482 Rainbow Rd � -�'.�
! • � DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P.O.Boa 848l210 Hospital Street
Mocksville,NC 27028
(336)751-8760
Account #: 990000830 Tax PIN/EH#: 5851-89-6160
Biiled To: Alex McGuire Subdivision Info: ��Z
Reference Name: Alex McGuire Location/Address: Rainbo�w Road-27006
Proposed Facility: Residence Property Size: 10 Acres
ATC Number: 2235
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MLJST BE ISSLJED 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 R CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health SpecialisYs Signature: � �� Date: /��'-9�-'y �
. CERTIFICATE OF COMPLETION
**NOTE** The issuance ofthis Certifica Completion shall indicate the system described on ImprovementlOperation Permit
has been install pliance 'h Article 11 of G.S.Chapter 130A,Section.1900"Sewage Treatment and
Disposal Systems,' but shall ' AY be taken as a guarantee that the system will function satisfactorily for any
given period of t' e.
� �" ° �,H,� s,e�
� ^ • D�., �,��-oa
l r �,
� o
, k � .
W
�
K�
N
� �
)r
Septic System Instalied By:
�J
Environmental Health SpecialisYs Signature: Date: l� --�� ���
DCHD OS/99(Revised)
' � , -- DAVIE COUNTY HEALTH DEPARTMENT n d 1`,�p,9q
• '' �-' � ' Environmental Health Section C
' P.O.Boa 848/210 Hospital Street •
Mocksville,NC 27028 /
� (336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990000830 Tax PIN/EH#: 5851-89-6160
Billed To: Alex McGuire Subdivision Info; Z
�
Reference Name: Alex McGuire Location/Address: Rainbow Road 27006
Proposed Facility: Residence Property Size: 10 Acres
ATC Number. 2235
**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
PERNIIT IS SUBJECT TO REVOCATION IF STTE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type � #People � #Bedrooms � #Baths 2
Dishwasher: � Garbage Disposal: ❑ Washing Machine: � Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste:❑
Lot Size / l�� Type Water Supply� Design Wastewater Flow(GPD) U�o� Site: New� Repair❑
�! i
System Specifications: Tank Size�DDd GAL. Pump Tank GAL. Trench Width L��Rock Depth /� Linear Ft. D6
�h�: �tD���l�s �k.e1� 1�'��.-e
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6 K BELOW
FINISHED GRADE. **'�*NOTICE: Contact a representative ofthe Davie County Health Department f r final inspection ofthis
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#i�336)751-8760.****
��`�e CI g/22-0 �
�
I ,r ^
r
Environmental Health SpecialisYs Signature: , Date: ��'b ��
DCHD OS/99(Revised)
�o` '����
� �- ��': =- ;� , �P CATION FOR S(TE EVALUATION/IAIPROVEMENT PENMR&AT C� C� � Q d �
� ��„� �,, Oavle County Health Department �
G' .,�'�g• j �� Env�inoutme�rta!He�/!fi Sertfon �
�k„� OGT 2 1999
� ��' � P.O. 8ox 848/210 Ho�pitsl BtrNt
yr��" (10 ��p �ox.,►�ii•, Nc z�o2e �
OJ � (336�751-6760 ENVIRONMENTAL HEALTH
DAVIE COUNTY
•**I?�ART]IH?*** THIB �IPIILICA'1'ION C�iNOT 8� PA��88�D UNLZS 8 71LL '� RZQOIRaD
tNrORl�ATi027 =8 pRGVIDILD. a��as to th� �'O�ATION BULLZTrii !or iastruatioaa. '
i. x... to b. s�u.a \ �= ca►taot P.r.oa �,'�:.�,L�L
IfL�l� ��• . � �1 1� ���� =OM p'hOn� — " L
��,rn�.wi::. ( �.s�... a�. ��—� �� lo
Z. 1ta� oa �sai!/i'tC i! Di!las�at tlsaa �bov� .
14iliaq �ddr��• CitY/tlab/!ip .
a. �►ppiiaatioa tor: 8it� lvslwtiioa � 0 Improvaawnt p�rait/l�TC �Hotb
a. sr.� co as.so.� �nt• � tsobii� 8om� O Bnaia�s• 0 tadwtsy � Oth�r
�
a. Z! R�.idsac�: f p�opl� � Badrooms r � f Bsthrooms �i /�
�0"Di.1►xa.a.r B' rtarb.q. oi.po,al �a.hiao xaobsn. 6"sa,.�.nb/rl�sbinq 0 sa..�.n!/�to alisbs�q
i. t! lwl���/ZnduslsY/Otl�sst fp�oi=! t7IP� + �o'Pi� � i1A1c� ,
i Coaud�� � �hox�s� � Orinalt � xabr Cool�r�
I1' �'00�8t�CVIC=: � S�it� �_ lttiaat�d 1�it�= t��iq� t0+u1� P� �fl
�. syp� o! xat.�r aupplpt 0 Couaty/Citp 0 N�11 �i Commuaity
�. Do yoa snHcipste�ddidau or espswiont otthe fs�ility t6�ey�tem u Intended to rerveT 0 Ya �
U ya,w6�t type?
. *"*IMPORTANTR**CLiENI'S MUST(aDMPtETBTHE REQUIREDPROPERTY INFOttMAT[ON REQUESfED
BE[AW. Either a PL.AT or SITC I'LAN MWS1'BBSUBbIIiTED b the eUeot �vlt6 TN1S APPWCATION.
Propeaty Dlmeasion�t � T�. �� f-+� L���� VN1tiTE DiRF,CTtONB(ti�om Mak�ville)to PROPERTY:
Taz 081ce PINt #. h����(r i� /,� 6 � /t� f`�U i�bn� � �t�r.r
Property Addreat Rad Nsme�(" � � � ��� � �-2 -}-� 4 c� 1 /J7 i���
� City2lp t-�C�UC�h.(SL �L �(�'iYt (� � �/l r%
. �
U lu s Sabdivision pravide Inform�Hon,u folla�v�s - �- � .
N�mes '
secdon: Blocks � I.ots nate rroperty ms�ed: (A' 20-a 9 ' `�`t•�'
Thb b to cerHty►thwt t6e intocrosHon pt�o�vWed b eorr�ct to t6e bat otmy Imm►ledga I anderebad th�t�ny penmtt(�)
iun�d 6ereaBer ara�ubject to�wp�ndon or rerocAdoo,Itt6e dte plaw or Intended me ehan�ti or if the IaPormaHon
•a6miqed in t6b applicstloa V falttlied or c�an�al l,41so,ander�tand�at 1 am raponstble jor oll chargu Incarnd jron�
t�ls apptkadon. 1,6ereby,�ive eowent to the Aat4orized Repreknhtive ott6e e Coaaty Ha L Dep rtment
to eater apon abovs dactibai pcopetty bcated In Dsvie Coaaty and o�nned by
to eondact�p tating proc,edara a ne�a�ary to determine the dte bWty.
DATE ��^01�"� �l 8IGNATURE �
'rHI3 AREA MAY BE USED FOR DRAWINa YOUIt BTCE PI.AN(Inclnde all oit6e folla�rinQ: Esbtin�and propaed
property Ilaa�nd dimen�tonM �trae ut���., ,�Qa kpa���ao��. .
� � 2c�'' �
(� 'Z°``� �x i s���� h.o u-� $ite A�vblt C4a e
D�h(�):
� �u.k�s�- ���,`z� . ;
Client NoHAcaHoa Dates
—�,t�� 1��-�-v��ro(�ss�y ' ' ,
1,,.i c�- ' LAS:
A�coont Na ��
Revtscd DCeD(07/49) Involce Na !��
� ,�;
� �Dw✓ie.C'ounty, Tiorth Carolina Spatial Data Exp... Page 1 of 2
O�.�A
' -' - " }' �J�1.L�7� d�il�l £���J���rt,r� � � - �
p� �.�'� No�ih Caru na
Click on the Map to:
`��Zoomin�ZoomOut�Recenter Map�Identify: Parcel M8p L8y@I'S
., i N D�awselecfetllavers:
--'�� �� Transportati0n
II __ StreetCenlerlines
� r- Interstate 40 �
, � US Highways —
I _ � -•�- NC Highvrays —
Other Streets —
1 ��Lk. � _, RailLines
�r-- - _ Govemment -
��I City Boundaries
�W Xh�6'160 E� �_ Townships
� ^— �__ Census Tracts
I �, �J School Districts
�
'. \\ � NaWral Resources
i \ ..� _ �_ HydrologY
�
I �� I���- 4 - � �_ Soils
�,.._j Localitles
---�._�"" � Schools
� � �' � FireDepartments
S'.': � F;[ Parcel Data
� 1 Parcels - -
, SCALE 1 : 13100 Locality Map �-� -- —
C� � � j � Draw Layers
2oom In Zoom Oul Full d nt �
/' • �
Reset Map J
Parcel Data
• Parcel Numbei(PINJ:5651896160
• County ID:03 E600000060D1 • Total Value:5178,790.00
• Property Address:464 RAINBOW • Ownec TUTfEROW JAMES L&FRANCES
RD W
• Legal Desc.:43.98 AC SR 7441 • OwnerAddress:187 JAMES WAY
• UseValue:52t,020.00 • OwnerCity:ADVANCE
� BuildingValue:552,830.00 • OwnerStafe:NC
• Eatra Featwes Value:55,4�.00 • OwnerZip'27006
• Land Value:5120500.00
PafCel QUefy his map is prepared for Ihe inventory of real property
ound wilhin this jurisdiction,and is compiled from
-ino a oaicel by one(c,�parts o'one)of the Jdlowing: ecortled deeds,plats,and other public recortls and
St.a St. Name St.Type ata. Users o(this map are hereby notified that the
ddress ' r forementioned public primary in(ormation sources
. �[ _, C _i _] houid be consWted(or verification of the informatlon
Last Name First Name ontained on this map. The county and the mapping
wnaf: - "— — nd softvrare companies assume no legal responsib��liry
or the inlormation coma�,nea en Ihis map or in this
.
.:- � '�'�' ;,t �' - DAVIE COLTNTY HEALTH DEPARTMENT
� ' " � Environmentai Health Section
Soil/Site Evaluation
� APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990000830 Tax PIN/EH#: 5851-89-6160
Billed To: Alex McGuire - Subdivision Info:
Reference Name: Alex McGuire Location/Address: Rainbow Raad-27006
Proposed Facility: Residence Property Size: 10 Acres Date Evaluated: 11—� `�Q_
Water Supply: On-Site Well � Community Public
Evaluation By: Auger Boring ✓ Pit Cut
FACTORS 1 2 3 4 5 6 7
Landsca osition -
Slo %
HORIZON I DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON II DEPTH �' 3 �' �
Texture rou
Consistence � . -
Structure L
Mineralo `
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineralo �
HORIZON IV DEPTH
Texture ou
Consistence
Structure
Mineralo
SOIL WETNESS
RESTRICTIVE HORIZON �
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE . ,�. ,
SITE CLASSIFICATION: P� EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT:
REMARKS: _ ��/�l��( � /7C�
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
Mois
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
tructur
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
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-gaUday/ft2
DCHD OS/99(Revised)
■�������■��■■■��■�■■■�■�■■����■■����■■■e■■■���■■�■�����■■■���■�■�■
■�■��■��■■���■��■�■■�■■��■■����■■��■■�■��■■���■��■■��■��■■■■■■���■
■�■������■���■��s��■■��■�■■■���■���■■■��■■�t�■���■����■■■������e■
■■�������■��■�■■■■��■��■��■����■ ■■■�■■�■■���■■�■■��■■■■■���■��■■
■■���■■■��■�����■oe�o�■o■.■s���■���■■����■■a��■��s■0■■■■a�ee■��■■■
■■��t�■�■■■■�����■■����■■�■■■��■■��■■■■��■■��■���■s��s■■���s����■■
■��■����■■�■■■��e�■■■�so■o�■eo��■■�■■�����■�����■s�■���■���oe■�■�■
■��■�■e���svs■■o�■�■e�se■■�ese■�■■����■������■�e■■s�■evesv■e�e■m�■
■����e���■■��■■��■o■�■■�■■�■■�■��■�■■�■■■■■��■�■���■�■���■�■■■■■�■
■■■��■�������■■■�0�0■0■�■■�■so■■�■�as�■�a■■■��o��mv■���■see■e■■a�■
■�����■���■�■■��■��■■■��■■��■■�■�����������■■�■o�■��■■�■■■■■■■��■
■�■���■■��■�■���■�■■��■■■■��■��■ ■�■■��■■���������■�■�■���������■
■�������■■��■�■������■���■��■■■��■��■■■�s���■■�■��■■�■■���������■■
■��■�■��■■�■��■��■�■s■■�����■■■�■■■��■■��■�����■���■■�o�■��������■
■����■����■■���■��■����■�■��■■■■�■��■■■���������■�■■����■■���■�■■■
■�■�■■���■�■����a■�■���■■�■■��■■■■■������■■���e����■■w■�■■������■■
■�■���■��■���■���■�■■■�■■�■■���■■■■����■■�■���■�■��■������■■�■■�■■
■�■���■■�■����■��■■■■■��■�■■���■■�■����■��■���e�■��■����■■�■■��■■■
■���������■�■��������■��■��■��������■�■�����■■■�e■■■�■■■�■■■�■��■
■■�■������e���■���■�■■��■s�����■ ■����■��■��■��■��■s������■��s�■■
■■��■�■■���■������������■■�■■�■■��■■����■■■■■■■■��■■���■�����■�■■■
■■��■��■■■�■■■����■■�■���������■■■■�■■�������������■■�■■�����■■■■■
■■����■■■■�■■■�■���■■■■�■■��■���■■�■■■�■■■������■��■■■�s�����■��■■
■■�■��■■�s��■■�e������■■�■s■■■■�■s�■■s�■■■■���e�■��■����se■���a��■
■■�■s����■��■■��■��■■��■�■■�■■■�■�������■�■■����■�■■■�������■��■■■
■■���■����■���■■■�■����■��■��■■��■���■■■■��■���■���■■s�■■■���■■��■
■■��■■e���■��■■�■�■■�■�■■�■��■�����■■■■■�■■�����■��■o��■���■■��■■
■■■�■■����■�■■�■■�■��■�■��■■■■�■ ■■■■���■■■■��■■■■o��������■■■��■
■�■���■■■�����■�■�■■■■����■���■■�■��■■■s��■■■�■��■���■■■■��������■
■�■���■■■■■■����■��■�■■■■�■■���■����o■■��■�■■�■��■■��■■■���������■
■�����■■e■■■■■��■■�■■■■■■■�s■�■����■■■■e■■��■■■■�■■■■■■■■�■■���■�■
■�����■■■��■■■�■■��■��■�����s��■�■�������■�■■��■����■�e�■�■■���■�■
■■�■���■■■��■■■���■�������■■�■■��■��■■s■■�������■■��■���■■■■■■e�■■■
■���■■��■■■�����■��■■■�r.��■■�■■■o■■�■������■■��■�■■�■o■�■��������■■
■���■����■■�����■��■■■■■s�e��■■���■�■e���■■■����■■■■■■■��■���■��■
■��■��■������o■■■�■■�■�■��v����■ ■■■�■■■■■■��■■■�e���■■■��������■
■���■■■■��■���■�■�■■■■■■■�■��■■��■e■■■■■■��■��■��■�v�■■■���������■
■■����■■■v■��■■��■�■■■�■■�■■■■■■�e��■■■o�■�■■■■■■■��■■■■����■���■■
■■�■��■■■�■���■e���■■■■■■�■����■�■���■■■■�o�■■���■����■■��������■■
�����������������������������������������������������5�������������
������������������������������������������������������������������
■��■��■e��■���■�������■��e�����■a�■����■�■■■s�■■�s�■e■���■�■■��■�■
�isiiii�iiiiiii�iiiiiii�iiiiiiii�iiiiii�iiiiiii�iiiiiii�iiiiiii�
■�■■���■��■■�����■���■■■■������■■■■■■�■■■■■■�■■■�������■�■�������■
■�■■■��■■��■��■��■■��■■■�■�■■���■■■■■���■���■■���■■�■■■■���������■
■�■■����■������■■■����■�����■■����■������■�■�■■■������■����������e
■��■����■������■■���■■s■■■■■■■■�����■■���■■■■■■■■■■■■■■���■■■�■��■
■�■��■����s■■■■�e■■■��■■����■■���■■■■��s���������o■■■■s■■■■�■■■■■■
■���■■��■■��■���■�����■■����s�.■■.......■�■■■■�■■■�■�������������■
■■■������■■■■■��■�■■■��■■�■������■iii�i������■����■■��������■�s■■
■■■■���������■■■■��■■�v�■■■��■■■ ■����■■■�i��■■■■■■■�■�������■���■
■�����■■■�■��s����o■w■■e■��oi��m��■■■■e�s���i���■�■■■■■��■�■■���■�■■
■■����■■��■���■�■�oe�■��■■�■���■�■�■����■�■�i■�■■��■■��■■■���������■
■■■�������■■■■��■����■■�■■■■�■�■■■■■��a■■■n■■■■■■■■��■��■■■■■■■��■
■■■■�■■■■s��s�■�■■�■�■����������■��■����■��i■�■��■■�oe���■■■■■�■��■
■���t�o■■■■■�������■■■■�■■�■��■■������■■■■�t■■■■■■■■■�����e�����a■■
■■■�������■■■�■■■����■■�■■����=�::==_=•.���i■■����������■■■����■��■
■■�■����■�■■����o■����■��■���■�����■■��o.-�■���■■��■�a�����������■
■■■�■���■■�����■■�����■■■■�■■■■■ ■�■■s�■���■��s��■■■■■■■■■�■■�■■■
■�����■�■■■■■■■�e�■■■�■■■■■�■■■��■■■■■■■■■■■�������■■�■�■o■■�■�■■■
■■���������■���■■■�������■■e�■���■�������■��■■��■■■■■■■o�s������■■
■■■■■■���■�������■■�■�■■�■■�■■■��■■�■■■■�■■�■■���■���������������■
■■�■■����■s■■��■�■■�■�■■�■��■■■■�■■�■�■■�■■��■���■�■■■■■�����o���■
■■������■■�■■■■■■■■�■��■�■■■■■■■�■����■■■■■■■■■��■��■■�■■o�������■
■��������■■■■■�■�■■■■��■■■■�■o�■������■■■■■■■����������■■■■■s��■�■
■����s��s�o�■e�■�■■■�■v■■�■■■■■■ ■�■■■■s■■■���■�����■■■■■■■■■��■■
■�■��■■��■■��■■�■�■■�■�■■�■■��■■�i■■���■s�■■��■■o■��■■��■■■■�����■
■■■��■■■��■��■■�■�■■■■�����■��■�■��■���■■�■■■�■■�■■�■■��■���■��■■■
■■■�■�■■�������������■����������������e�■■■■■�e■�■■�o���■■■■■■■■�■
■■■�■��■■��■■���■��■�����������■■��■��■■■■�■■�����■������■■■■■■■�■
■��■����■■�■■��■���■��■��■���■��■�■■■���■■�■■��■o���������■��■■��■
■�■������■�■�■■������■■�■■�■■�����o�■■��■■�■■��■■�■■�����■■■■■■��■
■��������■��■■��������■■�■��■���■�����■�■■�■■��■���■�����■■��■■■■e
■����■■�����se�■���������■■����o��■■■■■o■�■���■■���■�■■�����■�■■■
■��������■���■�■������■■�■■.■■■■ ■■■�■��■���■��■��■■o■���������■■
■����������������■��■����■■�■�■�������������■e��■��■■�o��■■����■■■
■�■���■■�■��■■�■�■■�■�■■�■■�■����■�������es■■�����■■■o���■�����■■■
■�■����������■�■o■■�■�■■■■■�■���o■������■■�■■�����■■■����■■����■■■
■�■���■����■■■�■�■��■�■■�■��■�■��■■�■■■�■■�■��■■■�����■���t�����■■
■■■��■��■��■■��■�■��■�■■�■■�■�■�s■�a��■���■■������■■s����■������■■
■■��■■��■■�■����������������■��������������■�������■��s���������■■
■���■■�■■��■�■�■�������■�����■■����■■���■��■����■■■��e��■������■■
■�■��■�■�■���■�e�■��■��■�■���■■■ ■o■■■��■■�■����■�■��������■■���■
■�����t����■���■�■�������■��■�■��■��■�■��■■■�■��■■■■■��■���■■�■�■■