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315 Timber Trails Lane Lot 7Davie Countv. NC Tax Par -A R Pnnrt Tuesday. January 10. 2017 WARNIN T: THIS 1S NUT A SURVEY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: O uu�E' All data Is provided as is without warranty or guarantee of any kind 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. Parcel Information Parcel Number: D201OA0007 Township: Clarksville NCPIN Number: 5812025318 Municipality: Account Number: 8305957 Census Tract: 37059-801 Listed Owner 1: WILLIAMS LARRY SHANE Voting Precinct: CLARKSVILLE Mailing Address 1: 117 BROOK HILL COURT Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: TRACT 7 TIMBER TRAILS SECTION 2 Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 10.15 Elementary School Zone: WILLIAM R DAVIE Deed Date: 1/2016 Middle School Zone: NORTH DAVIE Deed Book / Page: 010090924 Soil Types: MnC2,MnB2,MdB,ChA,MdE Plat Book: 0008 Flood Zone: Plat Page: 194 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: O uu�E' All data Is provided as is without warranty or guarantee of any kind 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. T OPERATION PERMIT Davie County Health Department 210 Hospital Street P.O. Bax 848 Mocksville NC 27028 Phone: 336.753.6780 Fax: 336.753.1680 Applicant Larry Shane Williams Address: 136 Alexandria Court City: Advance State2ip: NC 27006 Phone #: (336) 940-2477 /yor Unice Useon7v *CDP Fite Number 122399-1 County ID Number: Evaluated For NEW Township: J Property owner: Larry Shane Williams Address: 136 Alexandria Court City: Advance State/Zip: NC 27006 Phone #: (336) 940.2477 PropeLbj Location & Site information Address/Road #: ., Subdivision: Timber Trails Phase: Lot: 7 Shane illi-4pS TWih` _ r L./L? Mocksivlle NC 27028 Directions Structure: SINGLE FAMILY # of Bedrooms: 4 # of People: 2 -Water Supply: PUBLIC *IP Issued by. *System Classification/Description: *CA issued by: 2140 -Nations, Robert Saprolite System? OYes CDNo Design Flow:Pump 4 $ 0 *DistributionType: GRAVITY -SERIAL Required? QYes QNo Soil Application Rate: 0 - a *Pre Treatment: Drain field ld a 4 0 0 SQ• ft. *System Type: INFILTRATOR QUICK 4 STANDARD (Nitrification7Drain 6 Installer: Darrell salmons Total Trench Length: 6 0 0 8• Certification #: 2652 Trench Spacing: — _ ()Inches O.C. Feet O.C. `EH S: 2140 - Nations, Robert Trench Width: _ 3 Olnehes Feet 0 3% 1 a/ a 0 1 6 Date: Aggregate Depth: inches Minimum Trench Depth: 3 6 Inches Minimum Soil Cover. 4 Inches'Approval Status " Maximum Trench Depth: 3 3 6 6 ; .Approved ® Disapproved _ Inches ,-R Maximum Soil Cover: a 4 Inches CDP File Number 122399 - 1 Manufacturer. Shoaf STB: 760 Gallons: 1000 ❑ No Date: 0 3 / 0 1/ 2 0 1 6 *Filter Brand: POLYLOK Dual PL -122 With Pipe Adapter ST Marker: ❑ Yes R No Reinforced Tank: ❑ Yes ❑ No Piece Tank: ❑ Yes ❑ No Manufacturer. PT: Gallons: t County ID Number: z�r•�tFn� Lat. t Long: Installer. Darrell salmons Certification *: 2652 *EH 5: 2146 - Nations, Robert Date: 0 7/ 1 2/ 2 0 1 6 Pump Tank Installer: Date: Risersealed ❑ Yes ❑ No RiserHeight: r_1 Yes ❑ No (Min.6 in.) Reinforced Tank. ❑ Yes ❑ No \,,,1 Piece Tank: ❑ Yes ❑ No Pipe Size: inch diameter PipeLength: feet *Schedule: Pressure Rated ❑ Yes ❑ No Approved fittings ❑ Yes ❑ N9 Certification #: *EHS: Date: AD' =Val Status uppiy Line Installer: Certification #: *EHS: Date: / 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 E) Yes El No ❑:Approved O. Disapproved Vent Hole ❑ Yes ❑ No Anti -siphon Hole ❑ Yes ❑ No CDP File Number 122399-1 NEMA 4X Box or Equivalent ❑Yes Box 12 inches Above Grade ❑ Yes Box Adj. To Pump Tank ❑ Yes Conduit Sealed ❑ Yes Pump Manually Operable ❑ Yes *Activation Method: Alarm Audible ❑ Yes Alarm Visible ❑ Yes 214 *Operation Permit completed by; Authorized -State Owner/Applicant Signature: County ID Number: Electric EaulDment ❑ No Installer: ❑ No Certification #: ❑ No ❑ No *EHS: ❑ No Date: ❑ No ApProvai status ❑ Approved ❑ Disapproved ❑ No ations, Robert Date of Issue: 0 7/ 1 2/ 2 0 1 6 This system has been installed in with applicable NC General Statutes: Article 11, Chapter 130A, Rules1or Sewage Treatment and Disposal, 15A NCAC 18A .1900 of, Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by sewage septic system. Rule .1961 requires that a Type septic system meet the following criteria: Minimum System Review By The Local Health Department: Management Entity: Minimum System Inspection/Maintenance Frequency ByCertified Operator. Reporting Frequency By Certified Operator: Rule .1961 requires that a Type IV and V septic systems designed for a 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 owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the system owner and certified operator are the same. The contract shall require specific requirements for maintenance and operation, responsibilities of the owner and 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. Q Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** OPERATION PERMIT Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Drawing Drawing Type: Operation Permit r CDP File Number: 122399,7 1 °r County File Number: Date: Q Inch Scale: OBbck ONiA CONSTRUCTION ._ AUTHORIZATION Davie County Health Department " tY; 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Larry Shane Williams Address: 136 Alexandria Court City: Advance 7 State/Zip: NC 27006 Phone M (336) 940-2477 �ddress/Road M Shane Williams Mocksivlle Structure: # of Bedrooms: # of People: \ *Water Supply: For Office Use Only *CDP File Number 122399 - 1 County ID Number: Evaluated For: NEW township: PERMIT VALID UNTIL: 0 9/ 0 9/ a 0 a 0 Property Owner: Larry Shane Williams Address: 136 Alexandria Court City: Advance State/Zip: NC Phone #: (336) 940-2477 Property Location & Site Information NC 27028 SINGLE FAMILY 4 2 PUBLIC Subdivision: Timber Trails Directions ns 27006 Phase: Lot: 7 Classification: Provisionally suitable Minimum Trench Depth: a 4 Inches \Site Saprolite System? O Yes (9 No Minimum Soil Cover: 1 a Inches Design Flow: 4 8 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 a Maximum Soil Cover: 1 a Inches *System Classification/Description: *Distribution Type: GRAVITY - PARALLEL (eq. d -box) TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) S t. T k *Proposed System: 25% REDUCTION Nitrification Field No. Drain Lines Total Trench Length: Trench Spacing: Trench Width: Aggregate Depth: D 4 0 0 Sq. ft. ep Ic an 1 0 0 0 Gallons 1 -Piece: O Yes ®No Pump Required: O Yes O No ® May Be Required Pump Tank: Gallons 5 1 -Piece: O Yes O No 6 0 0 ft, GPM --vs— ft. TDH Inches O.C. 9 Feet O.C. Dosing Volume: _ Gallons 3 Olnches ® Feet Grease Trap: Gallons inches Pre -Treatment: O NSF OTS -1 OTS -11 / Septic Tank Installer Grade Level Required: 01011 O III 01V Page 1 of 3 CDP File Number 122399 - 1 County ID Number: ❑ Open Pump System Sheet ` Repair System Required: ®Yes O No ONO, but has Available Space Repair System *Site Trench Spacing: 9 O InchesInches) Classification: Provisionally suitable — ® Feet O Design Flow: Trench Width: 3 4 8 _ Fe tInch Aggregate Depth: Soil Application Rate: 0 � inches *System Minimum Trench Depth: a 4 Classification/Description: Inches TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP Minimum Soil Cover: 1 a Inches *Proposed Maximum Trench Depth: 3 6 System: 25% REDUCTION Inches Maximum Soil Cover: a 4 Nitrification Field a 4 0- 0. Inches Sq. ft. No. Drain Lines C *Distribution Type: PUMP TO GRAVITY Total Trench Length: 6 0 0 Pump Required: ®Yes O No O May Be Required ft Pre -Treatment: O NSF OTS -I OTS -II *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. R.- im 750 *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. R.�� e If system can not be located where the system was re-evaluted due to plumbing or house placement issues, the septic must be pumped. 1869 This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not to exceed five years, and may be issued at the same time the Improvement Permit issued (NCGS 130A -336(b)). If the installation has not been completed during the period of validity of the Construction Permit, 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(8)). 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? O Yes O No Applicant/Legal Reps. Signatu *Issued By; 2140 - Nations, Robert Date: / Date of Issue: 0 9 / rA 0 9/ a 0 1 5 Authorized State Agent: 0 Malfunction Log Oyes ® Hand Drawing O Import Drawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 L v I CDP File Number: 122399 - 1 'A Mocksville NC 27028 County File Number: 0 CV 4 � i Date:. 0.9 . / . P1.9 . /2015 . Click below to import an image from an external location: Drawing Type: Construction Authorization Page 3 of 3 P1 P2 ` r IMPROVEMENT PERMIT '`j�, Davie County Health Department art 1 A 3a,}' 210 Hospital Street P.O. Box 848 Mocksville NC 27028 r For Office Use Only 'CDP File Number 122399-1 County ID Number: Evaluated For: NEW Township* Phone: 336-753-6780 Fax: 336-753-1680 PERMIT VALID UNTIL 8114/2018 'NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Larry Shane Williams Address: 136 Alexandria Court City: Advance State/Z ip: NC 27006 Phone (336) 940-2477 Property Owner: Larry Shane Williams Address: 136 Alexandria Court City Advance State/Zip: NC 27006 Phone::: (336) 940-2477 Property Location & Site Information Address/Road ': Subduision: Timber Trails Shane Williams Mocksivlle NC 27028 Structure: SINGLE FAMILY of Bedrooms. 5 of People: 2 `Water Supply: PUBLIC tem ,­ Initials stem 'Site Classification: PS Saprolite System? QYes r`)No Design Flow 6 0 0 Soil Application Rate: 0 2 5 'System Classification/Description: TYPE III B. SYSTEM WiSINGLE EFFLUENT PUMP "Proposed System: 25''o REDUCTION Directions Phase Lot: 7 Llinimum Trench Depth: 2 4 Inches Llaximum Trench Depth: 3 6 Inches Septic Tank: 1 2 5 0 Gallons 1 -Piece: QYes QNo Pump Required: QYes Q No 0t.1ay Be Required Pump Tank: 1 2 5 0 Gallons 1 -Piece: QYes C)No Repair System Required: (',.)Yes ONo ONo, but has Available Space Repair System `Site Classification: PS Soil Application Rate: 0 2 5 `System ClassificationlDescription: TYPE III B. SYSTEM WSINGLE EFFLUENT PUMP 'Proposed System: 25 REDUCTION 131inimurn Trench Depth: 2 4 Inches Maximum Trench Depth: 3 6 Inches Pump Required: C)Yes QNo Q 1.1ay be Required Pagel of 3 - CDP File fJpmber '122399 - 'Site Modifications County ID Number: ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.. 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, Site Plan The improvement Permit shall be valid for 5 years from date of Issue with a site plan (means a drawing not necessarily drawn to scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale atone inch equals no more than 60 feet, that includes: the specific location of the proposed facility O and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy of the recorded subdivisions plat that is accompanied by a site plan that Is drawn to scale). The Department and Local Health Department may impose conditions on the issuanceand may revoke the permits for failure of the system to satisfy the conditions, the rules, or this article This permit is subject to revocation if the site plan, plat, or intended use changes (NCGS 13oA-335(q). 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 ApplicantLegal Reps. Signature: I Date: 'Issued By: 22,14 - Daywalt, Andrew Date of Issue: 0 8 / 1 4/ 2 0 1 3 �� OValid without Expiration? Authorized state Agent: O Create CA? G-iHand Drawing Olmport Drawing **Site Plan/Drawing attached.** Total Time:(HH 1,.M) 0 1 Hours 0 0 Minutes Page 2 of 3 Activity Code: s -a - IRS issued: neva, valid to, -60 mos. IMPROVEMENT PERMIT Davie County Health Department 210 Hospital Street P.O. Box 848 htocksville NC 27028 Draivina Drawing Type: Improvement Permit 5 CDP File Number: 122399 -1 County File Number: Date: ! ! Qlnch Scale: , _ QBlock ptj/A Page 3 of 3 4+ APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATGti OS Davie County Environmental Health D IVWh X11000 n �i P.O. Box 848/210 Hospital Street a: l� MocIcsville, NC 27028 (336)753-6780/ Fax(336)753-1680 V pplication For: Site Evaluation,, Improvement Permit Authorization To Construcl(ATC) / X Both • Type of Application: XNew System Repair to Existing System Expansion, Modification of Exigting Sysrcnrtir •**1AIP0RTAN7"** THIS APPLICA'iION C4N.Y0T 13E PRnC&'WF1J UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN fur instructions. API'LICANI'-INF•ORNIATION Name-MiLMS Address 1a City/S(ate/ZIP AAyr.�c E.tttail til�iCst�n� tPc•a�n,nrLe�, r.-,�_ Name on Permit/ATC ifDylerem than Above Mailing Address ict Person e Phone 33to -144 - a4a2_ ess Phone 14D4 -2,$b-1,, 14 PROPERTY INFORMA'T'ION *Date House/Facility Corners Flagged _ NOTE: A survey plat or site plan must accompany this application. Included: Site Plan Plat(to scale) T.-1 (Permit is valid for 60 month: with site plan. no expiration with complete plat.) I( Owner"s Name�a"WIT\�gpgS Phone Numbers i -3 ! -.(p4 r} Owner's Address ! tD (�I2X,.% o i m t (� CitylState/%ip t�ay(i�1C� �3'7QQl� Property Address r7 -T i1S Citymv ttilie j Lot Sax PIN# Subdivision Natne(if applicable)_:gp f -TCr_Section/L ot# r% DirtctiomToSite: Frt�n Yrs -S Y-ynW 4c, exZ4 110 tR c9(Qu),n if Ioo1 FYbr. 5�w�r _L_.. nv, t t�►.1� Chur�L gd. bn 1t�.:tz L [YL _FtniiYlelr �ty.r�.PA.!%ts Im (e R. rvv't�n�6e.Tr�ls ®tad broad 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 X_No Does the site contain jurisdictional wetlands" vYes x,No l Are there any easements or right-of-ways on the site? Yes JNo j Is the site subject to approval by another public agency? Yes y, No Will wastewater other than dumcstic sewage be generated" Yes )t No IF RESIDENCE FILL OUT THE BOX Bl:I.OW __ # People 4 Bedrooms -_ i1 Bathrooms!_ Garden Tubl�'1-hirlpool X Ycs v Nu l Basement: Yes XNo Basement Plumbing: Yes X No F NON -RESIDENCE FILL OUT THE BOX 13ELOW Type of Facility/Business 'Total Square Footage of Building . a People # Sinks 9 Commodes # Showers i# Urinals- stimated Water Usage (gallons per day) (Attach documentation of similar facility %mater consumption) -FOODSERVICE ONLY: K Seals Type system requested: XConventional Water Supply'rype:County+City Water Accepted' Innovative Alternative New Well ' Existing Well Other Community Well Do you anticipate additions or expansions of the facility this system is intended to serve'' Yes X No If yes, what type? This is to certil'v that the information provided on this application is true and correct to the best ol'my Knowledge. I understand that anv pennit(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 f dsified or changed I hereby grant right of emr) um the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that l am responsible f6r the proper identification and labeling ofproperty lines and comers and fixating and fl:>__in__ or sta n,• tihouse.1thciIity ucatlion, proposed well location and the location of any other amenities. Site Revisit Charge Property owner's or owner's legal representative signature Date(s):____ Client Notification Date: Date EI)S: CDP F* Sign given Yes FIND 1 Account # Revised 11/06 ` Invoice itUP • i S3 S 7S'�1 oto r7 '6 /0 Ogl A Ce -s ropose d mou-se, 1-cc,:�an \ • 3 q0 r, l p rox I DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATIONi PROPERTY INFORMATION L Z'a 7 Timpa-r4fs lace U(�'ih1C�Q� niC 2700 i Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 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: t LONG-TERM ACCEPTANCE RATE: REMARKS: 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 Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm 33-d 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 lyotes �, 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) TTAR T.nnv_tP.rm arrPntanri- rate - oalhiav/ftp r\nrir% ncInc in__..__�� rAddssiRoad Shane Williams Mocksivlle NC 27028 Structure: INGLE FAMILY of Bedrooms: 5 " i of People: 2 'Water Supply: PUBUC''., Subdivision: Timber Trails Directions COf;STRUCTION System 5pecirications-1, For office use only ACJ HORIZATION R "CDP File Number 12230-1 Davie County Health Departmerjt X210 f County ID plumber Hospital Street �., . Evaluated For: '� NEW 4\ „P.O.BoxL'84$ 0 0 Tornsh�p _ _Y Mocksville NC , ._27028-- " PERMIT VALID UNTIL: :, .Phone^ 336-753""=ti 80 Fax: 336-753-1680 2 5 ti 0 8 1 4 2 0 1 8 Inches `System Classification/Description: *Distnbution Type: PRESSURE MANIFOLD„,, tANIFOLD Applicant: Larry Shane Williams Properly Owner. Larry Shane Williams Gallons 'Proposed System: 25`a5 REDUCTION 1 -Piece: QYes ( No i Address: 136 Alexandria Court Pump Required: QYes ()No Q'f.lay Be Required Address'.",` 136`Alexandria Court Sq. ft. City: Advance City: Advance State.2 ip: NC 27006 State2 ip: NC.... 27006 Phone #: (336) 940-2477 Phone::: (336) 940-2477 UInches O.C. c, Feet O.C.- ` . Dosrn Volume: _ Gallons g Trench Width: 3 6 (7)lnche5 hFeet Property Location & Site Information rAddssiRoad Shane Williams Mocksivlle NC 27028 Structure: INGLE FAMILY of Bedrooms: 5 " i of People: 2 'Water Supply: PUBUC''., Subdivision: Timber Trails Directions Page 1 of 3 System 5pecirications-1, - ,i Mlinimum Trench Depth: 2 4 Inches "Site Classification: PS Saprolite System? QYes QNo Minimum Soil Cover: Inches Design Flow:6 Maximum e Trnch pepfh: 3 . 6 Inches 0 0 *` Maximum Soil Cover. Soil Application Rate: 0 2 5 Inches `System Classification/Description: *Distnbution Type: PRESSURE MANIFOLD„,, tANIFOLD TYPE III D. SYSTEM WISINGLE EFFLUENT PUMP Septic Ta►ik: 1 2 5 0 Gallons 'Proposed System: 25`a5 REDUCTION 1 -Piece: QYes ( No i Pump Required: QYes ()No Q'f.lay Be Required Nitrification Field Sq. ft. Purnp' Tank: 1 21,_: 5 0 Gallons No. Drain Lines 1 -Piece: QYes ONo ” Total Trench Length: 6 0 0', ft. GPL1—vs-- ft. TDH Trench Spacing: g UInches O.C. c, Feet O.C.- ` . Dosrn Volume: _ Gallons g Trench Width: 3 6 (7)lnche5 hFeet Grease Trap: Gallons Aggregate Depth: ,.inches Pre -Treatment: QNSF OTS -1 QTS -II Septic Tank Installer Grade Level Required: 01011 O III 01V Page 1 of 3 CDP`File Plumber- 122399 - 1 M //Repair System *Site Classification: Ps County ID Number: © Open Pump Svstem Sheet System ltequved: k_) T e5 VNO UN0, Dut nas AvallaDle Space Design Flow: n n n Soil Application Rate: 0 - 2 5 `System Classification iDescriptiom TYPE 111 B. SYSTEM W SINGLE EFFLUENT PUMP "Proposed System: 25% REDUCTION NIZZrification Field No. Drain Lines Trench Spacing: — 9 Inches 0. 8Feet O.C. Trench Width: 0Inches _ 3 6 O Feet Aggregate Depth: inches Minimum Trench Depth: 2 4 Inches Minimum Soil Cover. Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: Inches Sq. ft. 'Distribution Type: PRESSURE MANIFOLD Total Trench Length: 6 0 0 ftPump Required: OYes ()No Oftay Be Required \ 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. '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. This Authorization for Wastewater System Construction shall bevalid for a person equal to the period of validity of the Improvement Permit, not to exceed five years, and may be issued at the same time the Improvement Permit issued (NCGS 13DA-336(b)). If the installation has not been completed during the period of validity of the Construction Permit, 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 lays, 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: 2244 - Daywalt. Andrew Date of Issue: 0 8 / 1 4 / 2 0 1 3 Authorized State Agent:"I'),(� Malfunction Log OYeS OHand Drawing Olmport Drawing Total Time:(HH IMI) **Site Plan/Drawing attached.** 0 1 Hours 0 0 MinutesPage 2 of 3 S-8 - CA'S issued - new CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Dpwina Drawing Type: Construction Authorisation L Pane 3 of 3 CDP File Number: 122399 - 1 County File Number: Date: 08/ 1 4/ 2 0 1 3 Qlnch Scale: . QBlock ONtA DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 • (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Account #: 990004236 Tax PIN/EH #: 5812-02-5318.07 Billed To: Robert Sherrill Subdivision Info: Timber Trails 2 Lot # 7 Referent;e Name: Location/Address: Timber Trails Lane -27028 Proposed. Facility: Residence Property Size: 74x538x621 x5 ATC Number: 4607 **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 System Installed By: E.H. Specialist: Date: DCHD 11/06 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH ' P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax #(336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004236 Billed To: Robert Sherrill Reference Name: Proposed Facility: Residence ATC Number: 4607 pot, 1�d2 Tax PIN/EH #: 5812-02-5318.07 Subdivision Info: Timber Trails 2 Lot # 7 Location/Address: Timber Trails Lane -27028 Property Size: 74x538x621 x5 Site Type: .9<ew ❑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, Section .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 change. Residential Specifications: # Bedrooms 'A # Bathrooms # People Basement Basement plumbing Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size Type of Water Supply:ounty/City []Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) qe�%ank Size I CV—IAL. Pump Tank GAL. It d Trench Width M�� Max. Trench rDepth �& Rock Depth qLinear Ft._�� r Site Modifications/Condit' ns/ ther: r F—� �- L� ^� Y�� s� If I - Contact the Davie County Environmenial-Heald Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)729. --8760. 'F �e WV's c aP Environmental Health DCHD 11/06 (Revised) cLAJ � 2V � ao� 1 **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: ,IE�Tew ❑Repair ❑Expansion Permit Valid for:,o?55 Years ❑No Expiration Residential Specifications: # Bedrooms q # Bathrooms # People 4 Basement❑ Basement plumbing�l"/ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): Type of Water Supply: CQC ounty/City ❑Well ❑Community Well Site Modifications/Permit Conditions: �' �b CQ4an< Davie County Environmental Health t P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990004236 Tax PIN/EH #: 5812-02-5318.07 Billed To: Robert Sherrill Subdivision Info: Timber Trails 2 Lot # 7 Address: 12725 McCord Road Location/Address: Timber Trails Lane -27028 City: Huntersville Property Size: 74x538x62lx5 Reference Name: 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: ,IE�Tew ❑Repair ❑Expansion Permit Valid for:,o?55 Years ❑No Expiration Residential Specifications: # Bedrooms q # Bathrooms # People 4 Basement❑ Basement plumbing�l"/ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): Type of Water Supply: CQC ounty/City ❑Well ❑Community Well Site Modifications/Permit Conditions: �' �b CQ4an< 02/06/2007 11:07 7048731691 oZ(0?/Z0o7 ?31d FAX 3367517632 1' 'EC G E � V L PPU(ATI V •62001 BELL CONSTRUCTION ON FOR SITE EYAUA11ON/INPROVp1MM AERAIU di ATC Davfe County HOOfth ftmriment r,c � 948/210 �P to at R"kadua, XC 27020 (336)751-07511 ZD03/003 _'-- a APPZXC421(� taltispz MEN�iI tilt Ib R>k Rifer to the im p= = x'899 ALL x!� ItIDQv1RiD F1VItVvw� ZUMTIN for �+satrncticpa L /� ormea.e saes.* FO IIT _ 1e.elene aeec..e 1 �2A 2rc—Qv & RD, tier/■nu/ese J�yN7j� �-�"--`— See. Dlmb.- 977- 10&)2 ---�--E— °'8 �►..�,�,•• ■e■�» - a "" 361- oe086!;etre se ROAM df ettasea•e wee M.va �letsewe IWc.e. Rtby/st•�e�/ue s• application for; ❑ 8ite xvAluetion ❑ 1elprovesoat pazait/ATC �Both a. ereue to n esie., xRouse ❑ Imbue Rose ❑ Sueis►aao 0 SnduatcY Q Other a. u 0eeidenae: t People LL_ i bodtoosa y- s i BalllLooab �� �*ieb.w■Me xoael+lq,. *iapesel ri°�••�v �aai+a }�we...ae/rawel.e a a 40"M IN a'laems.Q i. S! aoelna.e/zaaoetay/0i0�se, aDactey 4VY. I M"MAd.. a Nap3e a stake p vete& C.alaty iS A7pD8,iRgIC>t:---- N seat* aatiseitea stater vac a 9 teellan■ Pee 0+fl 7. too of water wuwp y; � Cooatp/City�� ❑ Nell D COMMMAA tY ,. Do you anrielpalo addltio0■ or aspatulo*t ad the feeinty 1610 eyetem is unleaded to carve? ❑ Yee �No If ',bat type? •••tt�poRrtxr►► culprrs,�utrt:»oltteratlt8 • RBQU1R6Ltmosvlrevt,0•.,n.-.�.....-__-•_-- PAGE 02 Preparty bitoeeefeae: QJt,.� _ ^.1�C- �� X Jf W1UTX PIR9MON8 (hem Maekrvftk) ra PROPERTY: sex 011lca ATN; 11-�L�4- ii?I Pr*perq Addeeu: Read Neme��Lt�Lt? SAA 1. C CltyrzIp M Ute a S11WIT stoR provide htbrmatioe, s■ Ibtl*tve: Hama: 310cNcm:_ g _�` Yet: �_ _JiYLiL W to rrapet'ty I'U�ad: 1 h4 ii to certlfy'hot the iaferaral#om provided is correct to tate best of my MOw*dzL I uodaraund that Say permup) 10101011 hsreaiter are iabJeci to iwpneioa ra 10avoceliN, "'the este ptaee or imteaded abs wbottted to fhb applkatba is mttifled mr eh m �p , or It toe iaibrplOtien f" application t, hereby, give C001104 to fhe Authorized Reprcne l0 of the avi oaWA/0r all CA emu (Acylnd�M to enter Opaa above dotcribaf prtiMny Ixateu la Datta Cbnay ro11 *treed h oaaty as Department y In eoedaot an teatloEtnraeAwre■ a1ctM,n to detero;ine the site evitabliny, 17f19 AREA MAY 98 VSSD volt DRAWING YOUR 8M PLAN (loclad■ an of the iblteal■R: P�„y floes mad ,}d�itausllool.swoetares, eetbecb' and septic looltiobe). i d.NaR and proposed Site Revisit Chatpe Deee(i): Mat NeWlCaden Det*: R116s Account Nfk Re.leod DC}W (07/!9) invoice No. 02/06/2007 15:55 7048731691 BELL CONSTRUCTION PAGE 02 02/06/2007 11:07 ii',,ao Output 7048731691 BELL CONSTRUCTION PAGE 03 Page 1 of 1 http://maps,co.davie.nc.us/servlct/com.esri,.esrimap.Esrimap?ServiccName—davie&ClicntVe..• 2/6/2007 Davie County GIS Online `� Lem It • V\ 9atoe+w fue ms CRY Vft LlRAf .11 1' ••; \ .\ • ' rJ� ( I �i^ ` i"T'.1 .....>f�•...,/�_� \,r.-.-. HIT ' h. Contour .. rrA 5 :N. MMMATCRAUF PRIVA7T • '\ \ '�\ _ .. ;5 '.\\ �' tuftc .\• r. 1 .\ ��' %.1 AREA • � ', r ` \, . \. J (. � .i"•„\,•. �.' PtODRrty floe. rJ ' �' '' obi,. _ \ \ 0WAC4umytlway i� \\'s ..�r Ji •�!\ , •,,,, `• — • i / it / _ l . • • .� , OUTSIDE • • •11 . iptTaWldoCdahe..Ca�ryajCPl(Q3�7tnt, �' � � , http://maps,co.davie.nc.us/servlct/com.esri,.esrimap.Esrimap?ServiccName—davie&ClicntVe..• 2/6/2007 C h A AWL I ► DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990004236 Tax PIN/EH #: 5812-02-5318.07 Billed To: Robert Sherrill Subdivision Info: Timber Trails 2 Lot # 7 Reference Name: Location/Address: Timber Trails Lane -21028 �7 Proposed Facility: Residence Property Size: 74x538x621x5 Date Evaluated: Water Supply: Evaluation By: On -Site Well Community Auger Boring Pit Public Cut WCO)W11111111 Landscape position HORIZON I DEPTH Texture roup --Consistence -MAMA WIN f�r"MmMOM Mineralogy M l! WS3'ii..,F ��� —WIMHORIZON H DEPTH - � rte, Mqq Mineralogy129Z=F�.MF:'asw_M���� HORIZON III DEPTH 9�0IrsL[:,IRFAIMTexture --- group Consistence�.`�--- Structure _v HORIZON IV DEPTH Texture group •9qlalf-11111 "M Mineralogy_ SOIL WETNESS RESTRICTIVE HORIZON CLASSIFICATION ���--- go] W 1F.1 SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: I ,� 40 7S.Y% 4; ) EVALUATION BY: OTHER(S) PRESENT: Lt C. rteA VjT&j j 6 C A4,31 Airy LEGEND ry 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 firm 3YSA NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky NP - Non pfastic 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 NQts� 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) ■//■■■■/■t■■lI■■■■■■/■■■\Ott■■tt■■■/■■t■\�■■■■■■■■■■■t■■■■■■■■■■■■■ ■■■■■IIS\■■■■■■■■■■■■■■■■■■■■■■■■■■1iiJt►�■■/■■■■\\t■■■t/■■■■■tt■■■■■■ ■■■■►r,\Y■■■■■■■■!!■■■■■■■■tom%■/■■■■I.'1 ■■■■■1/■■/■\`�■\ ■■■■■■■■■■■■■■■■■ ■■■I.Nils■■■t■■■■■:rDrfl///■/■■%�.���■■■14Li►`.!■■■■■■■■■■\\■ \■■■■■■■■■■■■■■■■ ■■■■!^1\■■■■■■■■■■illi■G"r�'■■%■I■■■�E�■■■Gil'■t■■■t■■■■■\/i■■■■■■■■■■■■■■■■ ■■■GI■'■■■■■■■■■■■■■■\V■■I/t■I■■`ori■■■►\■■■■■■■■■■■\■\\■■■■■■■■■■■■■■■ iiiiiiiii ii �iiiiiP .' 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