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170 Matthias Court Lot 11OPERATION PERMIT y Davie County Health Department ►'�`�ls 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Builders, MD LLC Address: 8609 Scoggins Road City: Oak Ridge State2ip: NC 27310 Phone #: (336) 362-2234 Address/Road #: 170 Matthias Cout Mocksville NC 27028 Structure: SINGLE FAMILY # of Bedrooms: 4 # of People: *Water Supply: PUBLIC *IP Issued by. *CA issued by: 2140 - Nations, Robert Design Flow: 4 8 0 Soil Application Rate: 0 a 5 Nitrification Field No. Drain Lines Total Trench Length Trench Spacing: Trench Width: Aggregate Depth: *CDP File Number 124979-1 H5 -200 -AO -011 County ID Number: Evaluated For: NEW �Township: Property Owner: Patrick and Michele Walsh Address: 125 Embark Court City: Kemersville State2ip: NC 27358 Phone #: ertv Location & Site Information Subdivision: The Oaks at McAllister Phase: Lot: 11 Directions Hwy 158 turn right on Sain Road, Right on Old Hanford Ave. Left on Chandler Dr, right on S Madera Drive, Right on Matthias Court *System Classification/Description: TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) SaproliteSystem? OYes ONo *Distribution Type: GRAVITY -SERIAL Pump Required? OYes QNo *Pre -Treatment: Drain field Sq. ft. 8 4 4 0 ft. ()Inches O.C. — 9 Feet O.C. 3 Olnches Feet inches Minimum Trench Depth: 3 6 Minimum Soil Cover. 2 4 Maximum Trench Depth: 3 6 Maximum Soil Cover: a 4 Inches Inches Inches Inches *System Type: INFILTRATOR QUICK 4 STANDARD Installer: glenn meredith Certification #: 1857 *EH S: 2140 - Nations, Robert Date: 0 7/ 3 1/.2 0 1 4 Approval Status O Approved O Disapproved CDP File Number 124979 - 1 Manufacturer. shoaf Countv ID Number: HS -200 -AO -011 Lat. STB: 760 Long: Gallons: 1000 Installer: glenn meredith Certification #: 1857 Date: 0 4/ 1 4/ x 0 1 4 *EH S: 2140 - Nations, Robert 'Filter Brand: ST Marker: ❑ Yes ❑ No Reinforced Tank: ❑ Yes ❑ No 1 Piece Tank: ❑ Yes ❑ NO Manufacturer. PT: Gallons: Date: / Riser Sealed ❑ Yes Riser Height: ❑ Yes einforced Tank: ❑ Yes �, 1 Piece Tank: ❑ Yes Date: 0 7/ 3 1/ 2 0 1 4 Approval Status O Approved ❑ Disapproved Pump Tank Pipe Size: inch diameter Pipe Length: feet "Schedule: Pressure Rated ❑ Yes ❑ No Lpproved fittings ❑ Yes ❑ No Installer: Certification #: *EHS: Date: Approval Status ❑ Approved ❑ Disapproved pply Line Installer: Certification #: 'EH S: Date: Approval Status ❑ Approved ❑ Disapproved Pump Type: Installer: Dosing Volume: — Gal Certification #: Draw Down: Inches *EHS: "Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check -valve ❑ Yes ❑ NO Approval Status PVC unions ❑ Yes ❑ No ❑ Approved ❑ Disapproved Vent Hole ❑ Yes ❑ No Anti -siphon Hole ❑ Yes ❑ No / ❑ No ❑ No (Min.6 in.) ❑ No ❑ No Pipe Size: inch diameter Pipe Length: feet "Schedule: Pressure Rated ❑ Yes ❑ No Lpproved fittings ❑ Yes ❑ No Installer: Certification #: *EHS: Date: Approval Status ❑ Approved ❑ Disapproved pply Line Installer: Certification #: 'EH S: Date: Approval Status ❑ Approved ❑ Disapproved Pump Type: Installer: Dosing Volume: — Gal Certification #: Draw Down: Inches *EHS: "Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check -valve ❑ Yes ❑ NO Approval Status PVC unions ❑ Yes ❑ No ❑ Approved ❑ Disapproved Vent Hole ❑ Yes ❑ No Anti -siphon Hole ❑ Yes ❑ No • CONSTRUCTION AUTHORIZATION Davie County Health Department CDP File Number: 124979-1 210 Hospital Street P.O. Box 848 County File Number: HS-200-AO-01 Mocksville NC 27028 Date: 0 a/ 0 7/ a 0 1 4 Q Inch Drawing Drawing Type: Construction Authorization Scale:. . . QBlock = ft. QN/A U )-0 11 ws 111 : yffo i �s 7 .1 o a� �/yj a Co CA- e� Paae of 3 CDP File Number 124979 - 1 . LRMq( 4=PP_D!IuI4111 County ID Number: H5-200-Ao-011 NEMA4X Box or Equivalent ❑ Yes ❑ No Installer: Box 12 inches Above Grade ❑ Yes ❑ NO Certification #: Box Adj.To Pump Tank ❑ Yes ❑ No Conduit Sealed ❑ Yes ❑ N o *EH S: Pump Manually Operable ❑ Yes ❑ No "Activation Method: Date: Alarm Audible El Yes ❑ No Approval Status El Approved ❑ Disapproved Alarm Visible El Yes ElNO 2140 - Nations, Robert 'Operation Permit completed by: Authorized State Agent: Date of Issue: 0 7/ 3 1/ a 0 1 4 This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal, 15A NCAC 18A.1900 et. Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by a TYPE 11 A. sewage septic system. Rule .1961 requires that a Type TYPE II A. septic system meet the following criteria: Minimum System Review ByThe Local Health Department: N/A Management Entity: OWNER Minimum System Inspection/Maintenance Frequency By Certified Operator: N/A Reporting Frequency By Certified Operator: N/A Rule .1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain a valid contract with a public management entitywith a certified operatoror a private certified operator forthe life of the septic system. Rule .1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule. 1961 (2) (e) requires a contract shall be executed between the system ownerand a management entity priorto the issuance of an Operation Permit for a system required to be maintained bya public or private management entity, unless the system ownerand certified operator are the same. The contract shall require specific requirements formaintenance and operation, responsibilities of the ownerand systems operator, provisions that the contract shall be in effect for as long as the system is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of the Operation Permit that subsequent owners of the systems execute such a contract. OHand Drawing 41mport Drawing **Site Plan/Drawing attached.** OPERATION PERMIT Davie County Health Department CDP File Number: 124979 - 1 210 Hospital Street County File Number: H5-200-AO-011 P.O. Box 848 Mocksville NC 27028 Date: 0Inch Cn.�le• r1Q�.,..�. = # APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC �� Davie County Environmental Health /` ` P.O. Box 8481210 Hospital Street 1� Mocksville, NC 27028 97 (336)753-67801 Fax (336) 753-1680 Application For: n Site Evaluationlimprovement Permit n Authorization To Construct(ATC) n Both 9 Type of Application: ANew System I IRepair to Existing System I ;Expansion/Modification of Existing System or Facility ►**IMPORTANT'** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed Bui ld S Ll,(- Contact Person rl "dU3 Billing Address T b o 4 9d. Home Phone City/State/ZIP Business Phone 33 6 - 3b a - 96X Name on Permit/ATC if Different than Mailing Address YKUFLK1 Y 1NtUKMAI WN -Vale flousell~acfifly Comers slag ed NOTE: A survey plat or site plan must accompany this application. Included: n Site Plan flPlat(to scale) (Prnni(is valid fur 60 months w lh silrptan no expiration wi complete plat) _ Owner's Name i J 111I G h 6/ e- wdi is Phone Number Owner's Address t ZS 9r„ 4 r V C d t r/ City/State/Zip K -e rt T V i• Ile A1C,2-)35,T Property Address -7 r'►tG r AS CcuK'1 City »1 oc kS yl//t I.ot;S'i7•e JS 005' Tax PIN# Subdivision Name(if applicable — k Af 1h,.AlhilwSectio ow .Directions To Site: ! - Wi tk a•✓LC `- Jr Q ! L - nn dl C� r - 4r. t - If the answer to arty of the following questions is "yes", supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑Yes QINo Does the site contain jutisdictional wetlands? ❑Yes'yNo Are there any easements or right-of-ways on the site? XYes '4 No Is the site subject to approval by another public agency? ❑Ycs %No Will wastewater other than domestic sewage be generated? nYes XNo IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms # Bathrooms 3 . 5 Garden Tub/Whirlpool 6dYes ❑No Basement: UYes KNo Basement Plumbing: UYes No IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOOD§tkVICE ONLY: # Seats Type system requested: KConventional 'IAcccptcd ✓!innovative -'Alternative nOther Water Supply Type.xCounty/City Water u New Well UExisting Well U Community Well Do you anticipate additio}}�s or expa�ions of the facility is s� stem is intended to serve?'L'Yes 160If yes, wlrat type? Pool FossI b lV i n i c1 fU ✓e This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand thatianfesponsible for the proper identification and labeling of property lines and comers and locati fl in o takin dose/facility location, proposed well location and the location of any other amenities. 1�owner's owner's legal representative signature Site Revisit Charge Date(s): 2L Client Notification Date: Datd I EHS:� Sign given I ;Yes rINo Revised 11/06 C'f• Account # Invoice # CONSTRUCTION For Office Use Only ' AUYHORIZATION *CDP File Number 124979-1 �=' Davie County Health Department County ID Number: H5-200-Ao-011 f r 210 Hospital Street P Evaluated For: NEW P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone: 336-753-6780 Fax: 336-753-1680 0 a/ 0 7/ a 0 0 7 Applicant: Builders, MD LLC Address: 8609 Scoggins Road City: Oak Ridge StatefZip: NC 27310 Phone #: (336) 362-2234 Address/Road #: 170 Matthias Cout Mocksville NC 27028 Structure: SINGLE FAMILY 9 of Bedrooms: 4 9 of People: =Water Supply: PUBLIC Property Owner: Patrick and Michele Walsh Address: 125 Embark Court City: Kernersville StateRip: NC 27358 Phone 9: Subdivision: The Oaks at McAllister Park Phase: Lot: 11 Directions Hwy 158 turn right on Sain Road, Right on Old Hanford Ave. Left on Chandler Dr, right on S Madera Drive, Right on Matthias Court Classification: Minimum Trench Depth: 3 6 Inches \Site Saprolite System? OYes O Minimum Soil Cover. a 4No Inches Design Flow: 4 8 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 a 7 5 Maximum Soil Cover: a 4 Inches 'System Classification/Description: `Distribution Type: GRAVITY - SERIAL TYPE 11 A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: 1 0 0 0 Gallons 'Proposed System: 1 -Piece: OYes QNo Pump Required: OYes ONo OMay Be Required Nitrification Field 1 7 4 5 Sq. ft. Pump Tank: Gallons No. Drain Lines 5 1 -Piece: OYes ONo Total Trench Length: 5 8 a GPM—vs— ft. TDH ft Trench Spacing: — 9 QInches O.C. Dosin Volume: _ Gallons Feet O.C. g Trench Width: 3 Olnches _ . ()Feet Grease Trap: Gallons Aggregate Depth: 1 a inches Pre Treatment: ONSF OTS -1 OTS -II Septic Tank Installer Grade Level Required: 01 011 OIII OIV Page 1 of 3 CDP File Number- 124979 - 1 County ID Number: H5-200-Ao-011 ❑ Open Pump System Sheet System Required: V Yes V No vlvo, out nas Hvallapie Opdt;U /Repair System Trench Spacing: 9Q Inches O. O Feet O.C. *Site Classification: Provisionally suitable — Trench Width: 3 Inches Design Flow: 4 8 0 — Feet Aggregate Depth: 1 a inches Soil Application Rate: Minimum Trench Depth: 3 6 Inches *System Classification/Description: TYPE IIA. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS; Minimum Soil Cover a 4 Inches Maximum Trench Depth: 3 6 Inches 'Proposed System: Maximum Soil Cover: a 4 Inches Nitrification Field 1 7 4 5 Sq. ft. *Distribution Type: No. Drain Lines 5 Total Trench Length: 5 8 a Pump Required: OYes ONo OMay Be Required ft Pre -Treatment: ONSF OTS -1 OTS -II , "Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. 7; *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. 2( This Authorization for Wastewater System Constrution shall be valid for a person equal to the period of validity of the Improvement Permit, not to exceed five years, and maybe issued at the sametime the Improvement Permit issued (NCGS 130A-33G(b)} If the installation has not been completed during the period of validity of the Constriction Perni% the information submitted in the application for a permit or Construction Authorization Is found to have been incorrect, falsified or changed, or the site is altered, the permit or Construction Authorization shall become invalid, and may be suspended or revoked (.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature: ___ Date: 'Issued By: 2140 -Nations. Robert Date of Issue: 0 a/ 0 7/ a 0 1 4 Authorized State Agent: Malfunction Log Oyes OHand Drawing Olmport Drawing **Site Plan/Drawing attached.** Page 2 of 3 3F VICINITY MAP (Not to Scale) PB 7, PG 129 I N W+E S 10' Utility Esrn't East Knoll Brook Drive I 50' Public R/W d (Per Plat) I 10' Utility Esm't j I c W 9`I PB 7, PG 130 S s a N I 1 I I 1 I - I I X10) I PB 9, PG 318 I PB 9, PG 318 I I I I I I I S88042'00"E Matthias Court 50' Public R/W (Per Plat) `25) `, ,�--- PB 9, PG 318 Common Area GENERAL NOTES and LEGEND Telephone: 336.605.0328 PLOT PLAN for PROPOSED RESIDENCE 1. This plat Is subject to any easements, agreements or rights of way of record, prior to the date of Lot N0. 11 The Oaks at McAllister Park, Sheet One Of TWO this plat, which were not visible at the time of my inspection. This document was prepared without D mWandsolutionsofnc.com the benefit of a title repot. Firm License No. P-1190 Title Source: Plat Book 9, Page 318 2. The method of computation for acreage and ratio of precision is coordinate calculation. MOcksville Township, Davie County, North Carolina 3. All distances shown on this plat are horizontal distances, unless otherwise noted. Property Address;. 170 Matthias Court p 4. This plat and any accompanying documents are furnished to the person or fine noted and no alterations or use by others Is permitted without the express written consent of Land Solutions of North Carolina, PLLC. Survey Date(s): N/A EIP Existing Iron Pipe DMUE Drainage, Maintenance RCP Reinforced Concrete Pipe EIR Existing Iron Rod and Utility Easement CMP Corrugated Metal Pipe Prepared For: NIR New Iron Rod (Set) OSSE Off Site Septic Easement INV Invert Builders MD / R/W Right of Way PT Point (No Monument Set OHU Overhead Utilities ESMT Easement or Found) Q Property Comer DE Drainage Easement B/L Building Line 0 30 60 Scale 120 180 SDE Sight Distance Easement Fence UP Utility Pole PSSAME Private Sanitary Sewer Lines Not Surveyed LP Light Pole Access and Maintenance One Inch =Sixty Feet C/L Centerline Easement Overhead Utilities FOR ILLUSTRATIVE PURPOSES ONLY THIS MAP IS NOT A CERTIFIED SURVEY 200 South Regional Road, Suite 104, Greensboro, NC 27409 Post Office Box 347, Oak Ridge, NC 27310-0347 COPYRIGHT © 2014 by Land Solutions of North Carolina, PLLC I PROJECT NUMBER: 1 14100011 1 DRAWING FILE: 1 14100011 Telephone: 336.605.0328 Fax: 336.605.0329 LAN D mWandsolutionsofnc.com SOLUTIONS Firm License No. P-1190 LANG SURVEYING. DESIGN AND PLANNING 200 South Regional Road, Suite 104, Greensboro, NC 27409 Post Office Box 347, Oak Ridge, NC 27310-0347 COPYRIGHT © 2014 by Land Solutions of North Carolina, PLLC I PROJECT NUMBER: 1 14100011 1 DRAWING FILE: 1 14100011 r Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990004186 Tax PIN/EH M 5749-53-8619.11 Billed To: Cool Spring Builders, Inc. Subdivision Info: The Oaks at McAllister Park Lot # 11 Address: PO Box 2040 Location/Address: Sain Road -27028 City: Advance Property Size: see map Reference Name: Michael Moorefield Proposed Facility: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type:,R<ew ❑Repair ❑Expansion Permit Valid for: 0 Years ,Z o Expiration Residential Specifications: # Bedrooms_�/__ # Bathrooms3 # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) DesignFlow(GPD): Type of Water Supply: ?<unty/City El Well ❑Community Well Site Modifications/Permit Conditions: PUMP rr-1 Q01 t&f 6& aLrk) (2, .System Type LTAR Initial Re air- %�) Site Plan . \ 0' Environmental Health Specialist i.p.l l -06 00* 00; j Date C" 111j1YIV 1 I n NOV 2 71 AtV aAtV EVALUATION/IMPROVEMENT PERMIT & ATC vie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Appli ation For -" iL� !UatienthTfpr ement Permit ❑ Authorization To Construct(ATC) ❑ Both Type €A kation: XNew System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed CO" _>y� ' /i) Contact Person /% c1)�q /Vt oleT'��-�i Billing Address PC) irk A6,�- ❑Yes BNo Home Phone J City/State/ZIP rS PS't,'/% /u � Will wastewater other than domestic sewage be generated? Business Phone 33&-3`r i - `i 1�--3 (Ce// 11) Name on Permit/ATC if Different than Above Mailing Address City/State/Zip PROPEIZI'Y 1NFORMAIIUN 'FDate House/Facility Comers Plagged NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan*lat(to scale) (Permit is alid for 60 months w ?" site p n, no expiration with complete plat.) Owner's NameC . I-) r i�•'e U/� ':S Pho e umber � 1 C Owner's Address 5 / l City/State/Zip A Property Address �'�,�ic City Lot Size Tax PIN# Subdivision Name(if applicable) 0,"-f Section/Lo t# , Directions To Site: /il %1,G;t9 F 1`/If re-,, GI-/ I)tdS F 1&'ll�j/ r� If the answer to any of the following questions is "yes", supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑Yes 4B -K Does the site contain jurisdictional wetlands? ❑Yes BNo Are there any easements or right-of-ways on the site? ❑Yes E�No Is the site subject to approval by another public agency? ❑Yes C1fTo Will wastewater other than domestic sewage be generated? ❑Yes ago IF RESIDENCE FILL OUT THE BOX B LOW # People 1— # Bedrooms # Bathrooms Garden Tub/Whirlpool Etres ❑No Basement: ❑Yes ❑NottI Basement Plumbing: NW�`-'s'--eNo /f,.1A IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of FacilityBusiness Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage.(gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: Vonventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: County/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes G -No If yes, what type? This is to certify that the information provided on this application is hue and correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and corners and locating and flagging or )aking the ouse/facility location, proposed well location and the location of any other amenities. / f -✓' w Site Revisit Charge Property owner's orner's legal representative signature Dt fl--�7. GAG Date Sign given ❑Yes ❑No Revised 11/06 a e(s). Client Notification Date: EHS: Account # Invoice # DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990004186 Tax PIN/EH #: 5749-53-8619.11 Billed To: Cool Spring Builders, Inc. Subdivision Info: Black Forest Lot # 11 Reference Name: Michael Moorefield Location/Address: Sain Road -27028 Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit I--" Public Cut SITE CLASSIFICATION: Ps LONG-TERM ACCEPTANCE RATE: O-T2!�_ REMARKS: EVALUATION BY: �_ L -_FE✓ a 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 Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firth 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 lYQte� 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 05105 (Revised) Landscape position • . - 1, Wr_ SI �%r'�� ---- HORIZON DEPTH Texture group Consistence HORIZON • Texture _.. • r�M3r•OM■cI ME®mss®�■� Consistence Mineralogy 19�N W WWG6SI7---- group L4 Consistence AOF MineralogyTexture moi- ��---- M 'A VAG)101 ' ------ Texture group Consistence Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SITE CLASSIFICATION: Ps LONG-TERM ACCEPTANCE RATE: O-T2!�_ REMARKS: EVALUATION BY: �_ L -_FE✓ a 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 Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firth 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 lYQte� 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 05105 (Revised) Appraisal Card DAVIE COUNTY. INC Page 1 of 1 1/27/2014 10:48:58 AM ALSH PATRICK KABEI-WALSH MICHELE Return/Appeal Notes: Parcel: HS -200 -AO -011 170 MATTHIAS CT PLAT: 0009/318 UNIQ ID 13440 302351 NN: 26 - CHANGE OF OWNERSHIP ID NO: 5749535833 COUNTY TAX (100), FIRE TAX (100) - CARD NO. 1 of 1 eval Year: 2013 Tax Year: 2014 LOT 11 THE OAKS MCALLISTER PK 1.000 LT SRC= Appraised by 28 on 02/23/2009 06402 MEADOW RIDGE TW -06 Cl- FR -12 EX- AT- LAST ACTION 20130705 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE TOTAL POINT VALUE Eff. BASE BUILDING USE MOD Area UAL RATERCtEYB1AYBj REDENCE TO ADJUSTMENTS 971 1 1 DOD EPR. BUILDING VALUE - CARD 1.TAL TOTAL ADJUSTMENT TYPE: Vacant EPR. OB/XF VALUE - CARD ACTOR ARKET LAND VALUE - CARD 22,50 TOTAL QUALITY INDEX STYLE: OTAL MARKET VALUE - CARD 22,50 APPRAISED VALUE - CARD 22,50 TOTAL APPRAISED VALUE - PARCEL 22,50 TOTAL PRESENT USE VALUE - PARCEL TOTAL VALUE DEFERRED - PARCEL TOTAL TAXABLE VALUE - PARCEL 22,500 PRIOR UILDING VALUE BXF VALUE ND VALUE 22,50 RESENT USE VALUE DEFERRED VALUE TOTAL VALUE 22,50 PERMIT CODE I DATE NOTE I NUMBER AMOUNT ROUT: WTRSHD: SALES DATA FF. RECORD DATE I DEEDINDICATE SALES AGE M R TYPE / / PRICE BOOK1953 0930225 6 01 WD Q V 2300 0838445 9 01 QC E V 0814766 12 200 TD P V 7560 I 0689 11 200 WD X V 0 HEATED AREA NOTES % SIZE % OB/XF DEPR. SUBAREA UNIT ORIGANN DEP GS RPL OD UAL DESCRIPTION OUN LTH HUNIT PRICE COND BLDG# FACT Y EY RATE V COND VALUE TYPE AREA CS OTAL OB/XF VALUE IREPLACE SUBAREA TOTALS BUILDING DIMENSIONS ND INFORMATION HIGHEST THER ADJUSTMENTS LAND TOTAL ND BEST USE LOCAL FRON DEPTH/ LND COND AND NOTES OA UNIT LAND UNT TOTAL ADJUSTED LAND OVERRIDE LAND SE CODE 20NING TACE DEPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS IP ADJST UNIT PRICE VALUE VALUE NOTES FR RES 0100 0 0 1.0000 0 0.5000 45,000.0 1.00 LT 0.50 22,500.0 2250 0 C TOPO/LOC OTAL MARKET LAND DATA 22,50 OTAL PRESENT USE DATA C P- http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=H520OA0011 1/27/2014 DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 /Fax # (336)753-1680 OPERATION PERMIT Account #: 990006165 Tax Pili€/EH #: H5 -200 -AO -011 Billed To: Builders, MD LLL Subdivision Info: The Oaks at McAllister Park Lot # 11 Reference Name: LocalionfAddress: 170 Matthias Court -27028 Proposed Facility: Residence Properly Size: 1.00 Ac ATC Number: 6059 * *NOTE* * The issuance of this Operation Permit shall indicate the system described on the ATC 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. System Type.:_. S.T. Manufacturer Tank Date Tank Size Pump Tank Size Bedrooms: System Installed By: Installer# Date: GPS Coordinate: Environmental Health Specialist. DCHD 11/06 (Revised) Date: �DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990006165 Tax PIN!EH #: H5 -200 -AO -011 Billed To: Builders, MD LLL Subdivision Info: The Oaks at McAllister Park Lot # 11 Reference Name: LocationiAddress: 170 Matthias Court -27028 Proposed Facility: Residence Properly Size: 1.00 Ac ATC Number: 6059 Site Type: Clew ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Seciion .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use chance. Residential Specifications: # Bedrooms 14 # Bathrooms 3 # People 3 Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size I - Type of Water Supply: Z1 ounty/City ❑Well ❑Community Well a0�. System Specifications: Design Wastewater Flow (GPD) 986 Tank Size i� GAL. Pump Tank GAL. 'r /' Trench Width 36P Max. Trench Depth 3e Rock Dept Linear Ft. Site Modifications/Conditions/Other: lks stated In 15A NCAC ?.g.?.195?f °f a 6-fo G'A e�u do S Mnls may aEo bo use Contact the Davie County Environmental Health Section for final inspection of this system between 8:3U - 9:30.m, on the day of installation. Telephone 4 (336)751-576U. Environmental Health Specialist DCHD 11/06 (Revised) Date: