143 Timber Creek Road Lot 6Dirgctions to property: - L/1' '� Section: Lot:
AUTHORIZATION FOR ' `Y`.
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
M Z Z�6 Ap ZOdZ
Road Name: :
**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 l I 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.
ENVIRON HEALTH SPECIALIST DATE ISSUED
L_
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AS Seo
- ►bri
AUTHORIZATION NO:
0931 DAVIE COUNTY HEALTH DEPARTMENT
p
Environmental Health Section
PROPERTY INFORMATION
Permittee's
P.O. Box 848
.--;-
Name:
Mocksville, NC 27028
Subdivision Na qr
•
Phone #: 704-634-8760��"
Dirgctions to property: - L/1' '� Section: Lot:
AUTHORIZATION FOR ' `Y`.
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
M Z Z�6 Ap ZOdZ
Road Name: :
**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 l I 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.
ENVIRON HEALTH SPECIALIST DATE ISSUED
L_
bj r, ` •f 3' r,
C{ DAVIE COUNTY HEALTH DEPARTMENT
Y� IMPROVEMENT AND OPERATION PERMITS
,Permittee -s
Name:1'� ': 4v,
Directions�to property:
IMPROVEMENT
PERMIT
PROPERTY INFORMATION
Subdivision
q- r,-�r�
Section: .�.f,, Lot:
Tax Office PIN:#.��
Road Name• 1:
l j r{ �7114' 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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***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.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 3 # BEDROOMS ? # BATHS P # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
J'I
LOT SIZE TYPE WATER SUPPLY ( c:' DESIGN WASTEWATER FLOW (GPD) ? e� NEW SITE Lf REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE /DDG GAL. PUMP TANK%l9d t7 GAL. TRENCH WIDTH '� 1al ROCK DEPTH /--? LINEAR FT. "
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT l
,
**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) 634-8760.
OPERATION PERMIT
noa reew-
) BY: D
AUTHORIZATION NO.�L► 1_ OPERATION PERMIT BY: (1-C�W3�tA (\.)�N"�l DATE: /
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE T14AT 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.
DCI(D 05/96 (Revised)
1.V. LVA VTV
MOckSVill6; NC 27028
(704) 634-8760 }
I
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
4 THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed 1 Contact Person %C/G
Mailing AddressHome Phone
}' C« c'^.e/Zip Business'Phone_��f 7oC•'%�.
2. Name c 'r.,mit/ATC if.Different than Above
Mailing Ad6ress Z City/State/Zip
3. Application For: [ ite Evaluation [ ] Improvement Permit & ATC [ ] Both
System to Serve: [G House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other "
5'. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] Garbage Disposal
Washing Machine [ ] Basement/Plumbing [ ] Basement/N6'Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
} # Showers # Urinals # Water Coolers
If Fo6dservi.e: # Seats Estimated Water Usage (gallons per day)
7. Type'of water supply: [ounty/City. . [ ] Well [ ] Community;
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes 1pro
i If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** XT-UMOF THE PROPERTY MUST BE
y SUBMITTED WITH
,
6hS APPLICATION.
Property Dimensions: 1WRITE DIRECTIONS (fromocksville) TO PL'OP
ERTY
Tax
Office PIN: #
Property Address: ' Road ame z�./ efA 1
City/Zip /Z /Jt/Ia�1C� .. 7do 6 21 3 ✓P t
g
If in S1< :ivision provide information, as follows:
Name:
,
Section:__ Lot #: ''-7-
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 ys 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 / //Cl 0=14 el -'9 Zp/e/ Alk-- t uct all t ting ce ures as necessary to determine the site suitabi'ity.
r
DATE—
SIGNATURE
Revised
ATESIGNATURERevised DCHD (06-96)
'
.,THIS AREA MAY $E USEI) FOR DRAWING YOUR SITE PLAN:
,ccc� preo�o srce.1"�Z4�.1.
Davie County Heafth Department
and.Come Health agency
2nvironmenta( ealth Section
P.O. 80X 848 / 210 HOSPITAL STREET
COURIER #09-4-06
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-8760
May 22, 1997
F
Dick Anderson Construction
225 Wing Haven Lane
Mocksville, NC 27028
Re: Timber Creek II/Lot.6
Dear Mr. Anderson:
This letter is regarding Lot 6, Section II of the Timber Creek subdivision
in Davie County.
After further evaluation and increased lot size this office classifies
this lot provisionally suitable for an oversized, modified septic tank system.
If you have questions, feel free to call this office.
Sincerely,
Robert S. Hall, Jr., R.S.
Environmental Health Section
RH/xd
cc: Zoning Office
Davie County .health Department
and dome Health Agency
Environmenta(Heafth Section
P.O. Box 848 / 210 HOSPITAL STREET
COURIER #09-40-06
MOCKSVILLE, M.C. 27028
PHONE: (704) 634-8760
Dick Anderson Construction
225 Wing Haven Lane
Mocksville, NC 27028
February 27, 1997
SCG
Re: Timber Creekf/Lot 6
Dear Mr. Anderson: ,
I
This letter is to confirm our conversation on February 27, 1997, regarding
lot 6 in the proposed Timber Creek subdivision in Davie County.
Upon closer review this office feels that there is insufficient soil depth
to install a conventional septic tank system; however, a low pressure pipe
system or sand filter system may be an alternative. I have requested our
regional soil scientist to assist me in making this determination. He is
scheduled to be at our office on March 17, 1997.
If you have questions or I can be of further assistance, feel free to
call.
Sincerely,
/)6'W' ?�glq k,5 -
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
cc: Jesse Boyce, Zoning Officer
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME f!✓9'�DATEEVALUATED /ct
PROPOSED FACILITY 1-1 PROPERTY SIZE It, , 'v
SUBDIVISION ROAD NAME e O ' e2
Water Supply:
Evaluation By:
On -Site Well
Auger Boring
Community
Pit
Public 6i
Cut
FACTORS
1 2
3
4 5 6 7
Landscape position
Z__L
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
119,0
Texture group
Consistence
-
Structure
/71
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: P ? EVALUATION BY: I ZZ
LONG-TERM ACCEPTANCE RATE: l OTHER(S) PRESENT:
REMARKS: zoYG.t/
e-yLEGEND
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 (01-90)
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AL WORIZATION NO: Q 9 31 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Permittee's 'P.O. Box 848
Name: �A�/ ,9Vet2 v9-2 ! Mocksville, NC 27028
Phone #: 704-634-8760
Duqctions to property: %�� � ; " f;, /' �'` r/-
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION
PROPERTY INFORMATION
Subdivision N�arr
Section: Lzzr Lot:
Tax Office PIN,:# �Y^ r
Road Name: !' J t 1A,� Z fiy
**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 11 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 f
RESIDENTIAL SPECIFICATION; BUII:DING TYPE / # BEDROOMS `,sem # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or Nc
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or N,
LOT SIZE TYPE WATER SUPPLY !f DESIGN WASTEWATER FLOW (GPD)': ` t NEW SITE 1'' REPAIR SITE '
SYSTEM SPECIFICATIONS: TANK SIZE °�I'r"� /GAL. PUMP TANKL10 4 GAL. TRENCH WIDTH 7 ROCK DEPTH a LINEAR FI.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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) 634-8760.
OPERATION PERMIT
f
«(+ re
SYS M INSTALLED BY: D c�iw,SL, aA�M_,
i
iLn
l `�1,� ' ��T-�1�� DATE: / no 1 !
AUTHORIZATION NO. OPERATION PERMIT BY:
i
"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)