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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. b� y,•�v-ill hu:V-�.fyxfJ.'aYxtr ,_ _ ,.. �v 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—. $,APP -CC SCALE .1 "T Wv Xmpsrcv 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 RH/wd Enclosure(s): Soil/Site Evaluation(s) Billing Statement