The URL can be used to link to this page

106 Windemere Drive Lot 13x DAVIE COUNTY HEALTH DEPARTMENT L . Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900283 Tax PIN/EH #: 5870-69-0403.13 Billed To: Bob Cope & Son Construction Subdivision Info: Windemere Farms Sec.1 Lot # 13 Reference Name: Larry Cope Location/Address: Windemere Drive -27006 Proposed Facility: Residence Property Size: 130 x 248 ATC Number: 2290 **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 1 l 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 4 b1s� #People #Bedrooms 3 #Baths 2. :!�;- Dishwasher: Ci�� Garbage Disposal: ❑Washing Machine: ❑� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 130 �� Type Water Supply C00^W Design Wastewater Flow (GPD) 3a_ Site: New Repair ❑ System Specifications: Tank Size 10DOGAL. Pump Tank GAL. Trench Width 3fy I Rock Depth 12 Linear Ft.3CO' Other: Z -D-jSTe.►60rjoa -15VX&5 , 1n1ST4`L ",46-S Required Site Modifications/Conditions: 1 S DX 140ose , lo" Caif reap. L"- 4 IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 K 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 1:0.0 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** �- 1--10' W,14. 1 Environmental Health Specialist's Signature: Date: % �3 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 #: 989900283 Billed To: Bob Cope & Son Construction Reference Name: Larry Cope Proposed Facility: Residence r lwil l-1160'ii1 *-11111 Tax PIN/EH #: 5870-69-0403.13 Subdivision Info: Windemere Farms Sec -1 Lot # 13 Location/Address: Windemere Drive -27006 Property Size: 130 x 248 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 CONS TION IS VA FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: '113100 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. A !0 17 Septic System Installed By: Environmental Health Specialist's Signature : DCHD 05/99 (Revised) f�-75A 1;� � 0 Date: ' APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Heallfi SecYlon P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 D M�D,YIN ► 1 2000 ***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 1--TW`n-iy/C✓//. v Contact Person /.ptyy C�9/r i�� IF V Mailing Address �1s r%1� &Q Home Phone�� 7 �7% City/State/ZIP [� / Met' Xo � 9-701q Business Phone g- GGo L� - �3a 2. Name on Permit/ATC if Different than Above 111,,4 Mailing Address /f/ i -t — City/State/Zip 3. Application For: ❑ Site Evaluation Q'0Improvement Permit/ATC ❑ Both 4. System to Service: M/House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People NR' # Bedrooms_ # Bathrooms 6K51shwasher WGarbage Disposal IrWashing 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: County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes W -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: %"i0 WRITE DIRECTIONS (from�M/ocksville) to PROPERTY: Tax Office PIN: # e7G — (9 9r �/o3,i3�/�c4• L�I�T on (•.•,`.r�',e�t c/� Property Address: Road Name l.✓i�+dte�t ePe ///f• �� L` o /1 r �.j %; City/Zip ;/`t"414rn C -e Al. C • If in a Subdivision provide information, as follows: Name: r—'-tm $ Section: _ Block: Lot: _ n Date Property Flagged: / — // — docv 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 Da�y'e County Health Department to enter upon above described property located in Davie County and owned by #70C'.Pa �So tl to conduct all testiingg procedures as necessary to determine the site suit bility. DATE /�C3� 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). Site Revisit Charge Date(s): Client Notification Date: EHS• Revised DCHD (07/99) Account No. Invoice No. &If-? Bob Cope & Son Const. P. O. Box 1160 Cooleemee, N.C. 27014 (704) 284-4307 Lot 3wil1,.--Pr-e. N"a('A5 17 ei e- pld+0�l� 7 5 Ga le a r ( APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (744) 634-8760 ID 0 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED`UNL•ESS &WVIC W"'L".�;",, ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed J1s411i etJ Contact Person Mailing Address de i't{- Y Home Phone City/StateMp 4c -v % %2 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: 4. System to Serve: S. If Residence: ❑ Dishwasher 0' -'-Site Evaluation O House ❑ Mobile Home # People City/State/Zip ❑ Improvement Permit & ATC ❑ Business ❑ Indust # Bedrooms O Both ❑ Other # Bathrooms ❑ Garbage Disposal ❑ Washing Machine Cl Basement/Plumbing O 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: 3 County/City' ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes O No If yes, what type? REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: S 1 WRITE DIRECTIONS (from Mocksvilie) TO PROPERTY: Tax Office PIN: # Property Address: Road Name ge 4a lm -t7 1 City/Zip Md UA 11/'P_ Iq_e.. Q7"!o I 'lam If in Subdivision provide iZewa,0 ation, as follows: Name: Me v� Section: Lot 1 1 0 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 toe Davie County Health Department to enter upon above described property located in Davie County and owned by as necessary to determine the site suitability. DATE 6 � 7 ,'� 9 SIGNATURE Revised DCHD (06-96) conduct all testing procedures `" DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOTZ Soil/Site Evaluation APPLICANT'S NAME N��f Clc,� DATE EVALUATED PROPOSED FACILITY ,✓ PROPERTY SIZE SUBDIVISION ROAD NAME Water Supply: On -Site Well Community_ Public L---, Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slo e % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC Consistence Structure /C -11, 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: LEGEND DCHD (01-90) Landscape Position EVALUATION BY: 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■MEM■MMM ■■EME■ME■ ■E■■M■■M■ ■E■EM■■■■ ■M■ME■■■■ ■■■ME■■■■ ■■■M■■ME■ ■E■■■M■E■ ■ ■■■■■■■E■ ■■■■■■■■■ ■■■■■■■■■ ■■■■■■■■■ ■■■■■■■■■ ■■M■■■■■■ ■■■■■■■■■ ■E■■■■■■■ ■■■■■■■■■ NEEM■■■■■ ■■■■■■■■■ ■■MEMO■■■ ■■■■■■■■■ ■■■■■■E■■ ■■■■■■■■■ ■■■■■Mee■ ■■■■■■■■■ ■ ■■MEMO■ ■■■■■■■ MEMO■■■ ■E■■■■■ ■■■EEE■ ■■■■■■■ MONSOON ■E■EEE■ ■■■E■E■ ■■M■ME■ ■E■■M■■■MN■■■ ■■■■EE■■EE■E■ ■■MM■M■E■■E■■ ■E■E■■MM■■E■■ ■■■ME■■■EMM■■ ■■■■■■■M■■■■■ ■U■■■■■■■■■■ ■ ■■■■O■■■E■ ■NOM■■■M■■■■■ ■■■■■■■■■E■■o ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■■■M■■■■■ ■■■■■■■■■■■■■ ■UMM■■■eM■M■ ■ ■NE■■■■■■■ ■■NM■■■M■M■E■ MEM■■■■M■■■■■ ■UMEMM■■■■M■■ ■ARMEM■■E■■M■ iii[ MMM■■MMMM■ MONO ■EN■ ■■N■ ■O■■ ■E■■ ■ ■ ME ■■ ■E■■ME■■M■M■ ■■■E■■■■■■■■ ■■■M■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■M■■■■■ ■■■M■■■■■■■■ ■■■■■■■■■■■■ ■■■■■EE■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■E■■MEMMEME■ ■■MEM■ME■■E■ MENEM■ENNEN MEMNONMEMEMEMEMMMEMEMNON ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■.■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■/■ ■■��■■■■■■■■■■■■■E■e■■■■■M■■■■■■■Mee■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■EEE■■■■Mee■■■■■■■■■■■■■■■■■■■■■■■■ MONO ■■■■ ■■■■ MEMO MEMO MEMO ■■■■ OMEN ■■M■ NONE MEMO ■■■■ ■M■■ MEMO SEEN ■EN■ NONE