Loading...
128 Princeton Ct Lot 15 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section `Dj�_ P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900204 Tax PIN/EH#: 5860-81-9329 Billed To: J. D. Crews Homebuilder Subdivision Info: Princeton Lot#15 Reference Name: Location/Address: Princeton Court-27006 Proposed Facility: Residence Property Size: see map ATC Number. 2767 **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 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 �CG #People #Bedrooms 3 #Baths 2 Dishwasher: Garbage Disposal: ❑ Washing Machine: G?'-' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste:❑ Lot Size I7,31 x244q iType Water Supply Design Wastewater Flow(GPD)&_ Site: New ET Repair❑ System Specifications: Tank Size WCIiAL. Pump Tank GAL. Trench Width SLoO Rock Depth LZ Linear Ft.�O' Other: 1 B�sT��r�oa 1 �S-�-n.LL Required Site Modifications/Conditions: a�L�v_ C�tJ �Q r,►c )a IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS)IF 6-BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this 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.**** Peep. U �r JAM 1►- Environmental Health Specialist's Signature: Date:04o DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Moclksville,NC 27028 (336)751-8760 Account M 989900204 Tax PIN/EH#: 5860-81-9329 Billed To:'J. D. Crews Homebuilder Subdivision Info: Princeton Lot#15 Reference Name: Location/Address: Princeton Court-27006 Proposed Facility: Residence Property Size: see map ATC Number. 2767 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 Treatm and Disposal Systems). THIS AUTHORIZATION FOR WASTE W NS CTI V D FOR A PERIOD /OF FIVE YEARS. Environmental Health Specialist's Signatur : Date: 7 CERTIFICATE OF COMPLETION **NOTE** The issuance of this 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. ./"et VZ to Y-4 1004 Y-5 R Septic System Installed By: n Environmental Health Specialist's Signature: Date: Z/ O �=nL-V=� T DCHD 05/99(Revised) EVAWATIONAMPROVEOI . arruaAsialMl 0 vi C �1'PERMIT Health�16p81'671ent E Cm ME ' nD V-0. Box 840/210 Ros+pital.Rtr«it j Moakmmtrl.11., INC 270241 MAR 9P CO3 L (838)761—i17ti0 *s a 7MFG#iTAtI:'�•* THIS "PLICATION C.apmr BN MZtmsw VAAS 3 2= ni>V MAT1C0 is PVDvIM. Storer to the X011 am= At-strael �� i. Unie to be stilled sib CROWS }AVME8(tGL j)6&S Cataot: sm:sae lmaiisng AeAMss O{ EL1rQz Ro=-L slam al+aoe .�y - L1�GZ"� .ls� City/stste/mIr . 12CKSSLLE. z?K)iS9 sasiaew s►hons 334 7ba $. Raw an L endtIATC It 01tterent than 11bOn►r Wailing a►44tass citty/stats/zlp S. Application Ivor: U site #:valuation OI z=Pt VW tt t pa]mit/ATC 0 Both 4. syst s to nervine: U House 0 Mobile gam 0 Bnsisasrss 0 ludnats y 0 Otlatr a. if PA*Ld4maa: # people // # sedsooma .3 # Rathraasaa Z- W/Uishraaber a wave 01mosal 5/naamn Machine 0 8aseRmt/ft" bing 0 a"awnt/wo 91mebing 6. If acsin*ss/1ndLittsy/0ther: Opacity type {! People ! >ZiNca t° Co�uB,s # showers # Urinals # Water Coolers If FOS 2ZRV1CRs It Beats Sstimted hater Usage (Qalicar per day) 7. Type Of Water aVplg: 0 Qo=ty/City 0 Noll 0 Coamunity a. too you swWpste additions or expansions of the facility this system is Intended to stent? 0 Yat DTio If yea,twbat type. "s-INIMMAIVI""CV1WMA1VSrCQafPY..I;'TE nIZ REQUIRED PRiIPERTY it RW.MAT10"REQUESTED BF WW. Either a FLAT or SITE PLAN MUSTSESUMMED by the c0est with THIS A PIPUCA TION. Propeny Dimendoas: 113_)c z49X 123 X 2gq WRITE Dmic IoNs(frons mocktvw)to PROPERTY: Tax Office,PIN: 4 5860 - 81-9 3 7-19 U S "W.4 1 S8 - +21 6R7- -0 rJ Property Address: Roast Name T-k,W.--Tor1 CT- J3A-L_7' m DO N City11dp Alsy A N LE iJ G �R iIYGaTD hJ C1= if in a SubdWlsl as provide information,as failaws: Nasse: Co u o— SeCtian: Mock-. Lot: Date Pn"rty Flapied: 3 ' L—01 This is to certify that the Information pnvMtd is correct to the but of my kwwledge. I und�eratand that any permits) !sensed btreafter are subject to saspeasloo or revocation,if tlst Ate pians or Intended vie ebsatge,or if the Information sabmi ted in this spp*Atioo Is faixIW or clttta getl. t,rho,imdemend tbm I am rapaulkrfia,all chwgar brcunvd fMAv ._1drJrr.,tppl�ac�ae. I,�""I+S'►tie sansestt trs t1scAasthert�d�re�aalstire of:hc*Jmris Cs:pn�Iis:alttr�ptsltacent . . . to enter repose above described property 1ocatdl in Davie Comfy mW owst+ed by to conduct all testing procedures as necessary to ddermice Ike dte sai"11 . DATE $1GNA'I'URE THIS AREA MAY BE USED FOR DRAWING YOUR STEL PLAN(txhidt:all of tine following: Usting rind proposed ,property times and dtatau wov sinsctnsss. setbacks, and septic kentim). Ixs.6s v p 3 Account No. J Revised DCHD(07199) favoke No. h r y i :rlctlbtJ GT- •r riu PLIGATIONFO „� TE EVALUATIONAMPROVEMENT PERMIT &ATC I ;+ )�avie County Health Department Environmental Health Section 9 P.O. Box 848 7, 12 _.1 i Mocksville NC 27028 U 1 ENY1Rari�;Ei1TALllfnlTit (704) 634-8760 ilknF Cl'.ii2tTl! ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed � I 7 S Contact Person S.�r�L' 6' 9 alf Mailing Address /O 7M eJVj2&-=12P,4 s s i?O� Home Phone 5,4 City/State/Zip AQ-.14"c_ C . -Z7006 Business Phone '519 >L' 2. Name on Permit/ATC if Different than Above y ASL Mailing Address 17Ar7/ G--' City/State/Zip 3. Application For: [,-ZSite Evaluation ( ]Improvement Permit&ATC [ ]Both 4. System to Serve: N House [ ]Mobile Home [ ]Business [ ]Industry [ ]Other 5. If Residence: #People #Bedrooms #Bathrooms [ ]Dishwasher[ )Garbage Disposal [ ]Washing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing 6. If Business/Other:Specify type #People #Sinks #Commodes #Showers #Urinals #Water Coolers If Foodservice:#Seats Estimated Water Usage(gallons per day) 7. Type of water supply: [ ]County/City [ ]Well [ ]Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes [ ]No If yes,what type? L I 1111.IC •1 1•L,t I LM' SI-IL PLAN PROPERTY INFORMATION REQUIRED:***IMPORTANT***•AFDAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: C �- �� �6T3 "22;WRITE DIRECTIONS(from Mocksville)TO PROPERTY. Tax Office PIN: # !5--66o - �_- 5� . S /�P 404 S? o Property Address: Road?f tame R 4 G Ly City/Zip � .4NccAl. �, ; 70c) /1/C),r4-A cJ % Cc2L14q 77-&-'t- ,(Zy If in Subdivision provide information,as f llm�cr �J T S/.� [, Name: - ; Section: Lot#• A(0/ L47' /&Osi /jai A-1 AP) This is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s) issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE 7- / Z -h;'LSIGNATURE Revised DCHD(06-96) THIS M-,'EA MA11 13E USED F01? WMIPIN(i 110111% SITE PLAN.( Filed for re; 1107 the subdivision plot shown hereon has .,p It rlin the County Subdivision Regulations, C""ficate of APProval by t!w Planning Board or such earlanees, if any, as noted In the DEPARTMENT OF TRANSPORTATION .nn Ing Board and that I t has been approved for the DavisCouPsww BO°rd hereby approved itrwt Diat for the WooletroodSubdbidon' DIVISION OF HIGHWAY) Tilt* of the Register of Deeds. It Is hereby ppro,al for recordation does not IncludeIn Plot 60011 and atlllie sanitary lacllltles nor does It PROPOSED SUMMSON ROAD CONSTR- - - UCnON STANDARDS CERnF)CATION .r the construction or occupancy of pulldings Date Chdm ron,County Planning Board F 1 1 i n g Fee P< . .APPROVED- ...___. _ D61PJCT ENGINEER --- — D�iecro�, Davie County Planning Departrr7ent DATE oy Parcel 65 ,Iames Mayhew D.B. 071-392 S 83°51'35"E 1548.89' 150.08' 150.08' 150.08' control come ' • 150.08' " t 150.08' 150.08' 1 12.18' t - i 5.04' i • W In \ W ` W point - 4 N czn :tJ - 16 6 ��1zo w ; O N p N 4 o , point Z Z o N pS a it Z O r4 v v Z O (V D Z A �� point 1.18.69' 15✓,.00' 150.00' 1 150.00' 1SQ.00' �' 115:,..).x• . point S 85°44'i 5"E 1048.69'.--.-t. 1.50.00*Providence Court 1050.41' l 60public S 85°44'15"E 1050.00' --s. 'Z$ 150.00150.00' t 50.00' t 50.00' C �`+�. 1 a.J�' 150.00' 3.: `7) �� -fir 4 .n i > 1D � I I ) r) I I nl i I �� �r) IQ A " PLIGATIONM .L—T TE EV ALUATIONAMPROVEMENT PERMIT&ATC U �'; �)�avie County Health Department U Environmental Health Section Gf 1999 P.O.Box 848 2 Mocksville,NC 27028 E11ylR0r11.1E1ffAL 11EAL111 (704)634-8760 uiff CI`d1:ay ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. NametobeBilled ��i7A<< 10o 7-TS Contact Person ��1r�L•� n Mailing Address 20'7D /?O� Home Phone q .n City/State/Zip A Q%t4,yr c� N, C . Z 7 U U G Business Phone :5A �L 2. Name on Permit/ATC if Different than AboveAin� Mailing Address r7fl rr/ L'- City/StateMp 3. Application For: [,s�kSite Evaluation [ ]Improvement Permit&ATC [ ]Both 4. System to Serve: P4 House [ ]Mobile Home [ ]Business [ ]Industry [ ]Other 5. If Residence: #People #Bedrooms #Bathrooms [ ]Dishwasher[ ]Garbage Disposal [ ]Washing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing 6. If Business/Other:Specify type #People #Sinks #Commodes #Showers #Urinals #Water Coolers If Foodservice:#Seats Estimated Water Usage(gallons per day) 7. Type of water supply: [ ]County/City [ ]Well [ ]Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes [ ]No If yes,what type? L111101 A PLAI OR SHE CLAN PROPERTY INFORMATION REQUIRED:***IMPORTANT***,ATtT AT OF THE PROPERTY MUST BE SUBMITTED WITH TILS APPLICATION. Property Dimensions: C - �� �6T, ,WRITE DIRECTIONS(from Mocksville)TO PROPERTY: Tax Office PIN: #_t 86 b Property Address: Road Flame R A L 7—' hyc Lsr /2,0 A Citymp 4,0 VA Ale A/. ; _700 ' ll/v./l-A y % C_ 4-,e44?ZC:r.t- If in Subdivision provide information,as follows:��i�c-C- V �l c A,? o n/ G,i f' S 7- X XD C-:' Name: - ; Section: Lot#: LOT- On l_ NeLz This is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE 7- / Z ';'�' SIGNATURE Revised DCHD(06-96) / T11IS A1,'EA AI. I/ 13E USED F01Z I)RAIVINC 1/0111: SITE PLAN: 1 r - — — tllta Tor reptsl y that the subdlvlalon plat shorn hereon hos CQrt#✓clxte o1 Approval by the Planning Board DEPARTMENT OF TRANSPORTATION �• amply rl ih the County Subdlvls ion Repulaf Ions, I on of such var l onceu, It any, as noted In the The Davie County Planning Board h—by approved the Mol plat for the DIVISION OF HIGHWAYS In Plat Book P lannlnp Board and that 11 has been approved for Yaplerood Subdt.Won. e office of the Replster of Desds. It Is hereby PROPOSEDTANDMSCS"N ROAD approval for rec or datlon does not Include CONSTRUCTION STANDARDS CERTIFICATION tall and oil,its sanitory facllitlu or does It 1 for the construction or occupancy of Dui ldlnps Fr.q Fee Papa' Dote Cttdrrnan,County Pbminq Board APPROVED----.- -- - - - — DISTRICT ENGINEER Ly DATE - --------- ------ - -- - - -- Ft Director, Dovia County Planning Department I I� Parcel 65 James Mayhew D.B. 071-392 --- S 83°51'35"E 1548.89' 150.08' "control corners' 150.08' 150.08' 150.08' 150.08' 150.08' t 12.t 8' 5.04' •� point w w r ` _ Zr•� i lam ) ,� � 1 .. � - 14 � � 5 � 16 \1'vl � nj -7 v � ;n ao. _ n Point ]U IO N N I d N Ln ��TTI Z Z N N L7 N Z Z r' /1 Z point \ point tip/ r, 148.69' 151 00' 150.00' 150.00' 150.00' S 85°44'i 5'E 1048.69' tr Providence Court 105041 60 ' public S 85°44' I YE 1050.00' — �' ! 1 . t 50.00' 150.00' 1 t 50.00' t 50.00' C � r 3 _ ,n N �n -ry - - DAVIE COUNTY HEALTH DEPARTMENT L- Environmental Health Section Soil/Site Evaluation • APPLICANT INFORMATION PROPERTY INFORMATION Account M 989900111 Tax PIN/EH#: 5860-81-3295.15 Billed To: Gray Potts Subdivision Info: Princeton Lot#15 Reference Name: Gray or Betty Potts Location/Address: Baltimore Road-27006 Proposed Facility: Residence Property Size: 150 x 274 Date Evaluated: Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% HORIZON I DEPTH 0-10 d Texture groupL Consistence Gr SeGe Structure Mineralogy ; HORIZON II DEPTH Texture group Consistence Structure S(61,- Mineralogy Mineralo ' 1 HORIZON III DEPTH I Texture group Consistence Cr S S Structure Agk- MineralogyI: HORIZON IV DEPTH Texture group Consistence 5S Gr 5� Structure Li Mineralogy ; SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE 6.q, I \ n SITE CLASSIFICATION: t'S EVALUATION 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 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 Structure SC-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 05/99(Revised) MENNEN MEMiiiiiNNEN EMMONSiiiiiiiiiiiiiiiiiiMEMNON� ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■eee■■■■■■ ■■■■■■■■■■■■s■■■■■■■■■■■■■■■■■e■■e■■■■■■■■■e■■■■■se■■eee■■■e■e■e■■ ■eee■■■■e■■■■■■■■■■e■■■■■■■■■■e■■■■■e■■■■■■■■■■■■■■■■■■■■■e■e■ee■■ ■■e■■ea■e■■■■■■■e■■ee■■■eas■■■■■ ■■■e■■■■■■e■■■■■s■■■■■■ee■ee■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■e■■e■■■e■■e■■e■■■■■■■■■■■e■ r 1 I I 1 ------- - - -----.� + ? DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #. 989900111 Tax PIN/EH#: 5860-81-3295.15 Billed To: Gray Potts Subdivision Info: Princeton Lot#15 Reference Name: Gray or Betty Potts Location/Address: Baltimore Road-27006 Proposed Facility: Residence Property Size: 150 x 274 Date Evaluated: SSI Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% J HORIZON I DEPTH Texture group C_L_ L Consistence Gr Structure k Mineralogy HORIZON 11 DEPTH - Texture groupC Consistence Structure S Mineralogy = HORIZON III DEPTH At.4 - IS - Texture group5- Consistence s 5� Structure MineralogyI: HORIZON IV DEPTH Texture groupq Consistence 55&0 Gr SS P Structure k Mineralogy ; SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE \ SITE CLASSIFICATION: Y EVALUATION BY: T�3mow'n'v"p 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 clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE oist 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 Structure SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralogy 1:1,2:1,Mixed iVotes 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 05/99(Revised)