2997 US Highway 601 South Lots 40,41,42,43Davie County, NC r Tax Parcel Report Thursday, November 3, 2016
WAKf41N is '1'MN lb PI V'1 A I UK V E T
Parcel Information
Parcel Number
M50000003203
Township:
Jerusalem
NCPIN Number.
5745868957
Municipality:
Account Number.
7032000
Census Tract:
37059-807
Listed Owner 1:
BLACKWELL DAVID F
Voting Precinct:
JERUSALEM
Mailing Address 1:
2997 US HIGHWAY 601 SOUTH
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
.770 AC HWY 601
Fire Response District:
JERUSALEM
Assessed Acreage:
0.77
Elementary School Zone:
COOLEEMEE
Deed Date:
3/1998
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
002010278
Soil Types:
PcB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
37390.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
15000.00
Total Market Value:
52390.00
Total Assessed Value:
52390.00
All data Is provided as Is without warranty or guarantee of any Idmi either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use All users of Davie County's GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATIPN NO: DAVIE COUNTY HEALTH DEPARTMENT /�%U
-r..
Environmental Health Section PROPERTY INFORMATIOIQ
Permittee's�+ P.OrBox 848
�:+',
Name: �+ Mocksville, NC 27028 Subdivision Name:42429Z.4ge.15
Phone # 704-634-8760
Directions to property`. ei 41 Section: Lot:
AUTHORIZATION FOR
WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:#
Road Name: w— Zip: '
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEAttli SPECIALIST DATE ISSUED
+�iJ .Mt Ft a'+'S'`k X'> t�vwt K .: i .'. , ;_ .f � t 2'..:g - e - 1 •. .,. - ,. . .
�3dt / �{ # ri''Y�'�.. gad" •c'� i...s;�� a ,_�,. � _ x� �:_t'. . - — " s
DAVIE COUNTY HEALTH DEPARTMENT /%
.IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permi!
ame: /
i r (?�1 ' Subdivision Namef
N
Directionkto property: f r' t� Section: Lot;
IMPROVEMENT
PERMIT Tax Office PIN:#+`*-�11f -
b UI Road Name: Ar Zip:
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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)
i! ; ,.•4
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM. j{
RESIDENTIAL SPECIFICATION: BUILDING TYPE 1M # BEDROOMS %,7 # BATHS 1P # OCCUPANTS 2. GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZL+:)OPW TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ZTtO NEW SITE REPAIR SITE
00SYSTEM SPECIFICATIONS: TANK SIZE APd GAL. PUMP TANK Md GAL. TRENCH WIDTH ROCK DEPTH LINEAR Fr. 46
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
OP
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 6348760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
90 Obi
L
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
*,*THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96 (Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERM
Davie County Health Department
Environmental Health Section FS
P. O. Box 848
,�►l'"�' ��l �e� �, a Mocksville, NC 27028
elILICATION
(704) 634-8760
S' 4 ****IMPORTANT**** THIS CANNOT BE PROCESSED UNLESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be BilledlC1r �GLSLC'/
Mailing Address 31.3 4 1110:L AdI2J li
City/State/Zip
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Serve:
5. If Residence:
Dishwasher
8 Site Evaluation
ElHouse a/
Mobile Home
# People
City/State/Zip
Contact Person Sa-171.G
Home Phone 3.3 to " y 63 J a 70 �
Business Phone 901/'(0Y /- Zau e
❑ Improvement Permit & ATC
❑ Business ❑ Industry
# Bedrooms
❑ Both
❑ Other
# Bathrooms
❑ Garbage Disposal 21 Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other: Specify type
# Commodes
If Foodservice:
# Showers
# Urinals
# People # Sinks
# Seats Estimated Water Usage (gallons per day)
7. Type of water supply: A County/City
❑ Well
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Community
❑ Yes No
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 0O X 3 1 WRITE DIRECTIONS (from
1 Mocksville) TO PROPERTY:
Tax Office PIN: # S % �� - � 4 - 8'9� 7 1
1 LD1 Sa���as�'
Property Address: Road Name 60 -• Boxuloo'4 0 ec", 10yZ--`r31 `
1 Stop lic�1'i Cgreo�.� C tP
city/zip `iYl d�ks l l + yo. c
Aon„ 0,PRrox',mK3rt\4Z
If in Subdivision provide information, as follows: 1 t
r n 1 f l y ms
Name: �JdiCW ��� lk G rL> 1
1
Section: Lot #: %� y2-43 1
1
1
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 byaU i l: DY r to conduct all testing procedures
as necessary to determine the site suitability.
DATE 2 " 'Z --. 9� SIGNATURE
Revised DCHD (06-96)
MAP NO I
BOX14YOOD AC; ZE-
JERUSA�Em TStiP
DAVIE CD,"'TY. t4 C
SAM P:.riE JR . SVR'.EY0lR
APA� 14. "Y61 " . '00 C I ,L—.
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A W, f* -.AS
IL
ATP V P—Ag:AttX%
loo e3,
77 715
75
20
O feI
it
40
*Ibl
GIN
40
46.
4b
to
�(9
Ze73
or
powA ZJ
$4
55
58 59
51
50
.56-57
52
,; -SAO
MAP NO I
BOX14YOOD AC; ZE-
JERUSA�Em TStiP
DAVIE CD,"'TY. t4 C
SAM P:.riE JR . SVR'.EY0lR
APA� 14. "Y61 " . '00 C I ,L—.
$,APP -CC SCALE
.1 "T Wv Xmpsrcv
A W, f* -.AS
IL
ATP V P—Ag:AttX%
MAP NO I
BOX14YOOD AC; ZE-
JERUSA�Em TStiP
DAVIE CD,"'TY. t4 C
SAM P:.riE JR . SVR'.EY0lR
APA� 14. "Y61 " . '00 C I ,L—.
A419
Vi
4F
0 C
90
28 �29 i
38 3,3
:4e -44 145
77,
CRAF"C
*NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: Tax Office PIN: #_T7 V -g' y'(S7 S'7
/-/w y �� / ,fib is L�� G. 113 PROPERTYADDRESS, as follows:
Road Name:#tut/ to 6l s
City:
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the
incurred b from this application.
Lt 9 -
DATE -DATE
knowledge, aril I understand I am
SIGNATURE
CONSENT FOR SITE EV�N TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. 1 OWthe property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
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 said site's suitability for a ground absorption sewage treatment
and disposal system.,
��- 2
DATE SIGNATURE
for all charges
DCHD (1/93)
OWTE
DICATION FOR SITE EVALUATION/IMPROVEMENTS
PERMIT
FEB —91996 Davie County Health Department
Environmental Health Section
'fir
!
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By
}
Mailing Address 7_� /
Home Phone o� �o
MG(
Business Phone aLf a D �f6
2. Name on Permit if Different than Above
1'
3. Application for: ❑ General Evaluation eptic Tank Installation Permit
i
4. System to Serve: ❑ HouseMobile Home
❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other
❑ Unknown `/
5. If house, mobile home: Subdivision 0 OL- WOO
Section Lot #X7'3
;i
❑ Basement/Plumbing
No. of People Z-�` 7
❑ Basement/No Plumbing
No. of Bedrooms
E3 -Washing Machine
No. of Bathrooms —
ishwasher
Dwelling Dimensions
-15arbage 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: 2-rublic ❑ 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 from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: Tax Office PIN: #_T7 V -g' y'(S7 S'7
/-/w y �� / ,fib is L�� G. 113 PROPERTYADDRESS, as follows:
Road Name:#tut/ to 6l s
City:
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the
incurred b from this application.
Lt 9 -
DATE -DATE
knowledge, aril I understand I am
SIGNATURE
CONSENT FOR SITE EV�N TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. 1 OWthe property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
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 said site's suitability for a ground absorption sewage treatment
and disposal system.,
��- 2
DATE SIGNATURE
for all charges
DCHD (1/93)
- DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation c
NAME PV �� \ D �R�� DATE EVALUATED l Co
ADDRESS Q PROPERTY SIZE j b a k Li 40
PROPOSED FACIILTY \ o LOCATION OF SITE
Water Supply:
On -Site Well
_ Community
Public
Evaluation ByQkL-
Auger Boring
Pit
Cut
FACTORS 1 2 3 4
Landscape position
Slope %
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: Q 'S' EVALUATED BY: C`_!)'� _�%
LONG-TERM ACCEPTANCE RATE: .3 OTHER(S) PRESENT:
REMARKS: � � A � � �
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
Moist
VFR-Ve.ry 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
5C --Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
Mineralo¢y
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
4
.,� ,.. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERM
• '� Davie County Health Department
•' Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
�A �R 1%0 N
D
JAN - 41996
VJ
1
1. Application/Permit Requested By 0,aaw arre�1
Mailing Address Home Phone %7p ,2,f/4/ o`ID %/E
hiockgvble "' L X70 0-1 Business Phone t y y 26&6
2. Name on Permit if Different Vn Above
3. Application for: RSeneral Evaluation ❑ Septic Tank Installation Permit
4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of
❑ Business ❑ Industry ❑ Other ❑Unknown
5. If house, mobile home: Subdivision A0 /� CJ�GL Section of # �% y
ElBasement/Plu 'ng
No. of People
No. of Bedrooms
No. of Bathrooms
Dwelling Dimensions
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
No. of Sinks
No. of Urinals _
No. of Water Coolers
Water Usage Figures
7. Type of water supply: ublic ❑ Private
8. Property Dimensions A o%� Sewage Disposal Contractor
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
T - ❑ Garbage Disposal
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
If yes, what type?
❑ Community
"NOTE: . Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
�V
f
This is to certify that the information provided is correct to the best of my
incurr d from this applic ion. /
D TE (J
PROPERTY INFORMATION REQUIRED:
Tax Office PIN # 57VY-274606-
Road Name 6
Box # (if avai able)
City
and I understand I am responsible for all charges
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 9if I OWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
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 said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD (1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME ��"�'
f / DATE EVALUATED a�
ADDRESS A �-� PROPERTY SIZE
PROPOSED FACIILTY �C'C 6 v s Q pty�9t LOCATION OF SITE
Water Supply: On -Site Well _ Community Public s/
Evaluation BY: V�\' AugerBoring_ Pit Cut
FACTORS 1 2 3 4
Landscape position L L
Slope %
HORIZON I DEPTH
Texture group ai
Consistence
Structure
Mineralogy
HORIZON II DEPTH V A'
Texture group
Consistence
Structure I
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: U/ �aZ% 96 EVALUATED BY: R�
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS: 4 "�: '\
LEGE
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- Vf--ry 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
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME
ADDRESS
S p'
PROPOSED FACIILTY
DATE EVALUATED _)I
PROPERTY SIZE t) C' X 33 O
LOCATION OF SITE
1,001 -S.
Water Supply: On -Site Well _ Communl�ty Public
Evaluation By:t_' CX.- Auger Boring Pits -% Cut
FACTORS
1
2
3
4
Landsca a position
Slope z
19 - 3V
Is 30
I°-
Wa- 1,9 - '- d
HORIZON I DEPTH
! l'
1 1'
2�"
Q.,,
.11' l a►' Is
Texture group
Q
C L
L-
C L L 0 L
Consistence
1 -
Structure
(7Z
Mineralogyl
(: 14k
\
'
1'1 '
HORIZON II DEPTH
n`'
Texture groupL°
Consistence
V
V F -X- I
V
VY -7t
Structure
WT
VNw-,
r
s
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: S • EVALUATED BY: Qxc-�_
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS: aroma eQ �� �-° ,S • '~C - • S•
LEGENb
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
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 watef 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
OFFICE OF THE DIRECTOR
p avie (guuutg Xenith P epartmEut
David Correll
2887 Hwy. 601S.
Mocksville, NC 27028
Dear Mr. Correll:
nub cNeme pealth Apure
P. O. BOX 665
fflarksbille, �Karth ( arulina 27028
April 3, 1996
Re: Site Evaluation(s)
Boxwood Acres/Lot 40-41
TELEPHONE
17041 634.5898
'97(10
As requested through your application, Robert B. Hall, Jr., R.S., and
Charles E. Little, R.S., Environmental Health Specialists, with this office,
visited the aforementioned site on February 27, and March 27, 1996. The
purpose of said evaluation(s) was to determine the soil/site suitability for
the installation of an on-site sewage system. The results of the
evaluation(s), a copy of which is attached, indicate that the site is
unsuitable for the installation of an on-site sewage system for the following
reason(s):
Rule .1940 (d) - Topography
Rule .1944 (a) - Restrictive Horizons
Rule .1941 (a) (3) - Soil Characteristics
Due to the limitation(s) on your site, this office is not aware of any
modifications or alternative measures that can be implemented at the present
time to upgrade.the classification from "unsuitable" to "provisionally
suitable." Your application for an Improvement Permit must, therefore, be
denied.
You have the right to an.informal review of this decision by the
Environmental Health Director of this office and also by the regional staff of
the Department of Environment, Health, and Natural Resources. You should
contact this office to arrange for this further review.
You may also wish to obtain the services of a private consultant to
collect site-specific data and submit such data and a system design to this
office for technical review. A site may be reclassified to provisionally
suitable provided written documentation, including engineering, hydrogeologic,
geologic or soil studies indicates to this office that a proposed on-site
sewage system or a proposed alternative system can reasonably be expected to
function satisfactorily. The substantiating data from these studies must
indicate that:
A. The effluent (wastewater) will receive adequate treatment;
B. The effluent (wastewater) will not contaminate any ground water
or surface water; and
.Page 2
David Correll
April 3, 1996
I
C. The effluent (wastewater) will not be exposed on the ground surface or
be discharged to surface waters where it could come into contact with
people, animals or vectors.
Finally, you have the right to a formal appeal of this decision if you
file a petition for a contested case hearing with the Office of Administrative
Hearings, P. 0. Drawer 27447, Raleigh, N.C. 27611-7447. A copy of a petition
form can be provided to you upon request. The petition must be received by the
Office of Administrative Hearings within thirty (30) days of the date of this
notice. The hearing may be held in Davie County.
If you file a petition for a hearing, you must send a copy of the petition
to Mr. Richard Whisnant, DEHNR, Office of General Council, P. 0. Box 27687,
Raleigh, N.C. 27611-7687.
Please call or write this office if you have any questions or need any
additional assistance. Telephone number: 704/634-8760
Address: Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
Sincerely,
Robert B. Hall, Jr., R. S.
Environmental Health Section
Q� 1�' ' 1;�7
Charles E. Little, R.S.
Environmental Health Section
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Enclosure(s): Soil/Site Evaluation(s)
Billing Statement