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296 Bridle Lane Lot 15L DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section r r P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 \� (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003580 Tax PIN/EH #: 5870-21-8088 KB Billed To: Keith Batten Subdivision Info: Rabbit Farm Lot # 15 Reference Name: Location/Address: 296 Bridle Lane -27006 Proposed Facility: Residence Property Size: see map **NOTES* This improvemeei t/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 -2' #Baths Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift ,#/�Sfeats Industrial Waste: ❑ Lot Size Type Water Supply IZ Design Wastewater Flow (GPD) z �� Site: New Repair ❑ System Specifications: Tank Size GAL. Pump Tank GAL. Trench Widtli-� Rock Depth% Linear Ft� dd Other: As accepted in Systems may Iso be used Required Site Modifications/Conditions: 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.**** Environmental Hea Date: Uv DCHD 05/99 (Revised) Nva,ce sZ�i Account #: 990003580 Billed To: Keith Batten Reference Name: ATC Number: 4314 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5870-21-8088 KB Subdivision Info: Rabbit Farm Lot # 15 Location/Address: 296 Bridle Lane -27006 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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONST RU TION IS VALID FOR A PERIOD OF FI I, YEARS. Environmental Health Specialist's Signature: Date: C D CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate s stem described on Improvement/Operation Permit has been installed in compliance with Article 11 of G.S. Chapter 130A4 Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guar tee that a system will function satisfactorily for any given periodAtime. Septic Environmental Health Specialist's Signature: T Gpan, DCHD 05/99 (Revise t.-)SRscn itkJ� `SO Fa1sHdLvJ� C6 �o /J c_t 6OWS y�L .� S HoNf -T&Z1t- ^�ATO !9--J E I-Zq APPLICATION FOR SITE EVALUATION/IMPROVENIENT PERMIT Davie County Health Department EnvironmentalHeaith Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS AML THE INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETINor ins 1. Name to be Billed/h -2-3A4425M Contact Person V Pg�3�os' APA 12 2005 IUI Mailing Address L J . . City/State/ZIP/E/zf�lc-A/S _ /Y -c- ^�%'��� Business Phone � J I 2. Name on Permit/ATC if Different than Above _SH,-1j,i APPLICATION FOR SITE EVALUATION/IMPROVENIENT PERMIT Davie County Health Department EnvironmentalHeaith Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS AML THE INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETINor ins 1. Name to be Billed/h -2-3A4425M Contact Person V Pg�3�os' APA 12 2005 IUI Mailing Address =r e -o o��� P' _ Home Phone '2G. %%1— City/State/ZIP/E/zf�lc-A/S _ /Y -c- ^�%'��� Business Phone 2. Name on Permit/ATC if Different than Above _SH,-1j,i Mailing Address _ZJ'ax.�;' 3. Application For:'XSite Evaluation 4. System to Service: \\House ❑ Mobile Home City/State/Zip ❑ Improvement Permit/ATC ❑ Business ❑ Industry ❑ Other ❑ Both S. Type system requested: por Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People __-s—_ # Bedrooms !Z # Bathrooms ' P6ishwasher ❑garbage Disposal Washing Machine .2rBasement/Plumbing ❑Basement/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: ❑ County/City Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes �No If yes, what type? ***L11P0RTAN7'*** CLIENTS A1UST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN AfUST BE SUBMITT ED by the client with TIT IS APPLICATION. Property Dimensions: WRITE DIRECTIONS (frons Mocicsvilic) to PROPERTY: Tax Office PIN: # -5z-90 �'t / 1�-o k-&' r- 7v FO / T. , Property Address: Road Name L d / /� /'aa�� �o �� �zt� City/Zip �.4,���,.�.— o! 9vo4 If in a Subdivision provide information, as follows: Name: Section: Block: Lot: —f-= '9'V L, ,) ..� Lr.L d e le. Date home corners !lagged: L Z, -/"-5— 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 nui responsible for all charges inctirred frons this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described properly located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE y �i L /mss SIGNATURE TRIS A -MAYBE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed nr perty lines and dimensions, structures, setbacks, and septic locations). �-0 ; t ja wSr— Jw F— \ r C FP.r Sn I I n 0 a -_ I r S S l/ 1 I 1 �- �PLO t� 1 Sign given Revised DCHD (05/03 Datc(s): Account No. Invoice No. v� APPLICANT INFORMATION 49pount #: 990003580 Billed To:- Keith Batten Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SoiVSite Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5870-21-8088 KB Subdivision Info: Rabbit Farm Lot # 15 Location/Address: 296 Bridle Lane -'27006 Property Size: see map Date Evaluated: Water Supply: On -Site Well t! Community Public Evaluation By: Auger Boring it Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % o (o HORIZON I DEPTH 9 Texture group Consistence Structure r- Mineralogy % ,'C HORIZON II DEPTH Texture group Consistence Structure Mineralogy / /- HORIZON III DEPTH !!X� 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: 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 of 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 S B K - 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 DCl ID 05/99 (Revised) M G x Nov 1: 03 07:56a % twat 01 03 09:03a %a ■ aa%a Acura Service 3367613730 daviecounty envhealth 336 751 8706 P-2 10.1 DAVIE COUNTY HEALTH DEPARTMLNT linvironmental Health Section Soil/Site Evaluation �( �,,�. n ! \"', r fir. O� DATE EVALUATED .IDAp,SS PROPERTY SIZE PROPOSM FACULTY ___ `'"1'-� LOCATION OF SITE ,, Z 'Ok ) ' N Water Supply: On -Site Well Community Public L Evaluation Sy CLL Auger Boring Pit Cut FACTORS 1 2 3 1 Laras,a a position S1. -e x HOi IZON 1 DE?TH Tar cure rou l' C: L- C-. L. 1•-t.- Cc-. slvtance Structure f`R :t'neralogy HORIZON II DEP :H ," N �' `►� Tex^ure gtouo C• �'• - C" Ccns!stence v. Structure �`;i. she• +'� R Mineralogy HORIZON iII DEPTH Texture group Corsis^ence Structure `itneralcitv iiCZ120ti ::' C�?TH Tenure R -cup 1 _ Consistence ' Structure Ir l!neralogy SOIL l.'EiNESS �;S 55 5x ss N��•- QEST.RIC:IVE HORIZON SnPROL:TE CLASS MCATIC;7 t`t S d. c, `-S LOtiC-TERM, ACCEPTANCE RATE 3 SITE CLASSIFICATION: �_�. t� -' EVALUATED BY: �, t �* ` • \J •�� LOVC-TERM ACCEPTANCE RATE:. • J OTHER(S) PRESENT: Fr-MARKS: LEGEND Landscupc_Poaition R -Rid -"c S -Shoulder L -Linear slope FS -Foot slope ,N -Nose slope CC-Con.;ave slope CV-Co.vcx slope T-ierraee FP -Flood plain H-F:ead slope 'rr:tturc S -Sand LS-Loa,ny sand SL -Sandy loam L -Loam SI -Silt 5ACL-Si:'­ :lay lo.:m S:L-Silty foam CL -Clay team SCL-Sandy clay loath SC-San•ly clay SIC -Silty clay C -Clay CONSISTENCE Moles VFR-V •y friable FR -Friable FI -Finn VFI-Very firm EFI-extremeiy firm Wet NS -Non sticky SS -Slightly sticky S -Sticky VS -Very Sticky h?_Nun plastic SP-511chtly viastic P -Plastic VP -Very plastic Structure 3C-Si.•:ae 91'nir. M-6lnssivc CR -Crumb CR -Granular AHK-Angulor blocky SBK-SUbr.nQulafllocky PL -Platy PR -Prismatic Minernl A t:[, 2:t, MiKed Yotce Horizon depth - [n inches Ocpth o: fill - In ir,ches Restrictive horizen •• Thickness and inches groin land surface Saprollte - S(suital,lel. U(Unsuilable) Soi: wetress - Irctes from land surface to free water or inches from land surface to soil colors with chrenma 21 or lass Classification - S(Suitab1c), PS(provisionally suila00- U(unsuilable) LIAR -Long-:err: acteptanCe rate - 13a✓day/112 NOV-17-2003 07:57 3367613730 76% CM4 ' Nov 17 03 07:55a Rcura Service 3367613730P.1 —I E t O1 03 09:29a davie county envhealth 336 751 8786 p,l ge .HORIZATION NO: !J'975 DAYIE COUNTY HEALTH DEPARTMENT EnvirtnLmental14colthSection PROYURTY INP0101:\I ION Pcnniltcc's� P.O. liux 848 Name: "-1= t' ' i'' '` _ Mocksville,NC27028 Subdivision Name: -Lr + _ Directions to property: � , 1-. ` `, Phone#:704-634-8760 � _ section: AUTHORIZATION FOR `��'WASTEWATER Tax Office P1N:#�'�`! — SYSTEIM CONSTRUCTION Road Nae: i 11% . ti\ , i }.� Zip: m •'NOTE'#This Autlior:iation For Wastewater System Corst:uctioa MUST BE ISSUED by toe Davie County Envitvnn:ectal Hc:dth Section prior to issuance of anv Building Penn;12. This FormiAuthDriradun Nunbcr should be presented to the Davie Cuvuty Building In.apcctituta Office when applying for building Pernits. (In compliance with :'tliece 1 I O."G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Ttratment acid Mix,sal SyslumA °'+ �.: + .r:•' +7 • IS VAUD I.OR A PEIUOD OFF'IVE Y1-:A1tS. ENVIRON MF..N;ALIIE•ALT4SPECIALIST DA'.'EtSSUED RES:DE.NTALSPEC1t1CA71ON:BUILDINGTIPE-: Z NSEDROOMS- � ie ; 9156 ANTS 1-2- GARSAGEDISPOSAL Yes�o COMMERCIALSPECIFICATiON: FACILTIYTYP£ • cMv� # PEOPLE S PEOPLEVSHIFT #SEATS ' INDUSTRIAL WASTE: Ye: or No LOT StZE t.c,ou TYPE WATER SUPPLY \_•M: o�AI. DESIGN WASTEWATER FLOW (GPD) :3 Go N)iW SITE ✓( REPAIR SITE SYSTEM SPECIFICATIUNS: TANK SIZE OLD (IAL. PUMP TANK CAL. TREVCH WIDTH ROCK DEPTH 1 ' LINEAR FF. tl t)11• OTHER REQUIRED SITE MODIFICATIO.vStCONDMONS: IMPROVEMENT PERMIT LAYOUT -CONTACT AREPRESENTAnVE:LF THE DAVIECOU,TTYHEAL7DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTT-M HETIVEEN 8:50.9:30 A.T.I. OR 1:00- 1:50 P.M. ON . HE DAY F INSTALLA*rION. TELEPIIONE• 0 IS (704) 634-8760. OPERATION PERMIT > SYSTEM (I,- 1 1-1 AUTHORIZATION NOL OPL;RATI:)N PERMIT BY: DATE: -THE ISSUANCE OF THIS OPERATION PERMr"SHALL INDICATE THAT THESYSTE.VI DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I1 OF G.S. CHAPTER 130A. SEC 'rIDN .1900 "SEWAGETREATMENT AVD DISPOSAL SYSTEMS". BUT SHALL IN NO WAY GE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OPTIM& DCHD 05,96IRCvi" NOV-17-2003 07:55 3367613730 755 P.01 I CQUNT - REAL e Environmental Health Section P. 0. Box 848/210 Hospital Street Courier 09-40-06 Una-Lawilla Alr. 97n9k April 21, 2005 Keith Batten 5900 Holden Road Clemmons, NC 270012 Re: Site Evaluation/ Bridle Lane -Rabbit Farm Lot 15 Tax Office PIN: #5870-21-8088 Dear Client(s): As requested, a representative from this office visited the aforementioned site on, April 20,2005. 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, Aza&.e;;�dti• Robert B. Hall, Jr., R.S. Environmental Health Specialist RBH/dlf Enclosure(s) Account #: 990002955 Billed To: Randall Jones Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Tax PIN/EH #: 5870-21-8088.RJ Subdivision Info: Rabbit Farm one Lot # 15 Location/Address: Bridle Lane -27006 Property Size: see map 1,.V . ATC Number: 3600 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 I 1 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 Z #Bedrooms Z #Baths 'Z - Dishwasher: Cil Garbage Disposal: ❑ Washing Machine: 13" Basement w/Plumbing: ❑ Basement/No Plumbing: Er"' Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply WCL Design Wastewater Flow (GPD) Site: New Repair ❑ \ System Specifications: Tank Size 1CWGAL. Pump Tank GAL. Trench Width 3(e „ Rock Depth / Z� Linear Ft. �DO Other: 3 VST j oA) 1 %5 �„►viq�L U^i=S � �D. C, All % Required Site Modifications/Conditions: /ASTAt.t— oj t,-),jj0j22_ 40 ISS CW- Y -a %D'qF W.(1-4 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.**** � p 1 S 2- 110 AP?pDX Environmental Health Specialist's Signature: Date: 770 rV Y�c�X + -10 Mt r4 - 1(Q P, Pi= t72C)P. L-t.J- DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002955 Tax PIN/EH #: 5870-21-8088.RJ Billed To: Randall Jones Subdivision Info: Rabbit Farm one Lot # 15 Reference Name: Location/Address: Bridle Lane -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3600 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 Treatpaent and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATE ST IS V LID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: `� Z b 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 WAY be taken as a guarantee that the system will function satisfactorily for any given period of time. Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) 0 44 7-TF-1,VAt9iaLj 't 07-1 L- , -n Date: APPLICATION FOR SITE EVALUATIO PROVEMENT 1101MIT & A7 -C Davie County Health Department Environmenta/Hea/th Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed RC1y\ 1A \ �, Aonel Contact Person P-X�ta c�v or,, Mailing :Address j NA1 V 1 s C46 dy-- Cy\'11� Home Phone City/State/ZIP rSV 1 te. �� yr Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: &(Site Evaluation ❑ Improvement Permit/ATC D Both 4. system to Service: la' House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. Type system requested: Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People `s # Bedrooms It Bathrooms L17Dishwasher []Garbage Disposal L�Washing Machine ❑Basement/Plumbing LVDasement/No Plumbing 7. . If Business/Industry /Other: verify type It People It Sinks # Commodes It Showers Urinals It Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) _ 8. Type of water supply: ❑ County/City VWell ❑ Community 9. Do you anticipate additions or C\pansions of the facility this systelll IS 1iklFude(1 ,to.scrve? 0 Yes LRIN(I If yes, what type? ***LIIPORTANT*** CLIENTS AIUSTCOAIPLETETHE REQUIRED PROPERTY 1NI,0RIVIATION REQUES'1'l,l) BELOW. Either a PLAT or SITE PLAN t11UST BESUIli HM -D by the client with THIS APPLICATION. Property Diuicusions: c2T s/1 O 7�/l •%Ts��h WRITE DIRECTIONS (from Mockwille) to PROPEAC1,1': Tax Office PIN: #_ 8 ?D �. / g0 b4 -v to I'riet./ti �e•� • Property Address: Road Naine �1^IC yI,Q,, p/t� '�ll�, ��•�p,,:�•��'�W City/Zip it GK'_ n If in a Subdivision provide information, as follows: Name: Section: n'iF=_ Block: _ Lot: Date lionie corners flagged: I D - J .a - O---� This is to certify that the Information provided is correct to the best of my knowledge. I understand that any pernlit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if (lie hiforulation submitted in this application is falsified or changed. I, also, snderstand dial I wn I-gpOusible fur ((II chaiges incurred./r0111 this application. I1,'Iiercby, give consent to illc'Aulliorizcd*'Rcj resetltative of the Davie County.I1calth Dep:u•lmal( to enter upon above described property located in Davie Cow y an wned by _ to conduct all testing 1procedures as necessary to determine the ite suit bili DATE ! v � - I ' � 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). Sign given Revised DCIiD 05/03 5 Site Revisit Charge Datc(s): Client Notification Bate: l EHS: Account No. Invoice No. 6 Va. I • CB • Caolt Bolin Legend • PC . Pd of ea Currsun • T • Twlpmt • CH -Chord PT - Point of Urgency • TRANS. Tromolormor • CA. - Cin wtm • PVC - Pol"noc iorlh Pipe • UP-1h11ty Palo • 00 CMn Out • PA. -Proprfr LM VCP - Vldtod Cloy Pipe • VA .Controlled Aoons • R -Rodes • WM•Walr M"rr • CMP - Crwyotod Motel Pipe • RCP • RdnforWd Car*" PIPS • MH - Mn "M• RW• RV4 of Wry I certify fhat this map was drawn from an aced field survey made under my supervision: that the ratio of precision Is 1:10.000.. This 2 day of S J�t'f 199 lc_% 24&fg-b N'sµ .1994 ,,,`tttttrltr„trrr,, I wL S9 f.C.Tr o.,r I..e Cea^tte plL 1='rG `%% • E o y SEAL L-1 r o •; surt irll,tt\ TNs map does not meet N.C.O.S. 47.30 Bt,ni7c.£ standards and is not for recording. T�L1 S S u s;z.,v,4 Ac H SHAflY GP-OVE TOWNSHIP, 'bF.Z,l tit=. COUNTY, N.C. 8>=t►�IG I_o-r IS a>` RA'BSIT F=A-Q_M,PHc-SE P.?-. f:o , V'6 . "71 O C-> too SCALE 1" - oo ' GIZINSKI SURVEYING CO. LAi.JE 727 GALES AVE. WINSTON-SALEM, NC 27103 t=0:hV_ t 112_OP.'1D 722-0554 * swi+cz-�5a•ry+gleyer+rr �.+.kropir•�ogc..r—v�p..ysy 1.. 0 V DAME COUNTY HEALTH DEPARTMENT 0 •: IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION ¢ Name: Subdivision Name: et 1 tit 4 we., gDirections to pr9orty: � "' � �`� .Section: Lot: fi � • pERMTpTax Office P1N:#S% 10 - Y ` Road Name: F: r '*NOTE**This Improv n ent 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 firom.this Department pnorto thea constcuctionlmstallation of a system or the issuance, of a building permit :r (In compharice wi6 Article 1 Lof G.9. C> a 130A, Wastewater Systems, Section :1900 Sewage Treatment and Disposal Systems) s�sNOTICE*** THE PERMIT IS SUBJECT TO REVOCATION IF SITE .e�4 ti7+,• ° PLANS OR THE INTENDED USE CHANGE. YOUR"WASTEWATER. ENVIRONMENTAL HEALTH SPECIALIST % DATE•ISSUED SYSTEM CONTRACTOR MUST SEE THLS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPEClFICATIbIV: BUILDING TYPE W.# BEDROOMS # BATHS �• # OCCUPANTS `t GARBAGE DISPOSAL. Yes COMMERCIAL SPECIFICATI N: ,FACHM TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE y� �C TYPE WATER.SUPPLYa DESIGN WASTEWATER FLOW (GPD) G0 NEW SITE +: REPAIR SITE 4I' 0 SYSTEM SPECIFICATIONS: TANK SIZE Otte GAL. PUMP TANK GAL. TRENCH WIDTH ` ROCK DEPTH lar LINEAR FT. 061 OTHER REQUIRED SITE MODIFIC�TIONS/CONDITION9' " 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' 6348760: 9 DCHD 05/96 (Revised) A W G )c Zt 01 03 09:03a o-r- ML davie county envhealth 336 751 8786 DAVIE COUNTY HEALTH DEPARTMENT nvironmental Health Section Soil/Site Evaluation J' �(•'�^R� ��f \� t:\�� Off' DATE EVALUATED JDI2ESS > t� t"`" PROPERTY SIZE PROPOSED FACULTY _— L�u1' 3�a • LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By:Q-�-L Auger Boring �.-� Pit Cut _ P.1 +_ FACTORS l 2 3 4 Lar.isua a position 5 --5 S1,pe 9. -16 H01• IZON I DEPTH (�. " l '• 4+ `� Tey Lure rou L- Co-isis tence�- Structure .�� -.\�•--•\2 Mineralogy HORIZON II DEPTH LI 1 '• Texture group C'. t`. t!' Consistence VI Structure �iY'_ `�\�. -� >C� `�, F'• Mineralogy HORIZON III DEPTH Texture grouR Consistence Structure Mineralogy HORIZON !V DEPTH Texture group Consistence ' Structure Mineralogy SOIL WETNESS SS _5s RESTRICTIVE HORIZON - -- ` SAPROLITE-- CLASSIFICATION LONG-TERM ACCEPTANCE RATE 3 SITE CLASSIFICATION: .-'' EVALUATED BY: LONG-TERM ACCEPTANCE RATE:.. L.J OTHER(S) PRESENT: REMARKS: ._� __kms �.1�. a��.1• ��.9 - �. ��+.`�- i . LEGEND Landscape Position P. -Ridge S75ho1alder L -Linear slope FS -Foot slope N -Nose slope CC-Con(,ave slope CV -Convex slope T -Terrace FP -Flood plain H -Head slope 'rn-cturc S -Sand 1.S -Loamy sand SL -Sandy loam L -Loam SI -Silt cJCL-Si,',••_ :lay loam. SIL -silty loam CL -Clay loam SCL-Sandy clay loam SC-San•ty clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- V y friable FR -Friable FI -Firm VFI-Very firm EFI-Extremely firm Wet NS -Non sticky SS -Slightly sticky S -Sticky VS -Very Sticky NP -Nun plaslrc SP -Slightly plastic P -Plastic VP -Very plastic Structure iC Sir;tile grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky SBK-Subangular blocky PL -Platy PR -Prismatic Minerniogy 1:1, 2:1, Mixed Notes llorizon depth - In inches Depth of fill - In inches Restrictive horizon -• Thickness and inches from land surface Saprolite - S(suitattle), 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(auitable), PS(provisionally suitable), U(unsuitable) LTAR - Long -team acceptance rate - gat/day/ft2 Directions to property: AUTHORIZATION FOR Section: Lot: I WASTEWATER Tax Office PIN:#S! a - —:).1 _ SYSTEM CONSTRUCTION Road Name: �'. ° p: **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 go -t A,"x.440 IZATION NO: - 0975 DAVIE COUNTY HEALTH DEPARTMENT ,� •' Environmental Health Section PROPERTY INFORMATION Permitfee's P.O. Box 848 Name: Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 --T– Directions to property: AUTHORIZATION FOR Section: Lot: I WASTEWATER Tax Office PIN:#S! a - —:).1 _ SYSTEM CONSTRUCTION Road Name: �'. ° p: **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 DAVIE COUNTY HEALTH DEPARTMENT ~i r A' �.� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Perfi�t ee'�,•--� ,. ., � Name: v �- , (• } �'• `-�`� Directions to property:' Subdivision Name: f Section: Lot: IMPROVEMENT 'PERMIT Tax Office PIN:#f~ ,r - - .'40 t Road Name: 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 11 of G.S. Cliapter 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 c .;,<,.# BEDROOMS '� # BATHS a- # OCCUPANTS _ �- GARBAGE DISPOSAL: Yes o COMMERCIAL SPECIFICATION:, FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No ,i LOT SIZE C��- cla TYPE WATER SUPPLY W a�i*L DESIGN WASTEWATER FLOW (GPD) W NEW SITE � REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE 0 W GAL. PUMP TANK GAL. TRENCH WIDTH , ROCK DEPTH i, LINEAR FT. 0 OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT ,' .ter i / "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 SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: "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) 1� rr` " DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Pertndee' � • p, Name: `' �r�; Subdivision Name. t Directions to property: a - Section: —i Lot: EMPROVEMENT - PERMIT Tax Office PIN:#� , Road Name: 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) M.. ***NOTICE*** TMS 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 # BEDROOMS 5 # BATHS .�'.+.. # OCCUPANTS } GARBAGE DISPOSAL: Yes Qr'9I6,Y COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS"INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY l�3 DESIGN WASTEWATER FLOW (GPD) L7© NEW SITE Y%REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE Lo) -WGAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH i LINEAR FT. 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 SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: **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) �•a �.�h�, 9�`" APPLICATION FOR SITE EVALUATIONAM[PROVEMENT s � = 4��.� Davie County Health Department s� Environmental Health Section P1 ��P� b°��� P.O. Box 848 �� Mocksville, NC 27028 (704) 634-8760 M ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed S a 5 Q n V o Q c h Contact Person ' SCS QGh Mailing Address��•_fi'. Bo� i 2.6 Home Phone q {V City/State/Zip A dy a o C e, WC Z7C06 Business Phone -7 6 -7 - 6 9 00 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: Site Evaluation i�F City/State/Zip [Improvement Permit & ATC [ J Both 4. System to Serve: [XHouse [ ] Mobile Home [ ] Business [ 1 Industry [ ] Other 5. If Residence: # People %2 # Bedrooms_ # Bathrooms 2J Dishwasher [ ] Garbage Disposal [vf Washing 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 [\Nell [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [►ter o If yes, what type? Wr-To PROPERTY INFORMATION REQUIRED: *** IMPORTANT **JAW&AT OF THE PROPERTY MUST BE Rao NT SUBMITTED WITH IISAPPLICATION. Property Dimensions: gq 1-4 �X 6.y 5' 41 X B 8 $ • 3 $ ; WRITE DIRECTIONS (fro Mocksville) TO PROPERTY: Tax Office PIN: # 5970 - 21_ - _D� 8 S 1S $ To R B A LT M d r - E. -rt [., Property Address: Road Name 13 R I Q L.F- �A OF a, N ftTZ E 0 (A (3 P.\T F A e M City/Zip Fi SVR KC£ a.rj 006 BK ID LF- >. Rr49- - LbT -4 IS bN-K If in Subdivision provide information, as follows: Name: AM 17— N grA 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 County Health Department to enter upon above described property located in Davie County and owned by 4 - DATE 7 - 2,1 - 9 7 SIGNA Revised DCHD (06-96) to conduct all testing THIS AREA MAY $E USED FOR DRAWINQ YOUR SITE PLAN: te as necessary to determine the site suitability. APPLICATION FOR SITE EVALUATIONIIMPROVEMENTS PERMIT Davie County Health Department f E Environmental Health Section t� Q u P. 0.. Box 665. Mocksville, NC 27028 1. Application/Permit Requested By J NI oWT Ciy m o n / Mailing Address (� ` `A 3 � (/ ; Home Phone Business Pho ey f- 2. Name on Permit if Different than Above rr „11kAbrtf-dJRPt-AY_ 6 3. Application/Permit for: B-G-eneral Evaluation{ ❑ Septic Tank Installation 4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry 1 ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision web i It rY-, Section Lot # 1 Jl No. of People 3 No. of Bedrooms ` /"'� No. of Bathrooms 0 f( Z Dwelling Dimensions ' `x• 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: ❑ Public ET -Private 8. Property Dimensions Ste' Sewage Disposal Contractor ❑ Basement/Plumbing ❑ Basement/No Plumbing plWashing Machine ishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes B -14o If yes, what type? ❑ Community 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: 4ujL�(So I Cl`n CN n cL4 Z-2 V 1 -e— 0Y) - UWP. 4Adb6xv-cs 0 4c'(4 This is to certify that the information provided is corntobest of incurred from this applicatio . DATE and I understand I am responsible for all charges . C�16!11 SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE 9N ABOVE DESCRIBED -PROPERTY MUST CHECK ONE: 1 ❑ 1. 1 OWN the property. E '2. I DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representative o DavieGnu Health Department to enter upon above described property located in Davie County and owned by f� �( SSG aty Vrd U to conduct all testing procedures as necessary to dete 1" said site's suitab I for a ground absorption sewage treatment and disposal system. G� T ATE SIGNATUIRE r DCHD (12-90) i-A.6 -7 '7 .F-erre Z IF eawt V1 15 a I G-'7 Z jj A-4 T Z14 A% 1 ,J nt a d 7'E. __ N 4' 4)'c - — _ 7 _ e� { t �•� .V1 *Z' %l C.T *Z' 44- -6 NN C 0 oAr-> N4 z V9 %A 4\ L > CD tj 1 C,4-. C. PC ;4r;MOaty teat ate M 11v8 34C 2v L7(- /30/ See-e"See 2447.!. I-' • P S cc A-) i -T AND MICATIC" n the W-or(s) of the hereby certify los Or*) &I _-W. are -I." " IV dg::r!bo4 hqr#o" and that 1 ler) hereby r:"rl 0" a 41" at empont. te f 0. 1 Iglan with my (our) rr *air 1 a,) roods. silt. prkr P.... ow—W Mobiloft all Into. sm 0 a I Pb Ili we� Us, 00 --U Wassoonts• rights of .07. .%bar open spaces to ew-w 0-1 or private wP@P 80 mtOd- In ew-wV •' DAVIE COUNTY HEALTH DEPARTMENT ~ ' Environmental Health Section Soil/Site Evaluation NAME �^CM o \ `n� \' A C� �` 0� DATE EVALUATED Q i — 1 L4 ADDRESS r`\� PROPERTY SIZE O PROPOSED FACIILTY `� b9 LOCATION OF SITE r c\r5ti3 Water Supply: On -Site Well V Community Public Evaluation By:C'�-1L Auger Boring 1 Pit Cut FACTORS 1 2 3 4 Landscape position S �< __ Sloe Z 1,5., r-j�� d -s HORIZON I DEPTH 61,�, `' 40 Texture group C t_ C t- CL Consistence F3 Structure Z QJ� Mineralogy :i :� HORIZON II DEPTH Q,%' 4 Z 4 -L'' AF2'' Texture groupC C 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 CRcS S S LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: Q'S EVALUATED BY: 1� � LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: 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 ;lay 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 3C -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(01-901 ■N■ ■E■ ■EA■M■■ ■MEM■E■ ■ i • i CAPACITY PER OIS'R� ACfIE' AT sI�,L Y tS,LY. N.C. CLAM V 1r N.Q OOT�7 EROSION OOMROL SCONE 101 E-1 CLE~ =TAKE S�OilE 11. TOP QOANKMOrT 9ILINAY ELE1b CLEANOUT LIMAL 0 0 0b 0 0. + ' MIN 0 0 0 0 0 0 ► i 010000000000000�0.0 0 0 FLT�Ift FAWC dOTI'OM SECTION A -A TEMPORARY SEDIMENT TRAP DETAILS (NTS) CONSTRUCTION SPECIFICATIONS: 1. Clear, grub, and strip the area under the embankment of all vegetation and root material. Remove all surface soil containing high amounts of organic matter and stockpile or dispose of it properly. Haul all objectionable material to the designated disposal area. 2. Ensure that fill material for the embankment is free of roots, woody vegetation, organic matter, and other objectionable material. Place the fill in lifts not to exceed 9 Inches and machine compact it. Over fill the embankment 6 inches to allow for settlement. 3, Construct the outlet section in the embankment. Protect the connection between the riprop and the soil from piping by using filter fabric or a keyway cutoff trench bef,ween the riprop structure and the soil. Place the filter fabric between the riprop and soil. Extend the fabric across the spillway foundation and sides to the top of the dam; or Excavate a keyway trench along the centerline of the spillway foundation extending up the sides to the height of the dam. The trench should be at least 2 ft. deep and 2 ft. wide with 1:1 side slopes. 4. Clear the pond.oreo below the elevation of the crest to the spillway to facilitate sediment cleanout. 5. All cut and fill slopes should be 2:1 or flatter. 6. Ensure that the. stone (drainage) section of the embankment has a minimum bottom width of 3 ft. and maximum side slopes of 1:1 that extend to the bottom of ,the spillway section, 7.. Construct the minimum finished stone spillway bottom width, as .shown on the plans, with 2:1 side slopes extending to the top of the over filled embankment. Keep the thickness of the sides of the spillway outlet structure at a minimum of 21 inches. The weir must, be level and, constructed to -grade to oazwre;desigri copocit-y.: ' 8. Material used in the stone section should be d well -graded mixture of stone with a d50 size of 9' inches (class 9 erosion contrdl stone is recommended) and a maximum stone size of 14 inches. The stone may be machine placed and the smaller stone* worked into the voids of the larger stones, The stone should be hard, angular, and highly weather - resistant. 9. Ensure that the spillway outlet section extends downstream past the toe of the .embankment until stable conditions are reached and outlet velocity is acceptable for the recetving stream. Keep the edges of the stone outlet section flush with the surrounding ground and shape the center to confine the outflow stream. 10. Direct emergency bypass to natural, stable areas. Locate bypass outlets so that flow will not domoge the embankment. 11. Stabilize the embankment and all disturbed areas above the sediment pool and downstream from the trap immediately after construction. 12. Show the distance from the top of the spillway to the sediment cleanout level (one-holf the design depth) on the plans and mark it in the field. MAINTENANCE: Inspect temporary sediment traps after each period of significant rainfall. Remove sediment and restore the trap to its original dimensions when the sediment has accumulated to one-half the design depth of the trap. Place the sediment that is removed in the designated disposal area and replace the contaminated port of the gravel facing. Check the structure for damage from erosion or piping. Periodically check the depth of the spillway to ensure it is a minimum of 1.5 ft. below the low point of the embankment. Immediately fill any settlement of the embankment to slightly above design grade. Any riprop displaced from the spillway must be replace immediately. After all sediment -producing areas hove been permanently stabilized, remove the structure and all unstable sediment, Smooth the area to blend with the adjoining areas and stabilize properly. REFERENCE: "Erosion and Sediment Control Planning and Design Manual", North Carolina Department of Environment. Health, and Natural Resources, Section 6.60. 0 .4 y 5 lbs Ky 31 Fescue (certified) 40 lbs 10-1D-10 Fertilizer 100 lbs Agricultural Lime 50 lbs clean straw Type II Seeding (outfolls and postures) 3 Itis Ky 31. Fescue (certified) 20 lbs 10-10-10 Fertitizer 100 Itis Agricultural Lime 50 lbs clean strow As a suppliment, a mixture of German Millet and Annual Rye will be allowed in the winter and summer. The inspector is to approve all materials used for the work. SEEDING DATES Temporary: May 1st to August 15th Permanent: April ,15th to June 30th SOIL AMENDMENTS TEMPORARY Apply ground agricultural limestone and 10-10-10 fertilizer at 2,000 Ib/ac and 750 Ib ac respectively. PERMANENT Applyground agricultural limestone and 10-10-10 fertilizer at 3,000 Ib/ac and 500 Ib/ac respectively. MULCH TEMPORARY Apply 4000 Ib/acre straw. Anchor straw by tacking with asphalt, netting or o mulch anchoring tool. A disk with :blades set nearly straight can be used as a mulch anchoring tool. Use excelsior matting to cover bottom of chonnels and ditches with 2% slope or greater. The lining should extend to a minimum depth of 0.5 feet. On.chonnet side slopes above this height, and in drainages not requiring temporary linings, apply 4000 Ib/ocre groin straw by stapling netting over the top. Mulch and anchoring materials must not be allowed to wash down slopes where they can clog drainage devices. MAINTENANCE Reseed, refertilize and mulch immediately following erosion or other damage. A minimum of 3 weeks is required for establishment of permanent gross. inspect and repair mulch frequently. Refertilize the following April with 50 Ib/acre nitrogen. DATE 0 REVISIONS 1e• MW f- Nle Nile DITCH 18' MN POfMWK OMM MUST K PROWDED TO ASSM 0111110MAL F WIPE OIO M YB. SEED AND MIAAN fX11Eil00N. TRY Nin TO ills . MAX. 01UNM AREA - 5 ACRES WITHOUT SUPPOMINO CALCS.. DNEf13IOW AT Tf1E TOP Of SIAM MU3r DFtlY IMO AN Ap1;iO11ED SLOPE DRA^ mm/Om a mwr COMMONLY USED. (2) TEMPORARY DIVERSION BERM/DITCH i u r.,-: , ♦w, ,. r .. . .v -. +. .-. ::sem ... . '.: .. +:..... •. ;,. ,,. x. 512. .. a i, .... !t r } y. ... n a �a i ,y �4 k ..I GENERAL PLAN NOTES 1. SOIL EROSION. CONTROL DEVICES MUST BE INSTALLED INITIALLY AFTER THE GRADING PERMIT IS ISSUED AND ROUGH GRADING STARTS. NCDEHNR EROSION CONTROL INSPECTORS WILL CHECK THESE DEVICES FOR PROPER INSTALLATION AND COMPLIANCE WITH THIS PLAN. 2. .,ALL EROSION CONTROL DEVICES ARE TO BE INSTALLED iN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS. ANY CHANGES ARE TO BE APPROVED BEFORE CONSTRUCTION BY NCDEHNR EROSION CONTROL INSPECTORS. ADDITIONAL DEVICES WILL BE REQUIRED IF NECESSARY, 3. IF FILL MATERIALS ARE BEiNG BROUGHT ONTO THIS PROPERTY OR IF WASTE MATERIALS ARE TAKEN FORM THIS PROJECT, THIS INFORMATION MUST BE DISCLOSED AND SHOWN ON THE EROSION CONTROL AND GRADING PLAN. BORROW AREAS AND DUMP SITES ARE CONSIDERED TO BE PART OF THIS. PROJECT. 4. IN AN EFFORT TO MINIMIZE EROSION AND EXPOSURE TIME, EASEMENT AREAS SHALL NOT BE GRUBBED OR GRADED UNTIL UTILITIES ARE READY TO BE INSTALLED. ALSO, THE IMMEDIATE SEEDING OF DISTURBED EASEMENT AREAS AFTER UTILITIES ARE INSTALLED WILL ELIMINATE MANY PROBLEMS. EASEMENT AREAS WHICH CROSS OR ARE ADJACENT TO WATERCOURSES SHOULD RECEIVE SPECIAL CONSIDERATION. 5. NO LAND -DISTURBING ACTIVITY SHALL BE PERMITTED IN PROXIMITY TO A LAKE OR NATURAL • WATERCOURSE UNLESS A BUFFER ZONE IS PROVIDED ALONG THE MARGIN OF THE WATER BODY OF SUFFICIENT WIDTH TO CONFINE THE VISIBLE SILTATION WiTHIN THE TWENTY-FIVE PERCENT OF THE BUFFER ZONE NEAREST THE LAND -DISTURBING ACTIVITY. 6. ALL DITCHES WITH A GRADE OF 0% TO 5% SHALL BE LINED WITH GRASS. DITCHES WITH A GRADE OF 5% OR GREATER SHALL BE LINED WITH EXCELSIOR MATTING. (SEE SHEET EC2 FOR CHANNEL DETAIL.) 7. ALL ROADSIDE CHANNELS ARE INTENDED TO BE TEMPORARY MEASURES UNTIL ROADSIDE SLOPES HAVE STABILIZED. J o H o 13 P.O. ]BOX 879 4880 HARLW I SNE. WALKERIO . NC 27051 tel 336.595. 8917 '=0-336.595.8511 wtvbD�.00�n M M KKe, Y y� 55,.. IS -2-1, .. •. :, .f � , • } - + • . O.MACHINIE COQ dh' ALL PLL Ifs RFfiUNI�, OIC ' PAP WIDTH AT SWACE O ITM VIM DESXMTED IN TWWM# TO a ISE'SS�It001f`fOftl, 00M MUST K M1111116W0 PRIOR TO SOIL AND VEGETATION Q&~ s0CIdStNO OF THE AM (ft Of MM NfC1MON r. OVERFILL 6' To A � v �' 1aM1 sETiLn TOP SEEDBED PREPARATION. IM1HM 7 1 hg1011 M. I� OOlf�l�M AND pIM01014 AK Ii a >r.111f" Mff 0 ftAi�D° ). ALLOv FOR LM COM am FILL SLOPES 2:1 TO .3:1 4-6 bDONS SIMM K' LOTO MMINIMIZEtWIAl = BY 1, Leave the lost inches of fill toose and uncompacted. ;,.. 2. Roughen. slope foce by making groves 2-3 inches deep, perpendicular to CONSINU.O'NN �• the slope. T�w Raw&• QJ '__ ,� 3. Spread lune and fertilizer evenly over slopes of recommer+ded rates. a. ONERSIONS SNOIXa Im AM MI LD" Sr TO_1111540 Rf,MAN ' 0 0 0, r GENTLE OR FLAT SLOPES WHERE TOPSOIL IS NOT USED IN PLA00 OiIM 3 INYS. 0 0 1. Remove rocks and debris. Nil 81EEPOt 2. Apply lime and fertilizer at recommended rates: spread evenly and TMAN >:NdV incorporate into top 6 inches with a disk, chisel plow, or rotary d. CIEiCK DEVICE AFM EACH Wft WT ONCE A WEEK REQARDlM 1NATtiiML GIIaMD tiller. 3. Roke to loosen surface just prior to applying seed. RUM AS NDCARY STEEPER MAN V*V b ITER FA1R� SEEDING METHODS 1r MIN 1. Broadcast sped at recommended rates with a cyclone seeder, drop seeder, SLOPE 2.1 001 A or cultipacker seeder, 2. Rake seed into -the soil and lightly pack to establish good contact. MAX .---.-..I'll . PlATURAL. 011011l!fD SEEDING MIXTURE OR Fes. OR CUT As a minimum requirement, all graded areas not under pavement and withinf1<l. SECTION THRU TRAP SPILLWAY the rightpw­ -of-way and/or :easements shall be prepared, fertilized and limed, ,AyAp seeded and mulched 'immediately upon completion of construction as follows BiE1tM AS NONSWAY TO (specifications per 1000 squore feet): 1.500 OU.FT OF Type I Seeding (within ri ht -of wa ) CAPACITY PER OIS'R� ACfIE' AT sI�,L Y tS,LY. N.C. CLAM V 1r N.Q OOT�7 EROSION OOMROL SCONE 101 E-1 CLE~ =TAKE S�OilE 11. TOP QOANKMOrT 9ILINAY ELE1b CLEANOUT LIMAL 0 0 0b 0 0. + ' MIN 0 0 0 0 0 0 ► i 010000000000000�0.0 0 0 FLT�Ift FAWC dOTI'OM SECTION A -A TEMPORARY SEDIMENT TRAP DETAILS (NTS) CONSTRUCTION SPECIFICATIONS: 1. Clear, grub, and strip the area under the embankment of all vegetation and root material. Remove all surface soil containing high amounts of organic matter and stockpile or dispose of it properly. Haul all objectionable material to the designated disposal area. 2. Ensure that fill material for the embankment is free of roots, woody vegetation, organic matter, and other objectionable material. Place the fill in lifts not to exceed 9 Inches and machine compact it. Over fill the embankment 6 inches to allow for settlement. 3, Construct the outlet section in the embankment. Protect the connection between the riprop and the soil from piping by using filter fabric or a keyway cutoff trench bef,ween the riprop structure and the soil. Place the filter fabric between the riprop and soil. Extend the fabric across the spillway foundation and sides to the top of the dam; or Excavate a keyway trench along the centerline of the spillway foundation extending up the sides to the height of the dam. The trench should be at least 2 ft. deep and 2 ft. wide with 1:1 side slopes. 4. Clear the pond.oreo below the elevation of the crest to the spillway to facilitate sediment cleanout. 5. All cut and fill slopes should be 2:1 or flatter. 6. Ensure that the. stone (drainage) section of the embankment has a minimum bottom width of 3 ft. and maximum side slopes of 1:1 that extend to the bottom of ,the spillway section, 7.. Construct the minimum finished stone spillway bottom width, as .shown on the plans, with 2:1 side slopes extending to the top of the over filled embankment. Keep the thickness of the sides of the spillway outlet structure at a minimum of 21 inches. The weir must, be level and, constructed to -grade to oazwre;desigri copocit-y.: ' 8. Material used in the stone section should be d well -graded mixture of stone with a d50 size of 9' inches (class 9 erosion contrdl stone is recommended) and a maximum stone size of 14 inches. The stone may be machine placed and the smaller stone* worked into the voids of the larger stones, The stone should be hard, angular, and highly weather - resistant. 9. Ensure that the spillway outlet section extends downstream past the toe of the .embankment until stable conditions are reached and outlet velocity is acceptable for the recetving stream. Keep the edges of the stone outlet section flush with the surrounding ground and shape the center to confine the outflow stream. 10. Direct emergency bypass to natural, stable areas. Locate bypass outlets so that flow will not domoge the embankment. 11. Stabilize the embankment and all disturbed areas above the sediment pool and downstream from the trap immediately after construction. 12. Show the distance from the top of the spillway to the sediment cleanout level (one-holf the design depth) on the plans and mark it in the field. MAINTENANCE: Inspect temporary sediment traps after each period of significant rainfall. Remove sediment and restore the trap to its original dimensions when the sediment has accumulated to one-half the design depth of the trap. Place the sediment that is removed in the designated disposal area and replace the contaminated port of the gravel facing. Check the structure for damage from erosion or piping. Periodically check the depth of the spillway to ensure it is a minimum of 1.5 ft. below the low point of the embankment. Immediately fill any settlement of the embankment to slightly above design grade. Any riprop displaced from the spillway must be replace immediately. After all sediment -producing areas hove been permanently stabilized, remove the structure and all unstable sediment, Smooth the area to blend with the adjoining areas and stabilize properly. REFERENCE: "Erosion and Sediment Control Planning and Design Manual", North Carolina Department of Environment. Health, and Natural Resources, Section 6.60. 0 .4 y 5 lbs Ky 31 Fescue (certified) 40 lbs 10-1D-10 Fertilizer 100 lbs Agricultural Lime 50 lbs clean straw Type II Seeding (outfolls and postures) 3 Itis Ky 31. Fescue (certified) 20 lbs 10-10-10 Fertitizer 100 Itis Agricultural Lime 50 lbs clean strow As a suppliment, a mixture of German Millet and Annual Rye will be allowed in the winter and summer. The inspector is to approve all materials used for the work. SEEDING DATES Temporary: May 1st to August 15th Permanent: April ,15th to June 30th SOIL AMENDMENTS TEMPORARY Apply ground agricultural limestone and 10-10-10 fertilizer at 2,000 Ib/ac and 750 Ib ac respectively. PERMANENT Applyground agricultural limestone and 10-10-10 fertilizer at 3,000 Ib/ac and 500 Ib/ac respectively. MULCH TEMPORARY Apply 4000 Ib/acre straw. Anchor straw by tacking with asphalt, netting or o mulch anchoring tool. A disk with :blades set nearly straight can be used as a mulch anchoring tool. Use excelsior matting to cover bottom of chonnels and ditches with 2% slope or greater. The lining should extend to a minimum depth of 0.5 feet. On.chonnet side slopes above this height, and in drainages not requiring temporary linings, apply 4000 Ib/ocre groin straw by stapling netting over the top. Mulch and anchoring materials must not be allowed to wash down slopes where they can clog drainage devices. MAINTENANCE Reseed, refertilize and mulch immediately following erosion or other damage. A minimum of 3 weeks is required for establishment of permanent gross. inspect and repair mulch frequently. Refertilize the following April with 50 Ib/acre nitrogen. DATE 0 REVISIONS 1e• MW f- Nle Nile DITCH 18' MN POfMWK OMM MUST K PROWDED TO ASSM 0111110MAL F WIPE OIO M YB. SEED AND MIAAN fX11Eil00N. TRY Nin TO ills . MAX. 01UNM AREA - 5 ACRES WITHOUT SUPPOMINO CALCS.. DNEf13IOW AT Tf1E TOP Of SIAM MU3r DFtlY IMO AN Ap1;iO11ED SLOPE DRA^ mm/Om a mwr COMMONLY USED. (2) TEMPORARY DIVERSION BERM/DITCH i u r.,-: , ♦w, ,. r .. . .v -. +. .-. ::sem ... . '.: .. +:..... •. ;,. ,,. x. 512. .. a i, .... !t r } y. ... n a �a i ,y �4 k ..I GENERAL PLAN NOTES 1. SOIL EROSION. CONTROL DEVICES MUST BE INSTALLED INITIALLY AFTER THE GRADING PERMIT IS ISSUED AND ROUGH GRADING STARTS. NCDEHNR EROSION CONTROL INSPECTORS WILL CHECK THESE DEVICES FOR PROPER INSTALLATION AND COMPLIANCE WITH THIS PLAN. 2. .,ALL EROSION CONTROL DEVICES ARE TO BE INSTALLED iN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS. ANY CHANGES ARE TO BE APPROVED BEFORE CONSTRUCTION BY NCDEHNR EROSION CONTROL INSPECTORS. ADDITIONAL DEVICES WILL BE REQUIRED IF NECESSARY, 3. IF FILL MATERIALS ARE BEiNG BROUGHT ONTO THIS PROPERTY OR IF WASTE MATERIALS ARE TAKEN FORM THIS PROJECT, THIS INFORMATION MUST BE DISCLOSED AND SHOWN ON THE EROSION CONTROL AND GRADING PLAN. BORROW AREAS AND DUMP SITES ARE CONSIDERED TO BE PART OF THIS. PROJECT. 4. IN AN EFFORT TO MINIMIZE EROSION AND EXPOSURE TIME, EASEMENT AREAS SHALL NOT BE GRUBBED OR GRADED UNTIL UTILITIES ARE READY TO BE INSTALLED. ALSO, THE IMMEDIATE SEEDING OF DISTURBED EASEMENT AREAS AFTER UTILITIES ARE INSTALLED WILL ELIMINATE MANY PROBLEMS. EASEMENT AREAS WHICH CROSS OR ARE ADJACENT TO WATERCOURSES SHOULD RECEIVE SPECIAL CONSIDERATION. 5. NO LAND -DISTURBING ACTIVITY SHALL BE PERMITTED IN PROXIMITY TO A LAKE OR NATURAL • WATERCOURSE UNLESS A BUFFER ZONE IS PROVIDED ALONG THE MARGIN OF THE WATER BODY OF SUFFICIENT WIDTH TO CONFINE THE VISIBLE SILTATION WiTHIN THE TWENTY-FIVE PERCENT OF THE BUFFER ZONE NEAREST THE LAND -DISTURBING ACTIVITY. 6. ALL DITCHES WITH A GRADE OF 0% TO 5% SHALL BE LINED WITH GRASS. DITCHES WITH A GRADE OF 5% OR GREATER SHALL BE LINED WITH EXCELSIOR MATTING. (SEE SHEET EC2 FOR CHANNEL DETAIL.) 7. ALL ROADSIDE CHANNELS ARE INTENDED TO BE TEMPORARY MEASURES UNTIL ROADSIDE SLOPES HAVE STABILIZED. J o H o 13 P.O. ]BOX 879 4880 HARLW I SNE. WALKERIO . NC 27051 tel 336.595. 8917 '=0-336.595.8511 wtvbD�.00�n M M KKe, Davie Coz( iy YleallFi Department r ' and Nome Nealf .fyeney 210 HOSPITAL STREET 1 P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634-5985 January 5, 1996 Mrs. Teresa Ball P. 0. Box 2081 Advance, NC 27006 Re: Septic Tank Installation Rabbit Farm—Lot 15 Dear Mrs. Ball: On January 3, 1996, two members of this office met with Jesse McEwen at your home. A problem existed at your hone with the septic system which was installed on June 17, 1994. We discussed how possibly to solve your problem. The boxes were opened and the flow in the lines was adjusted. The lid on the lower box was replaced. It was suggested that a diversion ditch be placed above the system. Mr. McEwen said he would do this at no cost to the homeowner, if the homeowner would seed the area. work. We, also, talked about adding onto the lines, if these adjustments do not If you have any questions, please call me at 704/634 -8760 - Sincerely, Charles E. Little, R.S. Environmental Health Section CEL/wd