The URL can be used to link to this page

223 Rick WayAccount #: 989900150 Billed To: Rick Link Reference Name: Proposed Facility: Business DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Tax PIN/EH #: 5749.09-0292 Subdivision Info: Location/Address: Rick Way -27028 Property Size: 5.002 acres p�� . Anker 2734 **1VOTE* 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 #People #Bedrooms #Baths Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type_1 #People "!r#People/Shift _� #Seats Industrial Waste: ❑ Lot Size Type Water Supply /U14I/ Design Wastewater Flow (GPD) ZZ.5— Site: New/ Repair ❑ System Specifications: Tank Size /000 GAL. Pump Tank GAL. Trench Width —16 " Rock Depth &L r Linear Ftzo___' Other: 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.**** Ll Environmental Health Specialist's Signature: CZ Date: DCHD 05/99 (Revised) C DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848!210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900150 Tax PIN/EH #: 5749-09-0292 Billed To: Rick Link Subdivision Info: Reference Name: Location/Address: Rick Way -27028 o.....on" Ci7P' .r,.(IM acres Proposed Facility: Business ATC Number. 2734 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 CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: &ZZ Date: D 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. Sar s� fi �foP Septic System Installed By: 2 Environmental Health Specialist's Signature : / Date: /� — O/ L DCHD 05/99 (Revised) ------_ ___ —_ _APFUCATiON FOR SHE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department Please complete the highlighted area(s) and EnVifV17melltd/Mga/Hl 5&WOO return. - - P.O. Box 848/210 Hospital ;Street Mockaville, NC 27028 (336)7S1-8760 ***IlWORTANT*** THIS APPLICATION CANNOT HE PROCESSED UNLESS INFORMATION IS PROVIDED, Refer to the INFORMATION BULLETIN for 1. Name to be Billed- /y/}��C {` �l J f: Contact Person Hailing Address/,'JOp, Phone city/state/ZIP (/�+ ,p J» �� /(,/ Business Phone 2. Name ort Permit/ATC If Different than Halling Address City/state/Zip 0 FEB 2 0 ;IA 3.e�pe- om,: 1' 1ATC t. system to service: ❑ House 0 Mobile Home Business O Industry ❑ Other s. If Residence: f People / Bedrooms i Bathrooms O Dishwasher n datbage Disposal D WashifgMachine O Basement/Plumbing 0 Basement/No Plumbing 6. If Business/Industry/other: Specify type// —People_ / sinks i Commodes _ f showers 1 '+— !: Urinals �o f Nater Coolers F FOODSERVICE: 11 Seats Estimated Water Usage (gallons per day) 7. '7fpc of water supply: ❑ county/City 10ell ❑Community r. !3c ,au Abliclipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No it ye., what type? LA- t N c—fin i1 ***1MP0RTAN7`**-CLJEM AfVSTCOAfpLMTETHE REQU/RED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMI1 ED by the client with THIS APPLICATION. i?roperty uihye:uai ;ac' 7 0 0 Z Tax Office PIN: il- 9-0-22 2, Property Address: Road Name ° City/zip 4 If in a Subdivision provide information, as follows: Name: .i �'a�i'Y vm...o�vne. �-..'—'M� 4�:`an..p e-, oollV.Y:�'r�•. Z 'f C' e -n LP Section: Block: Lot: 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 plana or intended use change, or if the information submitted in this application is falsified or changed I, also, understand that Ism rerponsMiefor all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the D e my 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 suitabilitia 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). R.v-viseti ?CHD r 97/98) Account No. Invoice No. b f '� 0 z v S�f DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900150 Tax PIN/EH #: 5749-09-0292. Billed To: Rick Link .- Subdivision -Info: Reference Name: Location/Address: Rick Way -27028 Proposed Facility: Business Property Size . 5.002 acres Date Evaluated: Water Su pply: On -Site Well rCommunity Public ' Evaluation By. Auger Boring Pit Cut FACTORS.; 2 .. 3, 4 '.. 5 6 7 Landscape position: Slope % . HORIZON I DEPTH Texture group Consistence - Structure , Mineralogy HORIZON II DEPTH + .. Texture group Consistence Structure - L 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:� EVALUATION BY: < "� � . , .. LONG-TERM ACCEPTANCE RAPE OTHER(S) PRESENT:,_. REMARKS`. LEGEND R Ridge S Landscape Positi on - Shoulder L - Linear slope FS -Foot slope N - Nose slope CC - Concave S pe 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 Sand clay SIC - Y Y Silty clay C - Clay 1 CONSISTENCE t 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 Mineraloev 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)