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219 White Dove Lane Lot 8Account #: 990003605 Billed To: Paul Churchill Reference Name: ATC Number: 4070 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 01z/q Tax PIN/EH #: 5820-64-7656 PC Subdivision Info: White Dove Acres Lot # 8 Location/Address: White Dove Lane -27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRU TION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: lywl Date: ,h /P s7— W 3 bd✓aom CERTIFICATE OF COMPLETION aff **NOTE** The issu�6f this Certite of Completion shall indicate the system desc�d on Improvement/Operation Permit 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. LA42 Septic System Instal eAd Environmental Health Specialist's Signature : Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT t Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 S IMPROVEMENT/OPERATION PERMIT -z/9 Account #: 990003605 Tax PIN/EH #: 5820-64-7656 PC Billed To: Paul Churchill Subdivision Info: White Dove Acres Lot # 8 Reference Name: Location/Address: White Dove Lane -27028 Proposed Facility _Residence Property Size: 5.040 acres ATC Number: 4070 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People_ #Bedrooms #Baths `f Dishwasher: e Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: El/� Lot Size Type Water Supply C o Design Wastewater Flow (GPD) 0 Site: New M' Repair ❑ System Specifications: Tank Size/jGAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width Rock Depth --a Linear Ft. IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** R /o (vl (C (` do .. P Environmental Health Specialist's Signature: /y, �/ Dater—�D Os� rG DCHD 05/99 (Revised) /J� J APPLICATIO FORSTE EVALUATION/IMPROVEMENT PE / J Davie County Health Department u J_ % EnvironmentaiHealth Section //y i .0. Box 848/210 Hospital Stree APR 2 7 2005 Mocksville, NC 27028 L (336)751-8760 EI "RONMENTAL 14rA In, ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL D INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. ) l'LU KLr e ,Yl e 1. Name lee" ed Mailing Address q/ Home hone 33L / ` Gc // Contact ,Pe son y�C� c oC �� (7' j P City/State/ZIP S LL JXa�r n It— /� Bim= Phone t� /0 -- 2. J 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Ximprovement Permit/ATC ❑ Both 4. system to service: House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. Type system requested: ❑ Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People o2 # Bedrooms ;� # Bathrooms_ ODishwasher ®Garbage Disposal lashing Machine ❑Basement/Plumbing dBasement/No Plumbing 7. If Business/Industry /other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) S. Type of water supply: 0 County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes fd No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client witli THIS APPLICATION. Property Dimensions: �� WRITE DI ECTIONS (from M villc) to PROPERTY: Tax Office PIN: it Property Address: Road Name C'c' +` '��� ` ✓e City/Zip If in a Subdivision provide information, as follows: Name: ✓ e Section: Block: Lot: Date home corners flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 an) responsible for all charges incurred frons 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 to conductaIll tteo th gg procedures as necessary to determine the site suitability. DATE%o�%/ OS SIGNATURE `'� �s�� ✓( iUiiCAr�O TIIIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Sign given Revised DCIID (05/03 Datc(s): Client Notification Date: EHS: Account No. e 0 Invoice No. ---I'2 t 1PERS� Pg• P �,-[ BfloK 6 1 1 1 P t Vol 1 1 1 1 k.Ot 1 1 1 1 t,01 15 1 1 1 LOT 66�'3 . ' _ . , ...,.,�. .. ; t" t ; 110•%? • ��•1g 192 11Q.00 t 8. 1 0.L__-- ..' ./'' '� 111.97 gp•111.99 '79 43 AREA = 5.040' CRE MSEL ID 19 •. 1EL P • NA 85 ,� ••''' l6 Ls L4 � .••: .•. S4W /974 c APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & TC SFp Davie County Health Department 30 EnvimmnenAVHea/th Section 43 P.O. Box 848/210 Hospital Street �4�`�Otiil9 . Mock (336 8760 1751N7028 M ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS ,P/�ROOJVIDED. Refer/to the INFORMATION BULLETIN for instructions. 1. Name to be Billed WL&q /C c ye- S Contact Person Mailing Address YO 4& „1 �[� Home Phone City/State/ZIP ,Cl�Ql SIL 1 /Q �, �� Q -6� Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Site Evaluation ❑ Improvement Pennit/ATC ❑ Both 4. System to Service: �ouse ❑ Mobile Honie ❑ Business ❑ Industry ❑ Other 5. Type system requested: Conventional ❑ conventional modified ❑ innovative 6. If Residence: It People 'Z�' It Bedrooms # Bathrooms _Nl*�'_ Dishwasher []Garbage Disposal VW ashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type It People It Sinks 4' —. It Commodes It Showers # Urinals tt Water Coolers IF FOODSERVICE:. # Seats Estimated Water Usage (gallons per day) _ 8. Type of water suppiy:XCounty/City ❑ Well ❑ Community 9. Do you anticipate Tditions or expansions of the facility this systeui is intended to serve? ❑ Yes XN0 _S If yes, what type? ***IMPORTANT ** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the elicit with THIS APPLICATION. Property Dimensions:, en-- "7,0 Tax Office PIN: #JCS by - --;� (0S Property Address: Road Name �v V( J City/zip Yy)r kS�t ►1 'kq If in a Subdivision provide information, as follows: Namc: �Jb die LC--y-e; Section: Block: Lot: _ WRITE DIRECTIONS (from Mocksville) to PROPERTY: k1e, Date liome corners flagged: d 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 cliange, or if the information subtnitted in this application is falsified or changed. I, also, understand that I ani responsiblefor all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE J A 6 ZO 3 SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Cil UI -4-- tx,C Sign given Revised DCHD 05/03 0 SS SLS �C. Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. y Invoice No. �� Turmov SUKP=YIIiG C031PANY 127 -LIBERTY CHURCH FMAD MOCKSVILLE, KC. 27028 (704) 492-3616 50' EASEMENT 8 9 7 11 ;EMEW 12 6 13 io MAP SHOWING DMSION OF: WHITE DOVE ACRES MAY 12, 1997 REVISED: JULY 21, 1997 300 150 0 300 600 900 SCALE IN FEET 24128--1 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 990002939 Billed To: Michale Graves Reference Name: Proposed Facility: Residence Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5820-64-7656 Subdivision Info: White Dove Acres Lot # 8 Location/Address: White Dove Lane -27028 Property Size: see map Date Evaluated: Z9-1-6_3 Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 " 4 5 6 7 Landscape position .L Sloe % / HORIZON I DEPTH e6 Texture groupf L° Consistence Structure Mineralogy HORIZON II DEPTH ii Texture groupG G Consistence v •, Structure 14'-' J• 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: LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION BY:� L 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 DCHD 05/99 (Revised) October 3, 2003 Michale C. Graves 248 Allen Road Mocksville,NC 27028 Re: Site Evaluation/ White Dove Lane Tax Office Pin : #5820-64-7656 Dear Client(s): As requested, a representative from this office visited the aforementioned site on October 1 , 2003. Based upon the information provided on the Application for Site Evaluation and after an evaluation was completed on the site, the site was found to be provisionally suitable for the installation of an on-site sewage system. Before an Improvement Permit/Authorization to Construct can be issued the appropriate application must be filled out and the house/mobile home location staked off. If you have any questions, please feel free to contact this office. Sincerely, A4144 & 6A1041 -A. Robert B. Hall, Jr., R.S. Environmental Health Specialist RH/df • '� APPLICATION FOR SITE EVALUATIONAMPROVE ET -!-C —, ' Davie County Health Department I Environmental Health Section P.O. Box 848 OCT I 01997 ' Mocksville, NC 27028 (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1 Name to be Billed Mailing Address r b City/State/Zip Y' [ fit" (-ta � 4 l) Q- c; z;q 2. Name on Permit/ATC if Different than Above Mailing Address Contact Person P 1 LXX Home Phone n 4- -7 X 9 x City/State/Zip 3. Application For: t<Site Evaluation [ ] Improvement Permit & ATC [ ] Both 4. System to Serve: ` House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People #Bedrooms # Bathrooms Dishwasher. Garbage Disposal VWashing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: [ ] County/City ItA Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes A No If yes, what type? EITHER A PLAT OR SITE PLAN PROPERT INFORMATION REQUIRED:*** IMPORTANT ***)&=&W OF THE PROPERTY MUST BE _ 3 -- �% , D + SUBMITTED WITH THIS APPLICATION. r grty imensions: ��• - WRITE DIRECTIONS (from Mocksville) TO PROPERTY: /C i R(Iffice PIN�� Property Address: Road Dame ( �►Ls�. `�•l.;tl L-(�QJ��`� ) ►L>�y�� City/Zip y yv; `kt) If in Subdivision provide information, as follows: ! - Name: —A)ht h-, i4w Aa 9 , Section: Lot #: ; 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 Copnty Health Department to enter upon above described property located in Davie County and owned by = to ccojndduct-all testi g roro�dur s necessary to determine the site suitability. DATE [b g `1-) SIGNATUREC0C�-� � 7 /�l Revised DCHD (06-96) THIS AREA AIAY 13E USED FOR DRAIVING YOUR SITE PLAN: eS Lt7U� TUMMM SUiIP ING COMPANY 127 -LIBERTY CHURCH ROAD MOCKSVILLF, KC. 27028 C 704) 49?-,_Kl f% 5 SD`'D y 3 50' EASEMENT 6 7 13 12 / -'\50' EASEMENT 9 11 5dL 10 MAP SHOWING DMSION OF: WHITE DOVE .ACRES MAY 12, 1997 REVISED: JULY 21, 1997 300 150 0 300 600 SCALE IN FEET JOB NUMBEPc 241 iH�-... y DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME SArA PAL,- PROPOSED AL — PROPOSED FACILITY H DSS`_ SUBDIVISION w wl y - AC S Water Supply: On -Site Well Community, Evaluation By: Auger Boring Pit SECTION I LOT DATE EVALUATED PROPERTY SIZE ,, S. W�C ea - ROAD NAME W\\ Y Q4j7 Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH D - Z 0-:2-7- - 2ZTexture Texturegroup Consistence 5 Structure CR_ AA k- Mineralogy1 HORIZON II DEPTH Z - 2Z Texture group1 Consistence ; Structure !3 k 5 Mineralogyl; HORIZON III DEPTH 7 4 f Texture groupSa Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE 0 n SITE CLASSIFICATION: U EVALUATION BY: c-�--%►-�1� LONG-TERM ACCEPTANCE RATE: 0. O' -7 F2d47- Laocr OTHER(S) PRESENT: cK REMARKS: �ACIL 1 R. F iTt2-_Q_ .tirl> CtAy . r I 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 DCHD (01-90) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ 1■■■■■■N■■■■■■■■■■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■Nee■■■■■■■■■■■■■■■ ■N■■■■N■MN■■■EEM■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■!!�■■■■■■■■■■■■■■■■ ■■■■■■■■■■NE■■NM■■■M■N■■EEEE■■■■■■■■E■■■■■■■■■■■■■■■■iii■■■■■■■■■■■■■■■■■■■■ ■■■■■■■E■■■■N■■■■■■■■■N■■■■■■■■■■■■■■■■■■■■■■I�■■■�'i[■Ilii■■■ti■■■■■■■■■■■■■ I■■■■■■■■■■■Nee■■■■■■Mee■■■■■■■■■■■■■■■■■■•_■■■1■■r,�M��e■■NN■■■■■■■■■■■■■■■■ I■■■EE■■■■■■NE■N■■■■EM■■■■■EEE■■■■■■■EM■Cv■►.I■■■■■■■■■Y■■■■■■■■It■■■■■■■■■■■■■ I■■■■■■■N■■■■■■NE■N■N■■■N■N■E■M■■■e■■r.eMei■■■e■■■■■■■■e■■■■■■■■Ile■■■■■Nee■■■■ I■�■■■■■■ M■■■N■�■■■■■Iia■■■■■■■.■■■�iM■■■■■�■■i1Cit:!■M■■�11■■�■■■■■■■ IE■■■■MN■■■■■■N■■■■■■■E■�■■■■■■■■■■■■■E■■■■■■■■■■M■■■■■�■■■�-■ell■■■■■■■■■E■■■ I■E■■■■EE■N■■■EE■■■■■■riN■ME■EN■■N■■■■■■■■■■■■EM■E■EN■■M■E■■E■E■�le■■■■■Nee■■E■ IM■M■■■■■■■■■M■■■■E■��E■■■■■■M■■EEE■■M■■■■E■N■■■�:��■e■■■EM■M■M■IE■N■N■M■EE■■■ ■■■■■■■■■■■I■N■■■■■■■■■■■■■■■■■■■■■■■■■■■�■■!���- ��� �■■■■■■■�.i1■■■■■■Nee■ ■E■■■■■■Me��■■■■Nee■■■■e■e■■■■■■■■■■■■■■■■■■■!1!17■:+C=ii�.'I<J�::iii■■I■[■■■■■■■■■■■ ■■e■■■■■■■I■■■■N■■■■■■■■■■■■M■■■■■■■■■■■■■■■■i����■��■A■■■■■■eel■■■■■■■■■■■■■ ■■■■■Ne■I■M■■E■■■■■■N■■■■■N■■■■■■■■■■■■■■■■■■■■■■■■■■■■/1■■1[ltie/l■■I■■■■■■■■Nee■■ ■■■■■■■��■■■■■■N■■M■■■■■■■M■EMl��■■■■■■■eNE■■■E■■■■■■Mcg■■Y■■�■■It■■■■■■■■■■■■ ■■■■■■I■■■■■■■■■■■■■■■■■■Nee■■■e[I■■■■■■■ "�"ft!■■■■■■■■■■■■■■■■■11■■■■Nee■■■■■ ■■■I■■■■■■■■■■■■■■■■■■■■■■■■■■■■elle■■■■■■■■■■■■■■■■■G!■■■■■■■■■11■■■■■■■■■■■■ ■■II■■■■■■■e■■■■■■■■■■■■■■■■■■■IIG�T11■■■■■■■■■■■■e■■■■IJ�iL�/■■■eNee■�I■■■■e■■■■■■■ ��■■■■■■■■■■■■■■■■■■E■■■■■■■■■■■■Ile■■■■■■■■■■■■■■■■■■■■■■■■■■■■■1■■■■■■■■■■■■ ■■■M■■MM■ ■■NEEM■■■ ■■■M■■M■■ ■ENN■■■■■ ■■M■■MMM■ ■■■■MMM■■ ■M■■■NN■■ ■■■■E■■■■ ■■■■NE■■■ ■E■■■■■E■ • Davie County Health Department and Home Heafth Agency Environwnta(Heafth Section P.O. Box 848 / 210 HOSPITAL STREET • COURIER #09-4-06 MOCKSVILLE, N.C. 27028 PHONE (704) 634-8760 October 15, 1997 Sam P. Hall P. 0. Pox 294 Mocksville, NC 27028 Re: Site Evaluation White Dove Acres/Lot 8 Tax PIN: #5820-64-9480 Dear Client(s): As requested, a representative from this office visited t -he aforementioned site on October 14, 1997. Based upon the information provided on the application for site evaluation and after the evaluation was completed, the site was found to be, provisionally suitable for the installation of an on—site sewage disposal system. t If you have any questions, please'feel free to contact this office. Si41y, I Jep, R.S. Environmental Health Specialist JP/wd Enclosure(s)