`_'�. t7 C�( , L7 "')� r�.� . Subdivision Name Lot No, Sec. or Block No. Lot Size t'' ��-' — House —� Mobile Home —_—_ Business -- Industry No. Bedrooms �D No. Baths — _ No. in Family _ Public Assembly Other Garbage Disposal YES p NO p Specifications for System: Auto Dish Washer YES p NO O Auto Wash Ma^hine YES -NO Type Water Supply 'This permit Void if sewage system described below is not installed within 5 years from date of issue. . This permit is subject to revocation if site plans or the intended use change ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS SYSTEM. 7 1J y •1-f t' .J ) w Improvements permit *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985. Final Installation Diagra System Installed by F_uF N ' 3b� lye ku�n, t - l30' �r r� 1 ,.. .. 'J ,ro,... .. Certificate of.Completion _� -�__ Date - 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. @'[E ow I PLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 `3%A- ) 1. Application/Permit Requested By - Mailing Address Vao Home Phle R(P( U ---1 k4 COG Business Phone—IQ� 4n-,:�y D-7 2. Name on Permit if Different than Above 3. Application for: ❑General Ovalluation Septic ank Installation Permit 4. System to Serve: Q House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Ind ry ❑ Other ❑ Unknown ILI 5. If house, mobile home: Subdivision �(�� �15� �C � Section Lot # ❑ Basement/Plumbing No. of People YVW asement/No Plumbing No. of Bedrooms ashing Machine No. of Bathrooms ]] ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public Private ❑ Community 8. Property DimensionsSewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? "NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: -m"n ��'n ass C'd�� Cpu _ �9--��- Y"t� oo d. Av-(?-Q-s C>C This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. DATE— vSIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED-PROPERTYC Fanddispos ECK ONE: ❑ 1. 1 OWN the property. Q 2. I DO NOT OWN the property. ked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: ve consent to the authorized representative of the Davie County Health Department to enter upon above described cated in Davie County and owned by all testing procedures as necessary to determine said s' 's suitabili for a ground absorption sewage treatment a}-�y9 em. DATIN SIGNATURE DCHD'(1/93) DAVIE COUNTY HEALTH DEPARTMENT ' A Environmental Health Section Soil/Site Evaluation �j/✓�l/l� NAME Il 1/ DATE EVALUATED 71 ADDRESS PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITE Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Sloe Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure 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: EVALUATED 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 .lay loam, SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Moist VFR-V,--.-y 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 .3C-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(01-901 ■■■■■■/■■■.■■■JrG!�■11■■/■■■■■.■/■�■■■■■■■■■..■..■.//S■■%.''■■/./NOON■ ■■■■■■.■■■.■..■■►`�.■■■■■■■...... .■■■■■■■■■■■■.OWES■//■KG MEM■N■SN ■..■■■■.■■...■i�■►�i��■■...■■.■../■.■/..■.■.■.■.■ ■..i"SUAI■,■■.■■■■■■■ ■■/■■■.■■■■ !e!�����■■■.■■■■.■■■■../■.■/■■■ MOMMEM No ■■N ■ ►!■■■.■■■.■■■. ■■ w SNOW MONOMER ■■■/■■■S■1!�i��:���i:1■■■■■■■■■■■■■■■.■■.....■■ISS.■■■SOH..■■■.■■ ■.!:%...►! \��� �\I!1ls'\tea.\...■.■■■.■11►1■..■...■./. 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O. Box 665 Mocksville, NC 27028 AUG - 9 1995 1. Application/Permit Requested By Mailing Address /4.:?- rr0/ A) Home Phone A(C- oq r1oQ6 Business Phone 2. Name on Permit if Different thin Above 3. Application for. f(General Evaluation ❑Septic Tank Installation Permit 4. System to Serve: 'House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown vI' 5. If house, mobile home:Subdivision 0: N e- V'e� l{C es Section Lot #'a i. ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms 3 ❑ Washing Machine I• No. of Bathrooms 2- ❑ Dishwasher Dwelling Dimensions .3d X CD ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No.of People Served No. of Sinks No. of Commodes No. of Urinals i;•. No. of Lavatories No. of Water Coolers No.of Showers Water Usage Figures 7. Type of water supply: ❑ Public {Private ❑ Community 8. Property Dimensions Sewage Disposal Contractor ! 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No . If yes,what type? 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to " revocation, if site plans or the intended use change. Effective October 1,1989. Directions to Property: k . � t n r � J . Ni Nq SCS e /ve-w p� gC-AI N� This is to certify that the information provided is correct tot st of my knowledge, and I understand I am responsible for all charges E incurred from this application. I DATE NAT i _ A�2w CONSENT FOR SITE EVALUATION TO,BE.DONE ON ABOVE DESCRIBED PROPERTY F CK ONE: ❑ 1. 1 OWN the property. �. 1 DO NOT OWN the property. ked Box#2, the rest of this form MUST be completed by the owner or a person authorized by the owner: e consent to the authorized representative ofhg D vie Co ty Health Department to enter upon above described ated in Davie County and owned by all testing procedures as necessary to determin id site's sw li for a ground absorption sewage treatment �stem. � C DATE SIGNATURE DOHD.(1193) Int A; ( I s. M{CASHIN,.JR. E1.144.PG.75• CHARLES R. BOGER I' ).B.91 PG.511 I O.B,162 PG.764-766 I N 88'24'10" E afoot 393.56 S 82.55'47" f E/P 427.62 (al fence tomerl AiS e. +� � m m Aw-A m r' o J1 m to AMA C EOM o3 n ' ti� 1 n m i •tV .t t 1421.91101011 3G8.53 25.00 MP N 87'41 55" E MP hr �_ S 87'4r55" W 2500 396.91 •. 1393.53 total) I f RO i i I Q MP . I I AMA vLgaWY 6WVUuES • � I r'i °' I I C. ELLIS LEAGANS EDWARD H, LEAGANS LI GEORGE H. LEAGANS D.B.97 PG,474 I I (421.91 total i AQP IMT N 87'41'55' E MP 25.00 396.91 I � L NIP _ I I _ AIWA =5120'D ACRES I I JIWCLLCCS $A 14.76 R/SN . I • I3 I o h nI Sit 135 I I PUE)Dti G RIDGE ROAD I I frP nart i topp o NIP (� aroadl FLO:oulAolEl c ---•_--�_—�. � r/r spike '_"�^— �'�--�� '� r/r spidr S.0'north oI 1:1 '9 B9. y49 sO�, J 'r9 /p?J• /./�. /9. 9. 0 Agf7VFTV/!f 96e J•h vPJ?•�,h 6'9 Off, J�09 j EIP-EXISANG IRON PIN J IRON PIN . 1 R �Otl:' • DAVIE COUNTY HEALTH DEPARTMENT -�- Environmental Health Section Soil/Site Evaluation NAME1;,��a�e ; DATE EVALUATED ADDRESS �l J � PROPERTY SIZE PROPOSED FACIILTY �'�` LOCATION OF SITE 114 �S, Water Supply: On-Site Well _ Community Public Evaluation Byttl_ - Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape 2osition $ .7 Sloe z 9- 130 S, HORIZON I DEPTH - Texture groupL Consistence Structure G Mineralogy HORIZON II DEPTH 6 ' Texture group C Consistence Structure 1� Mineralogy ;� •� HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS 5 S RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION •5 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: �`�' ' EVALUATED BY: �! LONG-TERM &CCEPTANCE 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 :lay loam- SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Moist VFR-Vc.-y 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 3C-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 Ilorizon 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(01-901 ■■.■.■■■■■....■■■■■■..■■■.■...■.■■■■■■oaa■ ■ ■■■■E.i�■.�n�rn��■ern■■.■■ ......................■■.■■■..■EO.■■■■■M■■■�■■■■■Mil■ ■■■■■■■m■■■■■ ...............■................■......... ......■. ..■■■■■.■.■.. ■.■■..■.....■..■■...s■..■.■..... .a......■■■■■r.:�■ ■■■■■■■■■■■■■■ MOM M ■■■■■■■■■■■■■.■■■■..■■.■■■■■■■■■.■.■■■■■■ ■■■ /�! ■■■ ■■MEMO ■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■.■■■■■■.■■■■■N�ON.�i�/���■.■�■.■■■■■MI■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■. ■wwIEEE\■N■■■..■■■..■■MEM■ONNM■■ ■■■■■■■■■■■■■■.■■■■■M■■N■■■■■■■N.■■Nru■.■■■■H■■�■�■..■■NH■■NNE■.■ ■...■■.■■..■■■■■■■GI!�....■■■■■■.■11,1■\■/�■■■■■■OMNN■ ■■■■NOON =NM mm mom ■■■..■■..■■■■■■S■I,/►:sE►■■■■■■■■■ ■■■■■■■■a■N■ mom■■E■EM- - --EMIMMEMEMEME 0 ON ■N.. ........u■■■■■■■■.O■■■■O■■■■■■■■.■■■■■.■■■■H■�� MEMO ■■■■■■ ......■...........................■............ ■ ME MMMMENM■N CC::MIMMMMMMMM ■■..■■■■■..■■■■■■■■■E..■■■■■■■■■ ■■■MH■■■■■■ ■MOM■M■■ MEM■ME. ■.■ HE■NH■NH■HNN■■■■NNNME■O■■NN■■■■M■M■■MN'�■�■HMH=■C NOON■N■ ■■■■ ■ ■N■■.N■.■N■■■■■.MN.■■MN■■NMN■■■■■�■ ■■■■■■ ■ ■■ M`iM■M.■N■MsNE ■= ■■■■■■■■■■■■■■■■■■..■■■■■■■..■■u ■ ■■■■ ■ ■ ■■■ ■■■■■■ NENNMoMMMEiMMNMmNEEEmOMM ■■■■N■.MN■■■.N■E■■■■■NMN■EEEEMMMNM■ ■N EEE n■E ■ ■�"MENE■MM= ■■■■■■ ■E..■■ ■■..■. ■..■■■ OMEN Eu�'i .■■'� E....■ ■=;■iiiiiiEiiiiiii■�;iiiiiu =""'EM"" ' ' ' ■■N MEMN■■ ■■■■■■■■■■■■■MMN■.■N■E.N■■H■M.■■MN■E ON ■■N■■■■■ ■■■■■.■■■■■■■■■■■■. ■■■■■■■.■■■■ ■ ■. ■ ■■ SOMME ■■ 0 MIMERNME so M 0 M i■i■i■i■iiiiii■iMN■■■N■■■■MM■ ii' �0■EiiiMiiiMEii �iom i ■MN ■■MMMEMEMI■E" MH■■.■ ■■■ E■■ N■ ME MHMMMM I■EEMMEMME ■OMMEM■MMHM EN H■ MNSE■MS ■■■. ■NEN■■■■■OHM ■EMNON ■ MEMEMME ■EMMEMEHEM■■ MMM M■M■OMMEMMMEM ■ ■ ■ HN.■■■M■■■■ ■MEMMEN■ MMEM=E■.i�MEMEME■MMEMM ECrirM MOS■HMEMEMMM Mom MMMMMMMMMMMMMMMMMMM ME ONuEM�SHM EMEMMEN MMIMEMEMEM MEMMEMEMIN 0 0 MON ME ■■■■.■■■■■■■■■..■■■■■■■M■■■■■.■■■■■ ■ u■ ■■■ MEMNM ■..■u■■M■■■■..■■u■■■E■■■■■M■■■�■_._■ ■ ■ MEMME■H■■■■■■ ■...■■...■■■■.■■■■■■■..■■■■..■■■'■■ ■ ■■■■■■■■M■ NEM N��M������u������������H����Mu\�� ■ MEEMEM EMME� ■EMNO■ ■■EMM■MMM=N■■M■M�MEM■■MM■■ ■ . ... ■uMEMEMOM■EMEM■ ■■MEM■ .. ■N■■■ ■ ■MMMMMMMMMM■■■ N■ ■■■ ME■ EMMEMEMMEMEM■M ■■ SOMME .■M.■.■■E■C.■■■.■SO.■■ . ■N�E..■■■.�MOMME■HOM■OMEN.■ M■■■■■.H■.■■■■u■■..■■■■■■■M■■sou..=.........■■................ ...................................... .......................... .................................................................. Dame Cmnr v Nealt!r Department and .glome Nealtfi .f1yency '210 HOSPITAL STREET I P.O. BOX 665 27028 PHONE:(704)634-5C.8117 August 18, 1995 Boger Real Estate 142 Hwy. 801N. Advance, NC 27006 Re: 4 Site Evaluations;/5 Acres Each Pine View Acres/Lots 1-4 Pudding Ridge Road Dear Mr. Boger: � As requested, a representative from this office visited the aforementioned sites on August 17, 1995. . Based upon the information provided on the application(s) for site evaluations and after the evaluations were completed, the sites vere found to be provisionally suitable for the installation of an on-site sewage disposal system on each site. If you have any questions, please feel free to contact this office. Sincerely, Charles E. Little, R.S. Environmental Health Section CL/wd Enclosure(s) cc: Jesse Boyce APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE �--�- Davie County Health Department D Environmental Health Section P. O. Box 665 Mocksville, NC 27028 �' 9 1. Application/Permit Requested By D e., 'eei ES4/3-�Lc Mailing Address /5�� ,�/wH rst0/ V Home Phone Business Phone/ 2. Name on Permit if Different than Above 3. Application for: )(General Evaluation ❑Septic Tank Installation Permit 4. System to Serve: 'House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision : w e- V.e�1 A C z5 Section Lot # 31". ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms 3 ❑ Washing Machine No. of Bathrooms 2' ❑ Dishwasher Dwelling Dimensions .3a_ ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public VPrivate ❑ Community 8. Property Dimensions 5 a-C leo Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No If yes,what type? 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: f Y,,d e �a,�- d SeN�.w pu �l e 9 BALL ,8C�6�6 t;-o�n�G This is to certify that the information provided is correct tot st of my knowledge, and I understand I am responsible for all charges incurred from this application. DATE NATLYRE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY Fandd ECK ONE: ❑ 1. 1 OWN the property. �. I DO NOT OWN the property. ked Box#2, the rest of this form MUST be completed by the owner or a person authorized by the owner: ve consent to the authorized representative of h D vie Co ty Health Department to enter upon above described cated in Davie County and owned by it--- to � �S all testing procedures as necessary to determine id site's sui li for a ground absorption sewage treatment al system. DATE SIGN URE DCHD(1198) I � MxCASHIN, JR. .B.144 PG.75 CHARLES R. BOGER I.B.91 PG.511 I D.B.162 PG.764-766 I I I NIP N 68'24'10" E ---•- i1oM I 393.56 S 82.55'4T E 427, f!P 62 �� (at fence corner! �JOS R o m o 40 � a &001 ACRES � M o J: !2 AREA c .rit�DU��� N 1 N � o l Z NIP m N (421.91 tolol) 368.53 25.00 MP N 87.41'55" E NIP NSP S 87'41'55" W NIP 25b0 396.91 (393.03 total) I 1 i I o RO I I � co on I Ico m v i I - N1P ASMA = aOM3 a I MI cli I �I N M C. ELLIS LEAGANS I EDWARD H. LEAGANS I I GEORGE H. LEAGANS D.B.97 PG.474 i NP I Amo 87'41'55"�E NIP 1 396.91 25A0 I I . I I L I I NIP _ ,�.a ,��p�yyp —' i I GOb`3f-A C 52®'D " I I R CLWES sly 1" R/1M i I I la i co h � m I" ri I M O I= i ' I I PUDDIi G RIDGE ROAD o I I f1P 'a't app o NIP aouM of�1 0 M r/r spike SO?' /5r se R If-Y�<:TMI f g $. F466 S• /pJ2�. Jd9 .,*goo. //9,0, £IP_EXISTING IRON PIN PIP=PLACED IRON PIN