The URL can be used to link to this page

119 River Ridge Trail Lot 6i T l t r 'v a.i - .a '`^� yVv s v `N. _, ,...•y'.iV',,,..r�.s : . DAME COUNTY I1EALTH DEPARTMENT r�9 .'` IMPROVEMENT AND,OPERATIONP>ERMITS .. PROPERTY INFORMATION Permittee 's Name'.;'Subdivision Narr►e: Duecugnto Property• ..�:.� r• .NT Secpon: +� Lot: lip a J ,MPROVEM '" J• z:� PERMIT Tax Office PIN: Road Name ..a? r ' p: f . *!NOTE** This Improvement Permit DOES:NOT authorize the constriction or installation of a septic tank system or:any wastewater system An AU'T'HORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fr)m this Department prior to the construction/installation of a.' system or theissuance of a building permit. compliance with Article 1 I f of G S: Chapter I30A Wastewater Systems; Section .1900 Sewage Treahneat and Disposal Systems) ***NOTICE*** THLS PERMIT is suBJEGT TO REVOCATION N SITE PLANS OR THE:INTENDED USE CHANCE. YOUR WAS` MATER : ENVIRONMENTAI:'HEALTH S ._ IALIST. _ DATE:ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERWT BEFORE INSTALLING THE SYSTEM. . RESIDENTIAL SPECIFICATION BUILDING TYPE # BEDROOMS,---,57— # BATHS #,OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION FACILITY TYPE #•PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No, IT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER: FLOW (GPD) .Z NEW SITE_REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZEGAL PUMP TANK ' GAL. TRENCH WIDTH ROCK DEPTH_ .LINEAR FT. ,. ` OTHER r • 'RE UUM.SITE,MODIFICATIONS/CONDMONS; `r, a"_',. r ..�. r. ... _,.; Mr •.s„vw_ �..�.. ., .. ,; �� r tJ 'Y.. ,i � rr ... ...- r ..% f 1 ... AUTHORIZATION NO: 0 0 9 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee P.O. P.O. Box 848' Name:' 'I'-" �� `! ' �' ff�f�� t�5 Mocksville, NC 27028 Subdivision Name: j J' Phone # 336-751-8760 Directions to property: r �' 1 - K �/� Section: f Lot: -a AUTHORIZATION FOR WASTEWATER ,d�1-� SYSTEM CONSTRUCTION Tax Office PIN:# - .�. . � �^ - 64.! rz Road Name:. zip: .'.r;'cfiG� **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 I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED FOR SITE EVALUATIONAMPROVEMENT PER ou - - --__�__ ------------ Davie County Health Department Davie Environmental Health Section P. 0. Box 848 Mocksville, NC 27028 (704)634-8760 s ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed 6 f 4= Mailing Address Qa `^'1 K Vft 1 1. City/State/Zip 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: li7 Site Evaluation Contact Person Home Phone Q G8_ a (f P— Business Phone `7 q0 ,pq,�iq City/State/Zip ❑ Improvement Permit & ATC 7 Both 4. System to Serve: GY House ❑ Mobile Home ❑ Business ❑ Industry 5. If Residence: # People 115 # Bedrooms VDishwasher Garbage Disposal Washing Machine 1/Basement/Plumbing, 6. If Business/Other: Specify type 7. 8. # Commodes # Showers # Urinals ❑ Other _ # Bathrooms / ❑ Basement/No Plumbing . # People # Sinks # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) Type of water supply: ❑ County/CityWell Do you anticipate fdditions or expansions of the facility this system is intended to sT ve? 1f ves_ what tvne? ❑ Community ❑ Yes -,;/No PROPERTY INFORMATION REQUIRED: *** IMPORTAN *** A PLAT OF THE PROPERTY MUST BE g 6,q -7 71A1#-- SUB IT 6 D W TH THIS APPLICATION. Property Dimensions: IDac''ssy& 7 d 4,5 1 WRITE DIRECTIONS (from IV Mocksville) TO PROPERTY: Tax Office PIN: # Property Address: Road Name � 1 �lAt?lh( I� d�u c� (VC. �� i� 1 City/Zip � 1 If in Subdivision provide information, as follows: 1 Name: 1 Section: Lot #: 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 r the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by ��td ___ ___ _ __ __ _to ,conduct all testing procedures as necessary to determine the site suitability. DATE t l SIGNATURE Revised DCHD (06-96) , DAVIE COUNTY HEALTH DEPARTMENT } Environmental Health Section SECTION LOT ' Soil/Site Evaluation APPLICANT'S NAME r�hs ski" DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE SUBDIVISION ROAD NAME �.✓//f. �`' Water Supply: On -Site Well Community Evaluation By: Auger Boring ►/' Pit t i Public L Cut FACTORS 1 23 4 5 6 7 Landscape position p Sloe % HORIZON I DEPTH 1, � Texture groupL' L S 4 - Consistence Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure ." K 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 C2, SITE CLASSIFICATION: !! ] L��l /' LONG-TERM ACCEPTANCE RATE: REMARKS: � C _ r DCHD (01-90) EVALUATION BY: OTHER(S) PRESENT: 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 ■■■E■E■■E■■MEME■ ■MEMEM■■E■EEME■■ ■■MM■■■EM■M■■■■■ ■■M■E■ME■■E■E■■■ ■OM■E■E■■M■■■■E■ ■MEMS■EE■EE■E■E■ ■E■M■MO■■E■M■■E■ ■E■E■E■EEE■EM■E■ ■M■M■M■■M■■MMM■■ ■MENEMO■■■■E■EN■ ■■E■■■■ME■EM■■■■ ■■E■■■■■■OM■E■■■ ■MM■■■MM■■■■M■■■ ■■■■■■■■MOMM■■E■ ■M■E■E■■MMMOMME■ ■E■E■E■■■E■E■ME■ ■EMMEMO■■■■■■ME■ ■E■■■E■ME■■O■M■■ MEMO■■■■ w%M■M■■■ MME■M■■■ ■■MMM■■■ ■L■■■ME■ ■E■EME■■ ■E■M■■M■ ■ME■■■M■ ■■EEE■■■ ■■■MM■■■ MEN MEN mom MEN ■E■■■ MOONS ■LWIN ■■Mv■ ■■M■■ ■E■■■ ■■■■■ ■EE■■■E■■M■■■■■E■M■ ■EEE■■■■EE■■E■■■■■■ ■E■EEE■■■■■■■EN■E■■ ■■E■E■EE■■EE■■■E■E■ ■■E■■■ME■■ME■■■MEM■ ■E■■MM■MME■■MEE■■■■ ■E■EEE■■EEM■■EE■E■■ ■■■■■■MME■M■ME■■■■■ ■■■■■■ ■M■■■■ ■M■EM■ ■■MME■ ■■■■E■ NOOSE ■■■ iii ■ ■EM■ ■EM■ :f\■ ■EMME■■■ ■■■■M■■■ ■M■■■■E■ ■ME■■ME■ ■■■■■ME■ ■■■■■EM■ ■■■E■E■■ ■OMMOM■■ ■■■M■■■■ ■EMME■■■ MEMO ■E■■ NEON ■EM■ ■■E■ ■■N■ ■E■■ OMEN MEMO ■ 0 ■E■■ NONE Davie County Health Department and -Come Health .Agency Environmenta[Heaf& Section . P.O. BOX 848 / 210 HOSPITAL STREET COURIER #09-40-06 MOCKSIALLE, N.C. 27028 PHONE: (704) 634-8760 January 17, 1997 Tammy Hauser 287 Yadkin Valley Rd. Advance, NC 27006 Re: Site Evaluation River Rend Hills/Lot 6 Tax PIN: B700-00-0049 Dear Mrs. Hauser As requested, a representative from this office visited the aforementioned site on January 14, 1997. Based upon the information provided on the application for a site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of a modified, oversized on-site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, '000�v,,�" Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure(s) s