Loading...
134 Graywood Court Lot 8DAVIE COUNTY HEALTH DEPARTMENT 2 ' CD Environmental Health Section P. O. Boz 848/210 Hospital Street / Mocksville, NC 27028 �n (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900259 Tax PIN/EH #: 5861-38-2199.08dm Billed To: David Mallard Subdivision Info: Redland Place Lot # 08 Reference Name: Location/Address: Graywood Court -27006 Proposed Facility: Residence Property Size: 2.047 Acres ATC Number: 3660 **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 �oL)Sc #People #Bedrooms 3 #Baths 2-`:5 Dishwasher: Mo" Garbage Disposal: M10' Washing Machine: Ca"- Basement w/Plumbing: 9 Basement/No Plumbing: El Commercial Specification: Facility Type nn #People #People/Shift �`#Srea�ts Industrial Waste: 13 Lot Size 2'I �C.2+✓S Type Water Supplyl,E�J�1"r Design Wastewater Flow (GPD) JILx Site: New Repair El System Specifications: Tank Size IlCtO 'AL. Pump Tank1000GAL. Trench Width 3L Rock Depth 12!' Linear Ft. q004 Other: Lt V►STQ1 I lO� �`S Required Site Modifications/Conditions: 1r-1STALL v+J (�^� ► 0t�2 1�Z`� l 6 I �� L Ji IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER, RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Dayie-County-Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or :00 p.m. to Ila-p-ffi­&n the day of installation. Telephone # is (336)751-8760.**** 33' 0 O h I -A T / T 1� Environmental -Health Specialist's Signature: 1-V DCHD 05/99 (Revised) \QQ ODINa SPzoX { P'T BOc. 213 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section la P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900259 Tax PIN/EH #: 5861-38-2199.08dm Billed To: David Mallard Subdivision Info: Redland Place Lot # 08 Reference Name: Location/Address: Graywood Court -27006 Proposed Facility: Residence Property Size: 2.047 Acres ATC Number: 3660 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-C-ONSTJWqT—IOVI IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: 2 12 CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described 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 a arantee that the system will function satisfactorily for any given period of time. (to, -01 to tss- Pic:� 1, 91,E (JT DATA. Septic System Installed By: — Environmental Health Specialist's Signature: DCHD 05/99 (Revised) • �` `�� � � Gds Q)• - �'d-•`', ...g KYR 66 , W a/� A\ o. i Qi 0 w '1. 'I I N _. o V- I I o Irl rn Buffer c �I I 0 �N it (._TYP•)__ •Q F'�• o II ______1 _ 'o 's' (;CL p� to w I I tk X66 Q'G U) � I 124,Q1 { I I 9� �, 0.16' S� W 1 IN 39.0 r%.oArc)� ft. l� 4 SPH -108 Q46 XPH-10A ` 4s� N -23A 1 424 i-- S84'28'05"F 351 422 37,938 sq. ft. l^vJ r TAI.HFA�1k1 1 pA�ECIO'ONZY CATION FOR SITE EVALUATION/anioVEmENT I1L"11MIT & ATC Davie County Health Department Enviro11menia/Hea/i/1 Section P.O. Box 848/210 hospital Street Mocksville, NC 27028 (336) 751-8760 - ------ ------ - ..... ***IMPORTANT*** TIIIS APPLICATION CANNOT BE PROCESSED UNLESS ALL TIIE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed'^L5�7�. Contact Person -- Mailing Address Z,20 fiD Ott 7n9% 4 d Home Phone City/State/ZIP,eew, S j , l�'"= 6�270Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Improvement• Pe1.-lnit/ATC ❑ Both 4. System to Service: A House ❑ Mobile Home ❑ Business ❑ Industry ❑ Otlier 5. Type system requested: A Conventional ❑ conventional modified ❑ innovative G. If Residence: it People It Bedrooms It Lathroum:, p� � Dishwasher pGarbage Disposal lashing Machine ?Wasement/i>lumbing ❑basement/No Plumbing 7. If Business/Industry /Other: verify type it People It Sinlcs ff Commodes IF FOODSERVICE It Showers It Urinals It Water Coolerij 11 Seats Estimated Water Usage (gallons per day) 8. Type of water supply: KCounty/City ❑ Well ❑ community 3. Do you anticipate additions or CXp:1115iolls of the facility this systeln is inlcuded to serve? ❑ Ycs NN If yes, what type? ***1h11'0RTAJVY'*** CLIENTS h1UST CORIPLETETHE REQUIRED PROPERTY INFORMATION REQ0E'STI;U BELOW. I:itller a PLAT or SITE PLAN /11UST BE, SUBVITTED by the client ivith'1111S APPLICA'T'ION. Property Dimensions: T:1x Officc PIN: Property Address: Road Name -I ( G City/Zip If in a Subdivision provide information, as follows: Nalnnc: Scclion: Block: Lot: U WRITE DIRECTIONS (from Mnk to 1'R0I'ER T•1': t— Date home corners !lagged: L — o y This is to certify that the information provided is correct to the best of my knowledge. I understand that snny pe•uril(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the iniorulatiou submitted in this Application is falsilicd or changed. I, also, understand that I am responsible for rill charges ineurred front this application. I, hereby, give consent to the Authorized Representative of (lie Davie Cotill ly I1cal(I1 1)elm rtlncnt to cuter upon above described property located in Davie County and owned by _ to conduct all testing procedures as necessary to determine (lie site su' - l rty DATE SIGNATUI ' 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). Sign given Revised DCIID (05/03 Site Revisit Charge Datc(s): Client Notification Date: EIIS: Account No. _0 a Invoice No. .ns APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department Environmenta/Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 D ECE DtC 3 2G'o rawI N hAVI f TAI &&I try 1 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUI s. INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instruction 1. Name to be Billed i 3 ��retU 1/�(J� Contact Person Ofxa Mailing Address �2 - l' Home Phone J City/State/ZIP 6�7�� �O Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: IISite Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to service: ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms .� # Bathrooms ID, .'Dishwasher ❑ Garbage Disposal U Washing Machine Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 9—County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? EHYes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE TIIE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: �G �Cf /'G� S Tax Office PIN: # 594L"339- -;Z1 9 7,0 Property Address: Road Name L i / City/Zip If in a Subdivision provide information, as follows: WRITE DIRECTIONS/(from Mocksville) to PROPERTY: J.eg� Name: � n _ ��y - &IV � JIF-W r Section: Block: Lot: /Pf L=DT- 8 Date Property Flagged: Ir;2 ^3' This is to certify that the information provided is correct to the best of my knowledge. 1 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. 1, 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 ";- ani `i J� l ittT 5 to conduct all testing procedures as necessary to determine the site suitapility. _ --------- ,2i4V00AO�dlI�/�Gi� 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). Site Revisit Charge Date(s): Client Notification Date: EHS: Revised DCHD (07/99) Account No. Invoice No. APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department EnvironmentaiHeai y Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 11 D V DEC 3 Zop2 E/V�tDAVIE�pUNnFACTH ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUilM I INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed W9:V,e4V { 1-7 ja / V Contact Person Mailing Address C�1[L3�/L�l�� Home Phone City/State/ZIP Z p 5. �2 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: "ite Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. If Residence: # People # Bedrooms # Bathrooms . Dishwasher IJ Garbage Disposal LI Washing MachineBasement/Plumbing CI Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: R-1.ounty/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? 8 -yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBM17TED by the client with THIS APPLICATION. Property Dimensions: to Tax Office PIN: # Property Address: Road Name�J(/( City/Zip If in a Subdivision provide information, as follows: WRITE DIRECTIONS (from Mock(sv�ille) to PROPERTY: 45VLA A "3 F/.P. c� 4lC— Name: 32 M fir Section: Block: Lot:Lt71'49 Date Property 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 am responsible for all charges incurred from this application. 1, hereby, give consent to the Authorized Representative of the Davie County Hcalth Department to enter upon above described property located in Davie County and owned byyi to conduct all testing procedures as necessary to determine the site suita ility. DATESIGNATU 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). Revised DCHD (07/99) Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. Invoice No. •^ r Y DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Proposed Facility: Residence Property Size: Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5861-38-2199.10 Subdivision Info: Louise Smith Adams Lot # 10 Location/Address: Redland Road -27006 see map Date Evaluated: 12-193 27 - Community Evaluation By: Auger Boring ` Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L L Sloe % lo7o 170 HORIZON I DEPTH Texture group CL_ G�-- Consistence Structure G Mineralogy; HORIZON II DEPTH -3 to 2 Texture group Consistence StructureMineralo 5L/� I, HORIZON III DEPTH Texture groupGi Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE " SITE CLASSIFICATION: VS LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscape Position EVALUATION BY: l-(k_-Ly,Vy OTHER(S) PRESENT: 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) 49 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SoiVSite Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Proposed Facility: Residence Property Size: Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5861-38-2199.08 Subdivision Info: Louise Smith Adams Lot # 08 Location/Address: Redland Road -27006 see map Date Evaluated: a Z Lot Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope % o HORIZON I DEPTH d-Zv cD Texture group e --L- Ci— LConsistence Consistence wznv Structure Mineralogy; HORIZON II DEPTH "7 — 11 Texture group C� Consistence Structure G' Mineralogy 1 HORIZON III DEPTH 149 Texture groupS Consistence Structure S. Mineralogyf HORIZON IV DEPTH -�-( Texture group Consistence Structure C Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE 0.55--&4j SITE CLASSIFICATION: EVALUATION BY:� LONG-TERM ACCEPTANCE RATE: ©. *3 OTHER(S) PRESENT: REMARKS: fn-P0Vk'_ Z p" h2L3, j S I Zf: 7p LEGEND Landscape Position Z 1-01 t_l_ nl cx5v 7Zy�rb)VO4T— R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope L/�-+`tGGS W4-9 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)