Loading...
241 High Meadows Road Lot 29DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001597 Tax PIN/EH #: 5870-59-2169 Billed To: Marquis Building Subdivision Info: Windmere two Lot # 29 Reference Name: Location/Address: 241 High Meadows Road -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3561 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 VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: /4Date: //"), ?- — 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. �V Septic System Installed By: ? h/ ✓1 l'L Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) 5 DAVIE COUNTY HEALTH DEPARTMENTIlkgr Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001597 Tax PIN/EH #: 5870-59-2169 Billed To: Marquis Building Subdivision Info: Windmere two Lot # 29 Reference Name: Location/Address: 241 High Meadows Road -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3561 **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 HD0se #People #Bedrooms #Baths 2 Dishwasher: ice" Garbage Disposal: ❑ Washing Machine: d Basement w/Plumbing: ❑ Basement/No Plumbing: Er Commercial Specification: Facility Type #People #People/Shift #Seats Industria11all Waste: Lot Size 0.8L�' Type Water Supply &AVWDesign Wastewater Flow (GPD) Site: New 12 Repair ❑ System Specifications: Tank Size f CW GAL. Pump Tank GAL. Trench Width N Rock Depth //– Linear Ft.,60` Other: If —D15TF-t btu L c"� �;" Xc--S Required Site Modifications/Conditions: SOIL- IMPROVEMENT/OPERATION OIL 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.**** QQcs? ura -��V u+� i Og --'Z- CPO I-1 Environmental Health Specialist's Signature: DCHD 05/99 (Revised) ©JT Cl: X-&'?a,JAY \ � ALTEQNATI�� APV, Date: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section T_ P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001597 Tax PIN/EH #: 5870-59-2169 Billed To: Marquis Building Reference Name: Proposed Facility: Residence Subdivision Info: Windmere two Lot # 29 Location/Address: 241 High Meadows Road -27006 Property Size: see map ATC Number: 3561 **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 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 /T #People #Bedrooms _�_? #Baths 2_ Dishwasher: P" Garbage Disposal: ❑ Washing Machine:j2"" 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: Nev�Repair ❑ System Specifications: Tank Size GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width�/Rock Depth Linear Ft. :TlYl% 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.**** P41op 60 all /�&//) De,))Ialo�-Al C"71 / i'e/J7d vel-) Environmental Health Specialist's Signature: Date: �� .._.. CZY DCHD 05/99 (Revised) 08/22/2003 16:34 9406947 GORDON WHITNEY PAGE 01 i APPurATION FOR SITE EVAtlJmm/IMPROVEmw PERMIT & An Davie County Health Department Eft VIA Nh7tetfla/Ilt3aIM secam D.O. Sox 848/210 hospital Street Moakaville, HC 27028 (336)751-8760 S *** T *** THIS APPLICATIO1 CANNOT BE PROCESSED UNLESS ALL TIM AEQUIRED INFOFMTION IS PROVIDED. Hafer to the INFOIGWION BULLETIN for instructions. 1. Rase to be fulled (I )�Q�l'S �IL�I� J,.�JG Centset Pursues � (Zd/��i(,�� bkiliw Adase.a Q O. Z 1 ?y Ross, Phone g40 --1654 -7 p City/stat*/zzP AW&6xg nuainev, Phone 2. weas on Perait/ATC it Different than above Mailing Address city/state/zip s. Application s'or: (3 Site EvaluationImprovement Permit/LTC O Both •. aysaea to serwloe: House 0 Mobile Home 0 Business 0 Industry 0 Other S. If Residence: f People t Bedroms - - f Batth�hrrQo{{oms �( Dishwasher G ge GarbaDisposal )I 4aehing H-hine U nuns t/P10bUq 74 neui� & Fluiioq 6. If casinos/T--try/other: specify type t Foapla a Rinks s Commodes a shover■ f Vrinais a water Cooi*re IF FOODSERVICX., IT Seats Estimated Water Usage tgallas, per ass) 7. Type of water supply: it county/City ❑ Well 0 Cominity a- Do you anticipate additions or esponsloas of the facility this system is intended to serve± D Yea (ryes, what type? •* *IMPORTANT'** Chin MUSTCVMPLETETHB REQUIRED PROPERTY INFORMATION REQUEMM BELOW. Either a PLAT or SITE PLAN HVSTfiES1J8Mn7ED!Z the chest with THIS APPLICATION. Property Dimensions: ftc*te F ZSi %t 115 WRITE DIRECTIONS (from Mocksdlie)toPROPERTY. Tax Office PIN: a 5,970 59 2104 r -w -r t?y- Property Address: Rand Name Z*1 fits. P'ff.� ��//���� I, t 0. —c C.. �Ex}oct+,�t,r.P T Q z•►Ma C'tty/Zip Aso" t%a L)t sy0eW-eta TR s�'0 DouS It in a Subdivision provide information, as follows. L- .tel o t3 00LO syr' Name: \Alttjpe It w t'ItQMS _ ' Seetloe: �- Block: Lot: ZI Datc Property Floned: g'�C 3 This is to certify that the information provided is correct to the best of my knowledge. I understand that any per elf(s) issued betealter are subject to suspension or revocation, if the site pin= or intended ase change, or if the information submitted to this application is falsified or changed. I, also, anderrtand that I am responsible for all charges incamQfrom 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 1 �a7b to conduct all Testing procedures as necessary to determine the site sus lily. DATE !4kd 3 SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (include all of the W19wing: Existing a proposed property lines and dimenslons, structwos, setbacky and septic Mcatious). Site Revisit Charge Date(s): Client Notification Date: UU Account No. Revised DCHD (07/!9) Invoice No. '� O n� AUG � 2003 D OgNF O�q���iy r IR APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 AUG 2 5 1,999 ***nfp0RTANT*** THIS APPLICATION CANNOT SS: PROMSMM UNLESS JILL THS REQUIRED INTORMATiGN IS PROVIDED. Refer to the nWORMATIGN BULLETIN for instructions. 1. Yams to be Billed WEMIE•,3 J7C�/F:oP;nS,.rr C0'1qVIVJ`/ Contact person -i1yOVgay Mailing Address 2L3% REy1JQknnA RO. ams phone 336' 0--LoOO City/statenxv W1Nm.--)-SXtfir� ,tic 21106 Business phone 336.111- 00"14 Z. Issas on permit/A= it Different than Above Nailing Address City/stag/sip 3. Application ror: lite :valuation 11 Improvement Permit/ATC D Both sWD ,J 4. system to service: D�ns„HouseS 11 Mobile Home O Business 0 Industry 11 Other a. If Residence: f People # Bedrooms ! Bathrooms O Dishwasher O Garbage Disposal D Washing Machine O Basement/plumbing O Basement/Ho plumbing S. If Business/industry/Others specify type # Commodes t people • sinks showers f Urinals • Water Coolers Ip rOODSERVICB: # Seats estimated Water Usage (gallon• per day) 7. Type of Water supply: 0 County/City 0 Well 0 Community a. Do you anticipate additions or expansions of the facility this system Is intended to serve? 0 Yes U No Dyes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: Tax Office PIN: #d �U //7 -116J . 30 Property Address: Road Name /J�'C 11(c A City/Zip /%d r/dnc e "Vc- O%C If In a Subdivision provide information, as follows: WRITE DIRECTIONS (from Moclawille) to PROPERTY: J J pckS tRKtA To PACdt cw 1, EAVGUMPA d4 tOAEIL*v 0.0 LEFT. Name: IAIJ YO N(AC TAttx25 Nun �a►� p' Q/f Section: �� Block: Lot: � 29 Date Property Flagged: 5 w42.� � `/ 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 1, also, understand that I am responsible for all charges incurred frons this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located In Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE 8' W9 9 _ _ _ _ _ SIGNATURE AV /�/ THIS AREA MAY BE USED FOR DRAWING YOUR SrM PLAN (Include all of the f611owfug: Existing and proposed property Uses and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Revised DCHD (07/99) IDate(#)-. 1 Client Notification Date: I EAS: r Account No. /IX— Invoice XInvoice No. 0 C r m .TOCK -- I I � 8 CARL D. B. 1'I. 202 S 85'33'08' 261 I I 2.22 + 3dN GLE IRON FOUND 025 + - D S 83.23'37' E '76 48 - 49 26 29 616.09 1 271 252 25 254 50 56 fes/ �1 47 ti 2 5 9 rbc 250� 206 y 5e 1551 75 272 �, � C 57 249 Z4�• <o• 24 20 102 r 28 1 � � :r 9 20 � 74 154 153 1 273 258 259 17 0 9 1$- 187 �A 186 1 168 4 4 45 I8 1181 + 29 24 193 157 158 T w l ) 49 t 11lE n 1�S 194 216 11215 + IUO' I?� \70 X42 fr 244 195 9i is 79 ^ v 2 0 43 199 l98 1 2 11 197 196 1 217 �'l.' 1043 t Cry �� .Y + '��, f'• AL 4ton 2 221 18 t r) p /•,O 80 O 30 219 \q + 126 125 I 2�p , 81 lh 88 00 7p 12 71 70 29 y 101 t .� 22 123�ti �F 9 t� v 41 ^%) 89/ 0�n �. \ 22 Ay �v ^1 - "W / / p 169 168..-.-.- 120 >.97 3'97 -zuo 51 p' 54 5 57 O 1 118 9 + �r GE OAK _ I p16y ;;I gzga, � / 58 • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brant Godfrey Proposed Facility: Residence Property Size: Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5870-69-0403.29 Subdivision Info: Windemere Farms Sec.2 Lot # 29 Location/Address: Beauchamp Road -270016 See Map Date Evaluated: Community Evaluation By: Auger Boring Pit Public z� Cut FACTORS 1 2 3 4 5 6 7 Landscape position 21 Slope % HORIZON I DEPTH 6 � , Texturegroup S'C! fG L Consistence Structure Mineralogy HORIZON II DEPTH Texture group fANVC 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 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: U' LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscaae Position EVALUATION BY: AC4/ 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 EFT - 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) ■■■■■■■■■■■■■■■■■■■■■■E■■■ecce■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■N■■■■■■■■■■eee■■■ss■■■■■■■■■■■■■■■■■■■■■■■■■■■E■s■sN■■■■■■■■■■■ ■ No ON ■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ iiiiiiRMiiiiiiiiiiiiiN ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■Nee■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■N■■■■■eee■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■ ■ ■ ■ NEON NEON ■■■■ NONE SOME SEEN ■E■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■E■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ mom MEMMEM iMENNENMENNENMMEMEM ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■ u■■■■■■■■N■■■■■■■■■■■■■■■■■■■■■■ ■■ ■ ME No ■■ ■■