Loading...
105 Speer Rd , , DAVIE COUNTY HEALTH DEPARTMENT �/,�/—cz'� . _ . Environmental Health Section � P.O.Boz 848/210 Hospltal Street Mocksvllle,NC 27028 (336)751-8760 %� IMPROVEMENT/OPERATION PERMIT Account #: 989900204 Tax PIN/EH#: 5812-61-0113 Billed To: J. D. Crews Homebuilder Subdivision Info: Reference Name: Jerry Crews Location/Address: Speer Road-27028 Proposed Facility: Residence Property Size: 0.784 Acre **NOT�*��i�isgmprove8inent/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An ALTfHORIZATION 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). TIiIS PERNIIT IS SUBJECT TO REVOCATION IF SITE PLANS OR T��INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms � #Baths�_ Dishwasher: � Garbage Disposal:❑ Washing Machine: d Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #PeopleJShift #Seats Industrial Waste: ❑ Lot Size ✓�g Type Water Supply ('U Design Wastewater Flow(GPD)��� Site: NewJ� Repair❑ System Specifications: Tank Sizef�GAL. Pump Tank GAL. Trench Width���Rock Depth�7p_ Linear Ft.�� Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S),IF 6"BELOW FINISNED 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.m.on the day of installation. Telephone#is(336)751-8760.**** r Environmental Health Specialist's Signature: Date: % !�7`�U DCHD OS/99(Revised) f � ' ` DAVIE COUNTY HEALTH DEPARTMENT Environmental Heaith Section P.O.Boz 848/Z10 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 989900204 Tax PIN/EH#: 5812-61-0113 Bilied To: J. D. Crews Homebuilder Subdivision Info: Reference Name: Jerry Crews Location/Address: Speer Road-27028 Proposed Facility: Residence Property Size: 0.784 Acre ATC Number. 2388 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST 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 WASTEWATE CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health SpecialisYs Signature: � � Date: �(�-��/-Pf I� CERTIFICATE OF COMPLETION **NOTE** The issuance ofthis 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. �D�3��� �i 3 � �� Septic System Installed By: y!t ���'L�� .' 4 � � Environmental Health Sp�ialist's Signature: �Gx%� Date: �" `7� 2 � DCHD OS/99(Revised) `. ` APPLlCAl1UN D�v e C u11�tyAH@81th Depef4itENT PEflM1I dc ATC 4 12 fi� � � M � LK �U7 U . ,�, . . Envfrenmerttal Xe�/th Se�ctfon p.o. Bo: s48/zio xo�ta�. str�t M� 2 4 2000 " Moakaviile, �C 27028 �336)751-8760 EPIVi N�tENTAI NEALTH t**,II�pATa�NT*** THIS APBLICATIdN GMqOT 8S PROCEBSED ONLE3S ALI. '�tEQ�1YRSD TNFOJt�ATION I9 PROVIDED. Rafer to the �1TION BOLLETIN i�or ing�rna�l.ona. s. xame eo be s���ea �D CRe_�.c7S �}f�►�3u��deR3' oontaat �ereon �ERR�, C�t�1,J S w►s.isnQ �� �f01 ��.mn R� R�_ ao■s �oc� '-��7 2.-7�I $ csty/stata/z=r �UGksV;11� ,UG aZ7oZ� Bussness ahone St�_ �/��/�y��rn-/� Z. Itame on Pst�ib/111G it Ditlesesit than Aboroe Naiiing I�ddsesa Ctty/8tate/Lip 3. !►pplication zor: U Site Evaluatioa 0 Imprav�ement Pe=mit/l�TC O�8o�h a. systes to sesvice: ��ionae 0 ldobile Home 0 Snaiaess 0 Iadnstry � Other a. it Reaidaace: ! Paople i Hedraa�aus � N Bathrooma � 1�Dishxaahes 0 Oa�tsaQn Disposal Y ttaahinq Naclsiu� 0 Sasement/p2nabinQ 0 Basement/1b 8lvmbiag 6. if 8nsiaess/inQustry/other: 8peaily type # p�aple � Sit�ks t Caaemodes f 8tioxan � �rinals i Fatsr Coolera I!' FOOOBERLtZCB: � Seats $stimated itater Usaq! iQalions psr aay) 7. � o� xatnr anpplp: 1� Co�usty/City U ifell 0 Co�tousiity e. Do yoa�nttcip�tte:ddittoas or up�n�ons of the tacility t6is e�atem b inteaded to aerve! 0 Yei 9'1Vo � It 3a.what type" *"'IMPbRTA1VT"'CL[ENTS 111UST C�alPLE1E'TNB REQUIRED PROPBttTY INFORMA'T[ON REQU�STED BELOW. Ettiter a PLAT or SITE PLAN MUST BE SUBMIITED b tfu clknt wlth 7WS APPl.ICATiON. • �flY f��:.r� Prupecty Dlmea�ioas: 100 X �9 X 1�l0 x io0 X�fa�c lo� Wltt'f�DQtECTIONS(ttom ModnWqe)to PROPERTY: T�i Ottice PIN: a S 8 I z.-� ► -o I ► 3 �D1 nra,�-r�-�eF�' o,J �;��c��, PrnperlyAddre�s: Road N�ne SPrx� P...�_ IQo�— ����pf.1 ELrt�oz�1Q _ L-�FT o�./ City/Zip I�oUtS J�l l c �t/G Z?oZd� ��r.�Q P..d _ � �O�D /rT -�R�-,L �l- if ia a Subdjvldon provide informatioa,Aa totlorv� �10� N�me: �ection: Block: L�ot: Date Pnope.rt�'Ftagged. - ,�' Z`f—�� This is to certtfr tbr�t the tnformaiio�e prov�dtd W correct ta t�e best o�day kao�rledg� I anderabnd l6at uny permit(s) iuue@ hereatter are snbject to a�,spesu�on or revocAtion,i(t6e:ite plaaa or latended use ebasge,or if the informsttoa �b�jtted ia 16b sppikattoa is filsiBed or tluinged l,al.so,anderstand tbvt I a�n re.s�.ianstble for a!l cbatrgts tncurred fro»e t�r�r appllcar�on. I,hse�e�rr�xe coaaeu!*o We�A�horiu.d Repressgtat�vt ot the Davie County Se�tllht Dtpartmtnt to eoter apoo�6ove described pe�perty located in Davie Couaty and owoed b�• to cond�ct a!!teriiug procedara sa necessary to determine the dte ent DATE �'��`a a SIGNATURE TBIS AREA 1NAY BE USED F'OR DRAWIr1G YOUR SI7'E PLAH([acinde aU+o�the tollo�irg: E�tin�snd propoaed Property liaes and dlweostons, rirncturea, sdbscka, a�d septic[ocatlons). 5� Pt�c.� S��C'�Le� � Accouut No. ��� Revlsed DCHD(07/98) ���Na _��r.L..0 � DAVIE COUNTY HEALTH DEPARTMENT Environmentai Health Section Soil/Site Evaluation APPLICANT INFORMATION � PROPERTY INFORMATION Account #: 989900204 Tax PIN/EH#: 5812-61-0113 Billed To: J. D. Crews Homebuilder Subdivision Info: Reference Name: Jerry Crews Location/Address: Speer Road-27028 Proposed Facility: Residence Property Size: 0.784 Acre Date Evaluated: ������ Water 5upply: On-Site Well Community Public v Evaluation By: Auger Boring � Pit Cut FACTORS 1 2 3 4 5 6 7 Landsca osition ,L� L Slo % HORIZON I DEPTH Texture rou Consistence ' Structure Mineralo HORIZON II DEPTH � • ' Texture rou Consistence � . _ Structure /L- � �/ Mineralo , • - HORIZON III DEPTH Texture rou Consistence Structure Mineralo • HORIZON IV DEPTH Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE � CLASSIFICATION LONG-TERM ACCEPTANCE RATE < � SITE CLASSIFICATION: � EVALUATION BY: LONG-TERM ACCEPTANCE RATE: r �' 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 t ctur SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangulaz blocky PL-Platy PR-Prismatic Mineralo� 1:1,2:1,Mixed ts 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 DC�ID OS/99(Revised) ■����■����■���■��������■���■��■��■■����■■��������■��■■■����■����■■ ■����■■■��■���■��■■�■���■���■■■�■■■■�■�■■��������■��■■■■■��■■���■■ ■�����■■■�■�������■������■��■■■��■■■�������■����■��■■�■■����■0��■ ■�������■��■�■��■��■�■■�■■����■■ ■■■■��■■�������■■��■���■�����■�■ ■�■�����■■�■■■��■�o■v■■�ve■�■��■���■■�■�■■■�■�■■�■■��■■■■■�■■��■�■ ■���■����■■��■��■����■■■�■■��■�■��■■■��■■■����■��������■■■�■■����■ ■�■��■������■�■�����■�■■�■�o�e�■■��■■�■�■e■ss�m�o■�e■■■.■oos�����■ ■■����■��������■��■��■�■■��■�■�■����■■■��■■���■��■��■■■�■■■�■��■�■ ■■������■■�e���■o�■■s■o�■s�o■■■■■��■■�■��■■■�■■e���ss■■.oss■■e�e�■ ■■�■�������■���■�■s��■■�■����■■�■■��■■■��■■■�■e■����■■■�■�e■■■�s�■ ■■�a�■��s■�■e�o■■�■■o�■�■■�■■o���oo■se■■■■■��■�o■■�����oo�v■■�■�■ ■�■��■�■�■���■��■��■■■������■�■■ ■���■■����■����■■��■■■���■■�■■�■ ■�■�■��■��������■��■��■�����■�■��■e�a■���o�■■���■���v■o����■���o�■ ■�������■���■�■e�■�■■�■e��■���■��■■��������■����■�■��■�����■��tos■ ■��■�����■�■■�■■��■�■��■��■■���■���■���������■�■■�■■�����■�������■ ■■��■■��■■�■■��■■�■■■■�■■■�■�■��■�■�����■■���■��■�■■■w��■■�■�����■ ■■������■■�■�■��■��■■■�■■■�■�■�■■��■����■■��■■��■�■■���■�������■■■ ■�■��■��■��■■■■��■�■■�■����■���■a��■■���■■����a��■�■■�����■■■■��■■ ■����■�����■��■■���■■■■■■��■■��■��■■■���■���■�■���■■�����■■o����■ ■���������■���■�■�a■�■■�■■��■�■■ ■■■■■�■■■�������■■�■�■■����■���■ ■■���■■��■■■■����■�■■����■■��■■���■■■■���■■■����■�■■�■■■■�■■■�■��■ ■����■■■��■■�■������■�■���■■■■�■■■■�■■�■�■■��■�■■��■■�■�■■■������■ ■■����■■■��■■■��������■���■■■■■��■■�■■■���■���■��■���■■■■■■■■��■■■ ■■����■e■■�������a��s■��■■■s���■■■■■���■��■■■s���■����■■■e�■■■■��■ ■■�■��e������■��■�■�����■�■■���■■�■■���■■■■■■■����■�■■■■■�■�■�■��■ ■�■�■���������■�■�■■■■■■������■■■�■■�■�������■■■�����■■�■■����■■■■ ■�■�■■����o����■���o�■��■■o�������■��■�■■�■■���������■��o■�■■■��■ ■�■���■���■■���■■�����n��■■�■■■■ ■���■■����■�■■■�■■■��■�������■■■ ■■���������■■■������■���e������■■�■■■■■���������■■■�■■■�■■■��o�■�■■ ■■�■��■��■�■■■��■�����►.���■■�■�■������■■■■�����■■■��■■■■■■��■��■■■ ■■■■■�������■■■��■�■■■�■■r�����■■e■■■■■�■s�■■�����■���■o■■■■■s��■�■ ■���■■����■�t■■������■�����■■���■■■■������■����������■���■■�■■�■�■ ■���■■■�������■■�■�■■■■■����■�■�■��■■■���■�■■��■��■■����■�■���■��■ ■■����■■oo�v■��■�■■����e�■■�■■■�■■�■■■■�����■o��■��■■■������■■�■�■ ■■�����■■■�t■���■�■■������■■■■■��■�■■■■�■■���■�■■��■■■■■■�■■■�s�■ ■■���■��■■����■��■�■�■�■■�����■■ ■����■■■■■�■■���■�������■��■■■■■ ■�■■�■■�■■����■■����■■■■■�����■■■������■■�■���■�����■■■■■■��■■���■ ■������■��■���o■■���■■■���■■■��■��■�����������■�■■■����■■■��■■�■�■ ■�■��■■■������■e�■�■�■����■■����■�■■����■��■�■■■■■■�a■���■■�■■�■�■ ■��■��■■��■���■����■��■��I�G����■■i■■■��r�■����■���������■�■■�s■■■■ ■■�■��■■■�����■�■��■■■■■■u�■■■������■■■��i■�■■��■■�■■■���■■��e■■��■ ■�■���■e��■������■����■�■��■�■o���■�����■�i■e�����■■s■■■■�s�s�aa■■■■ �iiiiii�iiiiiii�iiii iii�iiiiiii '�iiiiiii'�iiiiiii�iiiiiii�iiiiiii� ■��■�����■■■■��t��o�r����■i�■■�■��■�■�����oi■■■■�■��■��■■■��■■■�����■ ■�■■■�o�����■■�■�■■�►�■���u■■■���■���■����i��■���������������■■■■��■ ■���■����■■■��■■��■�����■i��■■������������i■■�■�������������■������s ■■���■■������■■���■I1�■S��'��■■■■�■■�■■■���I■���■������■■■����������■ ■■■���■■�as��■■�■��u■■■�����■■■�■�■s■����i�■s��■��■■�■■■■■o�■■■��e■ ■■��e�■■������■�■���■■■■��==�::::::::�==='�■■■�■������■���■s�s�■��■ ■������■■���■■■��■r����■■���■��■■�■����■■�■■■�■■■■■■����■�����■�■■ ■�■���■�■■��■■���■r����v■■o�■��■■ ■�����■��■■��■��������■�■�■�■��■ ■■■���■��■����o■■�i��w■■■■■��v�m�■■■■��������e■s■■e■■■��■■■s�■■■�■■ ■�■���■��■■���■�����e�■�■■��■■■o�■��■■����■��■��■■■■■■■�■�������■■■ ■����■����■�■■��■�������■��■■■���■��■�■��■��■■■�■■��■■■■■■����■■�■ ■e��a■■■����■■■���■■■■■�����■■■�r��»■■■■�■■������■���■■�o����■■■■■ ■�����■■■�����■��■,���■■■�■■��■■��������������■■■�■■�����■■■��■■�■■ ■■����■■■��������■�������■■�■■■s����■�s■■�■���■■�■■■����■■■��■■■■■ ■�■■��e�■���■■■��■��e�.��■��■�■■�■���■a■��■■�■■■��������■■������■ ■����■e�■��■■�■��■��■�■■�:::_.�■ ■�����■■��■���■��■■■�e■■■������■■ ■■����e�■■������■■■�����������■■��::�::-�■■■■■���■��■����■■■��o�e�■ ■■■��■o�����■■■■����■��■■�■■�������■����■■�■■■�■■��■■�■■��������■■ ■�■������■■��s■���■■������■■■■��■��r_�■■�����■■��■��■���■�����■�■■■ ■�a��■����■����■��■■�■■�■��■■�■�■■i�■■■��e��■■��■■�■■■■■■�■������■ ■������■■�■���■�■�■■�■■�■��■■■■��■��■■■■�■■��■���■■����■�■■■��■��■ ■■�����■■�■���■�■��■■■■��■��■o■��■■�■��■■�■��■■e�■■����■■■■■■���■■ ■■�■s���■�■■��■■■■�■���■�■■������■����o■�■■��■■��■������■■■■■�■�■ ■��■����■■�■■��■�■��■���■�■��■■■ ■■�■�■■���■�■�■�■■������■�■■■■■■ ■�■■■■���■���■�■■■■�����■�■■������■■����■■��■��■■�■■■�■�����■�■■■■ ■�■��e�■�■��e■■�■�■■■■�����■����■��■��e�■■��■�������■o��������■�■■ ■■��■■■■��■�■�■���■■�■�������■■■■■�■■�■�■■�■����■■�■■■■■���������■ ■■■■t������■��■����■�■■�■�������■■��■�■��■■�■■■�■■�■■■■■������t■■■ ■�■■■���■��■�������■■■������■����■��■■■��■■����t�■�■■■■■■���■���■■ ■■■■�■■����■■���o��■■■■��■��■■�������■■■�■■��■■�■■��������■■■■���■ ■�■��■���■�■■■s■�■e�■■����■�■■■��■�s�s��■■�■■���■��■■■■■■■■■�■��■ ■�■��■�v�■�■■■�■������■��■■�■■■■ ■�■■■■��■������■���■■����■■■���■ ■t���������■�����■�������■����■���■�■�■■�■■e�■������■■���■��■■■��■ ■������■�■■�■■�■�■■���■■��■�■�■���■����■��■�■����■■�■■■■■■■■■����■ ■■■�■�■��■■��■�■����■�■■��■�■■�■���■��■■��■��■����■■■■■■■�■■■■���■ ■�■�■�■��■���■�■�■■�■��■■�■��■■■�■■�■�■■��■�o■■s�■■e■���■■■�■■■■�■ ■�■������■��■■�■��■�■��■■�■���■���■■�■�■■�����■���■�■■■■■■���■���■ ■�����■■����■■����■�■��■■�■��������■���■■�■■���■��■�o■����■��■■■■■ ■�■���■���■�■�■�■�■■�■��■�■■�■����■�e��■��■��■■■�■������������■■■ ■���■■■■�t■�■■■�■■v��■■��o�■■■�■ ■�■■�■■��■■�■�■��■��■����o���■■■ ■�■�■�■�■��■����■�■��■��■��■�■�����■�■�■■■��■�■■■�■���■���■������■ c—c�;�S� t- �# �3-;.��d �� - �, � �,-+ ���., .,� . _ , , ,� , ._ - - . �a38wn+ �+tnvaa ` - r - - - -- �---- � _- -_-�— - -_ -- - _-� --------- - --- -- -- — -- �� ,iNH_ . . , -- -- _ _ �,.-��;N �itii� ; ^..v -�- " =t -t — . . .. _ - _ —�_ --_ . _ . _. —� �- - — -� ' Nid ti0b� M�N —�d���N - ! dIHSNMf�l �lll^,���12�\fi.� Ni �Hl `_�NI�� !_'��"o '�d 'd��� � u);.�U: � � .;�" � _ = �� i � , - � Nicj NC7�� /1�I�N =�d�I�N � �la3dc;�� ����r�d_� �dd3r 3N1 ��, �� �. :� : rv���_: � Nld N���il J��d-ld =�d���d �" �, nn32�;-� ,3rm+ 3,i� , .' -r'. -+r�'� �31 ' Nld N0�1 ;�N1151X3 =�d'1�3 � '. .. - - --- -- --- -- --- . Mi?i311 �1 ' ( � �] Hr,�.�cn�, �AH W1d21Q �AH Q3�02lddV _ '3�1+�S SNOIST�3b `�:�r��.�•1 � ��r_�1 .��,_� �� ���.�I� / �b❑� ,�3n�nS �0 lv�d �� I�-+� - I�- �=��_�, � � �� - - ��,,_��_, �_� �,� � �-'�I ^ - �_,�,��! �_ ; .�fi i� � I ��"= F+1�"�C�- r�' ' .�NbdWOJ `�NI.[�Ad:15 M02I�1..Li1.L ��s?-� ���3n���_ Sn;y-�� ��+rv�i _.��3�c:�� �� '--_ ------------------- - --- ��`, � � c���'% � Q J �'\ �NtrdW�J =iN I t 3na�-�� r1C-i3:i.��_ !.3 3�lhv� �, �3r.�i�� Q�3I� �dni�d Nd w0d� r�nt�,�:; �_;,. o o� '�, o�W ':IH1 'PlOI_.I�h3dll= Qldd N0:i_3n1[? ,tW \ Z d3QN�� lyHl �-�I 1d?_i �MOd?1 l��il �-' ��idd�-� � I � n ,bS,oS.bB S 8S 6EZ 6,91 ',�d `�9 '8'Q �� , � 89S '�d `S�l '8'Q o �� .�!' X,��!1IIS.LOW '� 1'�'HOr d N ... o � ��dNIW11�� •� `�, w o s ..�d �8��o =�.��d ;' .� � � ��,,,, ; � o� � ` ' ; , � � `A'nJr�2. i2iu< z �/ /` o �� `Y\, ^ n I �/ •o • � M ,6S,6S.65 S o W I � L9'bOj `� � 1` • m ` � � Z V � \ • 9 � � o � �7 � �r N i � �i ` rc��,, � ,� W 1�, � •b�,yG.Cd N �► �V �0'00 I b . � N N U� � '•l W w . p �T W O - O` C Z u n �y --�r-� � •�Y l/L G •� -' ��Q Y � N �� o �^? - o W i p� I . � 8S'6E2 3 ,65�65.66 N 69l '�d `�9 '8'Q 89S '�� `S� � '8'Q '�!' �I��t�Il S.L OIY '� AIHO!'