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187 Longwood Drive Lot 52Account #: 990000955 Billed To: Samnaz, Inc. Reference Name: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 I q'7 %o itrj wood Tax PIN/EH #: 5961-59-5239.52 Subdivision Info: Redland Lot # 52 Location/Address: Longwood Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3199 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 STRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature:Ll& Date: 7 � 4 zl- 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 been as a antee that the system will function satisfactorily for any given period of time. A Septic System Installed By: Environmental Health Specialist's Signature: 2ymd�-14 Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT /3 7 LoNq wxd Account #: 990000955 Tax PIN/EH #: 5961-59-5239.52 Billed To: Samnaz, Inc. Subdivision Info: Redland Lot # 52 Reference Name: Location/Address: Longwood Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3199 **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 1 I 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 I? #Baths 0?. Dishwasher: 000' Garbage Disposal: El "." Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply �� Design Wastewater Flow (GPD) Site: NewRr Repair ❑ System Specifications: Tank Size/ pDd GAL. Pump Tank GAL. Trench WidthT6 Rock Depth Linear Ft Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISERS) 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. . n e day of installation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: A Date: DCHD 05/99 (Revised) i f APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & AT Q lrl Davie County Health Department Environmental Health SectionJUL P.O. Box 848/210 Hospital Street , 5 L = Mocksville, NC 27028 1-- (336)751-8760 ENVIRONMENTAL HEALTH DAVIE COUNTY ***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 ��ch "��, _ Contact Person l -P— Mailing Address Mailing 4:+ -2-1 1 A. y��/ J� -t LV Home Phone �' 8-7m — City/State ZIP 72_ Business Phone 3'7 V D 2. Name on Permit/ATC if Different than Above P „ Mailing Address City/State/Zip 3. Application For: A Site Evaluation improvement Permit/ATC ❑ Both 4. System to Service: qY House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: YYY#��People # Bedrooms_ # Bathrooms 6 Dishwasher ((Garbage Disposal Washing Machine LI Basement/Plumbing F1 Basement/No Plumbing If Business/Industry/Other: Specify type # Commodes !_ # Showers Z— # People # Sinks I— # Urinals r— # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: VCounty/City ❑ Well Aarcommunity 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ 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 with THIS APPLICATION. Property Dimensions: I x 2a )c 1327i Tax Office PIN: # .�'�q t'P I ci - �2 35.52 - Property Address: Road Name Z, ID h<JrNaA ' City/Zip ONV_ . _ r• s _ WRITE DIRECTIONS (from Mocksville) to PROPERTY: If in a Subdivision provide information, as follows: Name: LAI i. CW(AV Section: Block: Lot: Date Property Flagged: 7 — S' O Z 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 to conduct all testing procedures as necessary to determine the site suitability. DATE SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Inclu �a oo!` ng: , xisting and proposed property lines and dimensions, structures, setbacks, and septic locations). i Site Revisit Charge Date(s): Client Notification Date: L -J 1� Revised DCHD (07/99) EHS: Account No. Invoice No. S� + APPLICATION FOR SITE EVALUAIION/IMPROVEMENT PERMIT & ATC _ Davie County Health Department Environmental Health Seatfon P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336) 751-8760 ***IHPORTANT*** THIS APPLICATION CANNOT BE PIW=SSZD UNLESS ALL INTORMATION IS PROVIDED. Refer to the INTORMATIOH BULLETIN for .1 _1 , - I . 1 /_ 1. Name to be Billed Mailing Address 1 -?63 City/state/EIP Contact Parson r' JUN t 4 26101 RE D truatfA 1ftX 1FNTAI .'.ZUAV1�EC011ivl y / Rosa Mon. W Business Phone 2. Nacos on Permit/ATC if Different than Above Hailing Address�� City/state/zip 3. Application For: @"Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to aervioet O'House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other Wt 5. If Residence: 1 People 1 Bedrooms i Bathrooms ❑ Dishwasher ❑ Garbage Disposal ❑ hashing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Others specify type # People / sinks 1 Commodes 1 showers 1 Urinals # Nater Coolers IF FOODSERVICE: # Seats Estimated Nater Usage (gallons per day) 7. Type of hater supply: 0--County/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑ Yes ❑ No If yes, what type? ***1A1P0RTANT*** CLIENTS MUST COMPLETETIIE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: 61 r&S -7L Tax Office PIN: ff 151?'jv 1 —•51i — .5 39 Property Address: Road Name A"if S City/Zip r�1�Egr✓ee, V -(f If in a Subdivision provide Information, as follows: Name:J� P ,;(' A- � Section: Block: Lot: Y WRITE DIRECTIONS (from Mocksville) to PROPERTY: �Ar - D - 7 -/,-PI 4- /3�; of Date Property Flagged: 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 Ifealth Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the silo salla IIIty. i DATE 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). 0 Site Revisit Charge Date(s): I Client Notification Date: I EIIS: Account No. Revised DCHD (07/99) Invoice No. 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 #: 5861-59-5239.52 Subdivision Info: Redland Lot # 52 Location/Address: USHighway 158-27006 see map Date Evaluated: Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position I L Slo e % S HORIZON I DEPTH •• 12— Texture group Consistence : S Structure Mineralogy 1 HORIZON II DEPTH Texture group C Consistence`41-re-1 V Structure Mineralogy: I HORIZON III DEPTH - - S2 -Texture group Consistence S �' Structure Mineralogy : C HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE i • > v, SITE CLASSIFICATION, 15 EVALUATION BY: !�- - I61EA C-44 A 1114 LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: l REMARKS: 6fSTi.M lni�P-YO (iK P1C LLQ i"� 1�� 70 RA tc/ 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) 1./59 Ac. ± 1 p 0 10' Public 1 1 0 z Utilities n Easement I �' i � � 1 31 J 45,789 sq. ft. 1.051 Ac.t w 0' -a_ S 86'44'41" E r0' 357.26' o N 86.44'41" W 274.96' Q)30ypical Setbacks m 41,191 sq. ft.Interior Lot `� 0.946 Ac.t o0 0DIANE POTTS ^ o q - 571, PG. 724 33,874 s ft. �I 23 v S 86'44'41" E o0.778 Ac.t N o 381.08' a'= 1 s'2 9 N 86'44'41" 274.97' O 44,122 sq. ft. 0 0 10' Public Utilities 1.013 Ac.t o 50 � I asement w 108.06 Eo — I S 86'44'41" E 37,552 sq. ft. C°I I 407.75' CN 0.862 Ac.t I �Iw m ole 28 —1° 0 45,294 sq. ft. N 86'44'41" W n 1.040 Ac.t 274.25' o MB�41q. 433.42'(Total) S 86'44'41" Eft. 35,ft. `t I z CN f 0.817 Ac.t 00 274.57' 158.85' m 36,112 sq. ft. 0.829 Ac.t '�I o a, I� 27 h (u civ I 30,580 sq. ft. o _ � I 0.702 Ac.t � N z o N 86'44'41" W o o _ a 1- 272.93' 15' S 86'44'41" E N 04 Typical Setbacksj 30I �� 238 42. co Z 25 Corner Lot I I n o I 52 NI � 45,182 sq, ft. n I_ o 1.037 Ac.t 36,244 sq. ft. I cc 0.832 Ac. f c°y'� t°C36 30 j 10'x70' Si ht j Easement 1 iv �.c6 - 30,091 sq. ft. —_ 90.1 —C37 2 `O I 10'x70' 0.691 Ac.f 40'04" E — "' �S8332 03 E`�8 Z Sight Easement ?here Drive f 94.24' G� �S 83'32'03" E_�/G� C8 ,'(Total) ® �50 Public R/W) Tie 117.77 J� O 115.18'— —C35 _C34_ N 83'32'03" �, by �ne Bethlehem n 10' Public <24� X98.17' �� N 8332'03" W DrLve �� Utilities 38,496 sq. ft - 30.00' I 113 Easement C 3 \ 10'x70' Sight 84._� 1 0.884 Ac.f 4 Easement 10'x70' Sight G10 46,506 s ft. 1.068 Ac f I 32,240 q. ft. Easement 0.740 Ac.t � SEE SHEET 1 OF 2 D.C. MCCULLOH D.B. 188, PG. 541 D -SO 901 4. c.+ w N C, D.C. MCCULLOH D.B. 160, PG. 64 07 N � o J o: 1*1 or plat bearings as noted 4. Total Area 40.22Ac. 5. Total lots Phase I - 41 Lots Average lot size - 0.890Ac. 6. Zoned R-20 7. .Llinimum building setbacks: ' Front .... 30'/Side....15'/Back.... 30'/Side Street. 8. Public Streets, 20' wide ribbon pwemerrt 9. Public Water Systems & Private Septic Sysje7 10. All utilities underground NOTE : This survey is subject to any facts that may be disclosed by a full and accurate title search, N( furnished me as of this date, and may be subic easements, rights-of-way, restrictive covenants, assessments, if any, as the same may appear o; record in the Office of the Register of Deeds, Cl. of Court, Town or County Tax Office or which n have been acquired by prescriptive use. Redland Way Phase I Owner: Westview Development Comp( 2631 Reynolda Road Winston-Salem, NC 27106 (336) 777-0078 SCALE: 100 0 50 100 I I I I FIELD WORK BY CHECKED BY.• CJ JEB TAX NAP: PARCEL D-7 121.01 TOWNSHIP. CITY. • COUNTY, Farmington -------- Davi,; STATE: DATE. PAGE AVML NC 06-10-02 ` of JOB NUMBER.- DRAWN BY* 01205 RLB BEE11011 EneinEER1011 101 ENGINEERS SURVEYORS PL.ANr 503 HICH STREET WINSTON-SALEM, NC Z7101 TELEPHONE: 910-748-0071