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346 River Oaks Ln (2) � DAVIE COUNTY ENVIRONMENTAL HEALTH ` ..�,»� �P.O.Box 848/210 Hospital Street � Mocksville,NC 27028 (336)753-6780/Fax#(336)753-1680 OPERATiOI�i PERMiT Account �: 990005811 T�x Pif�:�N#: F90000004103 y� . .. Biiletf To: Carlton Terry � � Subdivisior� lnfo: . . _ Re�er�nce Na��e: _ . . ... � � LocatianiAddr�ss: River Oaks Lane-27006 ' _ . . .., Propos�d Facilify: Residence -. . , ., . . _ :� Pro�er#y Sixe: 107 Acres , ,. . , � � ,�.; ;• � ATC Nurnb�r: 5913 . � *"NOTE"*The issuance of this Operation Permit shall indicate the system descnbed on the ATC has been installed f 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. . . � System Type;_�S.T.Manufacturer Tank Date 7 �S Tank Size� � Pump Tank S�ze / Bedrooms: ' - � System Installed By:�r14'n �� /1%e� Installer# Date: O/ �� GPS Coordinate: . . . ��X��Q .,y. . � I ~ . : . ' ��' • ` . , . �� . � � � . I � ,hy � I� ^ � f�'�'I � �'1 . � ��''�t,� � I ��q'�� I 1��G ' � . t ,�,�,�, . . ,`� � � � - � � I .. �- Environmental Health Specialist Date: 0 3 . DCHD 11/06(Revised) . • • DAVIE COUNTY ENVIRONMENTAL HEALTH • P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)753-6780/Fax#(336)753-1680 AUTHORiZATiOIv FOR WASTEWATER SYSTEM CONSTRUCTiON Accou�t #: 990005811 . . 7ax PI�tiEH#: F90000004103 . • Biilcd To: Carlton Terry .. : � Su��ivi4ior� 1nfo: � _ Re�ereEice Nar��e: , .., .. .. . :�:�LacatiaNAddr��s: River Oaks Lane-27006 -:., Praposed Faci€ity: Residence . ;;,; , ., :, `::..:�Pra�zr#y Size: 107 Acres � ,-, . . � Site Type: �New ❑Repair DExpansion f�TC Number: 5913 . ' ,., •� � .�, _ **NOTE**This Authorization to Construct(ATC)MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s),(in compliance with Article 11 of G.S.Chapter 130A _ Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans,plat ,or the intended use change. Residential Spec�cations: #Bedrooms � #Bathrooms�.#People�Basement�Basement plumbingfA Non-Residentia{Specifications: Facility Type #People #Seats _ Square Footage(or Dimensions of Facility) _ _ _ Lot Size �7 GC Type of Water Supply: OCounty/City f�Well ❑Community Well , System Speciiications: Design Wastewater Flow(GPD)� �� Tank Size a�50 GAL.Pump Tank / GAL. . Trench Width,��_ Max.Trench Depth�� Rock Depth /Z" Lineaz F� ��'/�U��c�� Site Modifications/Conditions/Other: �y6�' ��v�.S��`eyi Contact the Davie County Environmental Health Section for final inspection of this system between ' 8:30—9:30a.m.on the da of instaltation. Tele hone# 751-87611. -�. —___�__� — . �, � � . � . , � �,� �fi' _ _ �� . � �GG �� . � � �� r ' \ ' � .. ' � � � ' � , i . r . - . '.a��_.� . .. _ - ,. )� . . Environmental Health Specialis Date: c�� DCHD 11/06(Revised) � . � �� Davie County Environmental Health � , � ""'�- P.O.Box 848/210 Hospital Street ' Mocksville,NC 27028 (336)753-6780/Fax(336)753-1680 IMPROVEMENT PERMTT Account #: 990005811 Tax PIN/EH#: F90000004103 Billed To: Carlton Terry Subdivision info: ` ,_ _ _ � Address: 107 N. Hemingway Court Location/Address: River Oaks Lane-27006 City: Advance Property Size: 107 Acres Reference Name: Propo.��#,�,hR I�mpeovement Permit DOES NOT authorize the construction of a wastewater system. An � Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A,Wastewater Systems). This Improvement Permit is subject to revocation if site plans,plat or the intended use change. Permit Type: �New ❑Repair ❑Expansion Permit Valid for: f�5 Years ❑No Expiration � Residential Specifications: #Bedrooms�#Bathrooms�#People�Basement❑ Basement plumbing,� Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) Design Flow(GPD):� Type of Water Supply: ❑County/City �Well'�OCommunity Well Site Modifications/Permit Conditions: S stem T e LTAR Initial � P ,;� Re air / f9✓1 Site Plan . � , L�.I '. :�, . , . rbQ°��` � � �as . Environmental Health Specialist � Date_��(�i! L � - ` / i.p.l 1-06 . . ,_• , APPLICAT OR SITE EVALUATION/IMPROVEMENT PERMIT & ATC �� Davie County Environmental Health �°�� ,�,� P.O.Box 848/210 Hospital Street q � p PQR � � 1� Moc►csvit�e,NC 27028 � '�i� � I b z012 A (336)753-6780/Fax(336)753-1680 �yj _ !� � Applicatto�� ite Evaluation/Improvement Permit 0 Authorization To Construct(ATC) ❑ Bot , -� Type of Application: ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facil�ty ***IMPORTANT***THIS APPLICATION CANNOTBEPROCESSED UNLESS ALL OF TH�REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. . APPLICANT INFORMATION �' iit/ � _ __ , _, Name Q�� (.Qr 1�,-� 2�^ Contact Person (�t� . �rr�. Address �0 � AJ•%/�,��,�taa� Home Phone 336-9yD-S T City/State/ZIP �9-y(u��,N� 2�C106 B�si�ess�Phone �6— �y 9��//3 cr�� Ja�b�-�� el.he-� Name on PermidATC if Different than Above Mailing Address City/State/Zip PROPERTY INFORMATION *Date House/Facility Corners Fla ed T��lf/- �� NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit�is valid for 60 months with site plarr;no expiration with complete plat.) Owner's Name :// �r��r %,sr„ -0'.•._�e„t�b�o�ce %e�r,, Phone Number 336-�`/`'/-�yr3 Owner's Address G�- N• �%N� u��, City/State/Zip�:�UC 2�f�JiS Property Address (1 E�2 O�C l( City �Q-a(��.,� Lot Size /( � •9-C Tax PIN# � 6ODODD��0.� Subdivision Name(if applicable) ' Section/Lot# Directions To Site: ' k G�+��va.-�l k - !�// w �1 � �d�� 15-�°s�-�� d� o� 1-� If the answer to any of the followmg questions is•"Yes",supporting documentation must be attached: Are there any existing wastewater systems on the site? Yes �No Does the site contain jurisdictional wetlands? _Yes �CNo Are there any easements or right-of-ways on the site? Yes �io Is the site subject to approval by another public agency? ^Yes �No ,� Will wastewater other than domestic sewage be generated? Yes No IF RESIDENCE FILL OUT THE BOX BEbOW #People #Bedrooms � #Bathrooms Garden Tub/Whirlpool�Yes �No Basement: es ❑No Basement Plumbing: es ❑No IF NON-RESIDENCE FILL OUT THE BOX BELOW Type of FacilityBusiness Total Square Footage of Building #People #Sinks #Commodes #Showers #Urinals Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: #Seats Type system requested: L�Conventional OAccepted OInnovative ❑Alternative- ❑Other l - Water Supply Type: ❑ County/City Water �New Well ❑Existing Well ❑ Community Well Do you anticipate additions�o"r�"e�x'pansions of the facility th/is system is intended to serve?�Yes ❑No If yes,what type? ��u,�rror.�G,n oc/��7w�7' �h^/�-�u�L This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered;the intended use changes,or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized �Representati of the Davie County Health Department to conduct necessary inspections to determine cbmpliance with applicable laws a es. I un that I am responsible for the proper identification and labeling of property lines and corners and locat' g an ging aking the house/facility location,proposed well location and the location of any other amenities. � Property ow r's owner's legal representative signature Site Revisit Charge Date(s): ��j^�2 Client Notification Date: Date EHS: � Sign given OYes ❑No Account# ��5�/�---- Revised 11/06 Invoice# �-C7/�" , �. . � r `� �� ` � �� . ,� � ��1; �� _ =_ �.'�► t .:_ �.,��.�:�.�'. `� ��__�'��.�_�� ' �.Q�. �"'""`� � ASSOCiRTE9. PR 11/7/2011 Project#2011-118 Mrs. Wendy Terry 107 North Hemingway Court Advance,NC 27006 This report details the fmdings of a preliminary site soil evaluation performed on approximately 2acres located at Parcel#F90000004103 in Davie County. The evaluation was conducted at the clients request in order to determine the site's suitability for the installation of sub-surface wastewater disposal systems to.serve domestic strength wastewater. This report does not address systems receiving more than 3,000 gallons per day of flow. The evaluation was conducted by James L. Beeson who is a licensed soil scientist. The evaluation was conducted during moist soil conditions on l 1/7/2011 with the use of a hand-auger. Characteristics that affect the suitability of sub-surface systems include soil depth to expansive clay, seasonal high water table,rock, and unusable saprolite. Topography and slope also affect the suitability of an area for septic systems. The evaluation of these components was conducted on the site. The level of the evaluarion was preliminary for selected areas. Findings are conveyed by showing areas on the enclosed map that are usable for different system types. Conventional areas are hatched in red and have usable topography and a minimum soil depth of 24 inches. The hatched areas are generated by using a global position system in the field. These areas are not surveyed and therefore may be lacking in accuracy. Once the soils map is complete the size of area required for a septic system can be estimated. Systems are sized according to the number of bedrooms in the proposed dwelling. Systems are not sized based on the number of family members or the number of bathrooms in the dwelling. Each bedroom in the proposed dwelling is calculated to generate a daily flow of 120 gallons. A four-bedroomdwelling would have a daily calculated flow of 480 gallons. The daily flow is divided by the loading rate based on the soil texture. This 5401 Thacker Dairy Road�Greensboro,NC 27406 • 336-215-8820 • ` . . site has a clay texture so would have an estimated loading rate of.275 gallons per square foot of trench bottom per day. This loading rate will eventually be determined by the local health department! This division would result in the required trench bottom area of 1745 squaze feet. The trenches are three feet wide which means the total trench length for a gravel conventional system would be 5$2linear feet. The common chamber type systems would require 25%less trench length or 4361inear feet of trench. These trenches are spaced on nine foot minimums widths and must converge and diverge with contour. The conservative estimate of the area required for , a gravel conventional type system on this tract is approximately 8,000 square feet. The approximate azea required for a chamber type system is 6,000 square feet. The system area must be doubled in order to fulfill the required repair area requirement unless the tract was originally recorded prior to 1981. In conclusion,the tract containing the house site described by Mr. Swicegood will support a five bedroom house with a Conventional style septic system. If you have any further questions please feel free to call. Sincerely, , .,%''��""' �� 51.�B�rs � e�is o :'�'iL"-�"'./ .L - � '� ��'..� �� ,� I11 d� � � -+a.,�..�. r.r�' James L. Beeson Attachment I .1950 Locarion of Sanitary Sewage Systecns (c) Every sanitary sewage treatment and disposal system shali be located at least the minimum horizontal distancc from the following: ' (1) Any private water supply source including a well or spring 100 feet (2) Any public water supply source 100 feet (3) Strcams classified as WS-I 100 feet (4) Water classified as S.A. 100 feet from mean high water mark (5) Other coastal waters 50 feet from mean high water mazk (6) Any other stream,canal,marsh,or other surface watezs 50 feet (7) Any Class I or Class II reservou 100 feet from normal pool elevation (8) Any permanent storm water retention pond 50 feet from flood pool elevarion , (9) Any other lake or pond 50 fect from normal pooi elevation (10) Any building foundation 5 feet (11) Any basement 15 feet (l 2) Any property line 10 feet (13) Top of slopc of embanlanents or cuts of 2 feet or more vertical height 15 feet (14) Any water line 10 feet (1� Drainage systems: (A)Interceptor dtains,foundation drains and storm water divetsions (� upslope 10 feet (ii) sideslope 15 fcet (iii) downslope 25 feet (B)Groundwater lowering ditched and devices 25 feet (1� any swimming pool l5 feet (1'n any other nitrification field(except repair area) 20 feet (b) Ground absorption,sewage treatrnent and disposal systems may be located closer than 100 feet from a private well supply,except springs and uncased wells located downslope and used as a sounce of drinking water,repairs,space limitations and other site-planning considerations but shall be located the maximum feasble distance and, in no case,less than 50 fee� (c) Nitrification fields and repair areas shall not be located�nder paved areas or amas subject to vehicular tiaffic. If effluent is to be conveyed under areas subject to vehicular traf�c,ductile iron or its equivalent pipe shall be used. However,pipe specified in Rule.1955(e)may be used if a minunum of 30 inches of compacted cover is provided over the pipe. Note:Systems over 3000 GPD or an individual nitrification fields with a capacity of I500 GPD or morc havc more resMctive setback reqnirements,see.1950(a)(l�(d)for specifics. i � � U �' �� — �� i .'� tu � . V M �� /'� "k6 ` ` ' � K. � �: � y s.�' Q , �,� * ti _ p.a , � i. � � v 2 �� ., w �� '�--��'t7"4 16 •,�t� .• `'�� '. �+1` � f qY .M ' 1 '. 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' J y�l:�, f.. l 1f1��: D 1 :� ji . , . � {F' , A . / ` � �� 2'✓ . .. . �4 rSpi � `':..' .�� r�. . � . Y ••'�.. ' ,�:: Y '� �F'� ii � �.' �, . � .r . ., y. : _ � ` ` ' F . • .� � ' 1� r �' �, Y'.\�+;, . .� ...-�f�\ ...: �'�I, . Y ' .. . �.�._' •.�..'_�� . .+f�� i _� . J�'� . " . .,� , f ... ._ ... 1.:. n..�i � .2��L"�•,�', r`..: " ;` �, ,' , , ` DAVIE COUNTY HEALTH DEPARTMENT , Environmental Health Section � Soil/Site Evaluation � APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990005811 Tax PIN/EH#: F90000004103 Billed To: Carlton Terry Subdivision Info: � . Reference Name: Location/Address: Bailey Road-2700 Proposed Faciliry: Residence Property Size: 107 Acres Date Evaluated: �' L ZD Z Water Supply: ' � On-Site Well � Community Public � Evaluation By: Auger Boring_� �- Pif Cut � FACTORS 1 2 3 4 5 � 6 7 Landsca e sition Slo % b Q o ' � HORIZON I DEPTH p�' p"3C> Texture rou G G ' ' Consistence Structure L Mineralo ,`l " HORIZON II DEPTH ' 38_ �. _ ._ Texture rou _ �(',L ..:": Consistence U -(L Structure Mineralo I�l � HORIZON I1i DEPTH Texture rou Consistence � Structure Mineralo HORIZON IV DEPTH Texture rou Consistence � „ Structure _ ... . . . _ . .__.- _ ' Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE , CLASSIFICATION LONG-TERM ACCEPTANCE RATE .'�5 w SITE CLASSIFICATION: �� EVALUATION BY: � � LONG-TERM ACCEPTANCE RATE: +� OTHER(S)PRESENT: REMARKS: , _ . �. LEGEND Landscape 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 , Ts�tiug 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 .. . .ON4IST�.N . ..,..: .. II'iQist: - • 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 S r, ,r . __ , _ SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangulaz blocky ' PL-Platy PR-Prismatic , Mineraloev 1:1,2:1,Mixed : . 1YQtes 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/OS(Revised)