Loading...
149 East Robin Drive Lot 9Account #: 990004320 Billed To: Rick Tomkinson Reference Name: REPAIR PERMIT Proposed Facility: Residential Repair DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 REPAIR OPERATION PERMIT Tax PINIEH #: C7100B0019 ' Subdivision Info: Woodlee Lot # 9 LocationiAddress: 149 E Robin Drive -27006 Property Size: 1 Ac ATG'*PSh 0t2t* T$032uance of this Operation Permit shall indicate the system described on the ATC 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. System Type:A.T. � Manufacturer �1 Y—�C� Tank Date_ Tank Size_ Pump Tank Size'./ / Bedrooms System Installed By: �3k"'1111 kltD&AO Installer#: Date: ,7 GPS Coordinate: FA DCHD 11/06 (Revised) i • DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 REPAIR IMPROVEMENT PERMIT AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004320 Tax PIN; EH #: C7100B0019 Billed To: Rick Tomkinson Reference Name: REPAIR PERMIT Proposed Facility: Residential Repair Subdivision Info: Woodlee Lot # 9 LocationiAddress: 149 E Robin Drive -27006 Properly Size: 1 Ac Site Type: ❑New JORepair ❑Expansion ATC Number: 6032 **NOTE** This IP/ Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS IP/ AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms -3— # Bathrooms a # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size ��n( Type of Water Supply: ❑ County/City ❑ Well ❑ Community Well System Specifications: Design Wastewater Flow (GPD) �CTank Size�Tl0q AL. Pump Tank we" GAL. Trench Width Max. Trench Depth_,�Rock Depth Linear Ft.6 �2G Site Modifications/Conditions/Other: Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (3361753-6780. N Environmental Health Specialist DCHD 11/06 (Revised) Sw -LeA c�a�� 4)e C ti(gg��^�G// AM vw L4,A-00 loQ /) I . l W Nk 1;1vef:A ll 793_-67&,5 — DAVIE COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST APPLICATION IP/ATC OSWW REPAIR Name I C Address AA Mailing Address (if different from above) Email Address: Subdivision Name Number -33(." gl�_Z�j Date System Installe Name System Installed Under Type Facility �S� Number Bedrooms 1 Number People Served Type Water Supply Specific Problem Occurring Date Requested I3 Info Taken By ; THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY KNOWLEDGE, AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED FROM THIS APPLICATION. Signature of owner or Authorized Agent Initial Fee Date REHS Revisit Charge Date Reason, Permittee'1 , �' DAVIE COUNTY HEALTH DEPARTMENT Name: t i i >�1(• a e'1 Environmental Health Section PROPERTY INFORMATION P O Box 848 Pd - Directions to property: Mocksville, NC 27028 Subdivision Name: Phone #: 336-751-8760 Section: Lot: • �, tf / � i° C.' :1 r i �f ?i U t rl t Cr t,'� 6+,4, " AUTHORIZATION FOR WASTEWATER , � SYSTEM CONSTRUCTION Tax Office PIN:# - - AUTHORIZATION NO: 002772 A Road Name*;� f +`� n' `� Pr Zi 2 **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 Pennits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) • r ,' j —,***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. JTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE - tf # BEDROOMS T'? # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or�'Np COMMERCIAL SPECIFICATION: FACILITY TYPE � # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE (' 1 • TYPE WATER SUPPLY t rt , r� i d_ DESIGN WASTEWATER FLOW (GPD) 36 6 NEW SITE REPAIR SITE (� SYSTEM SPECIFICATIONS: TANK SIZE t�n_GAL. (PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: L k( FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. \,s, 11 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 02/02 (Revised) ; f %i `' + Z/.7 Z_ I N UV f . " Pcrnittee'-s, PAVIE COUNTY HEALTH DEPARTMENT j Name.' -� Environmental Health Section PROPERTY INFORMATION J P.O. Box 848 i Dii4tions toproperty: I `d ; _ 1 C `'t C f l' � -' J CT', � � c� r Mocksville, NC 27028 Subdivision Name: Phone #: 336-751-8760 Section: Lo[: AUTHORIZATION FOR/.' WASTEWATER Tax Office PIN:# - - SYSTEM CONSTRUCTION ILI c, 1; AUTHORIZATION NO: 002772 A Road Named � ' �'�° •? + zip: .-� � {_.�` **NOTE** This.Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance;of any Building PefiriitS: This Fonrt/AuthorizationNumber should be presented to thu Davie County Building, Inspections Office.when applying for Building Permits. (In compliance with Article l l of�G.S. Chapter 1304; Wastewater Systems, Section'.) 900 Sewage;Treatment and Disposal Systems) ; �/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION i IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE ff # BEDROOMS # BATHS # OCCUPANTS —.)_ GARBAGE DISPOSAL: Yes or COMMERCl/A^L SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE'GAL. PUMP TANK 4 GAL. TRENCH WIDTH - ROCK DEPTH LINEAR FT. OTHER y� REQUIRED SITE MODIFICATIONS/CONDITIONS: iy IMPROVEMENT PERMIT LAYOUT �d L 'w Q \ ./� f � Gt yr t`• ,} •r t 11 ty ' .r c _ t.. FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751 87fia 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 I I 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 02102 (Revised) Ft NAM ADD 0r�C��'�'� Qd � DAVIE COUNTY EOIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) PHONE NUMBER N� a7oo p _SUBDIVISION NAMEomh� DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED N� TYPE WATER SUPPLY ? .mac SPECIFY PROBLEM OCCURRING //VeS C/ CA-f)/!/A 4p ' Ile) k" ✓Irr /?—!-r I DATE REQUESTED E3/W l Q'? INFORMATION TAKEN BY. This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1/93 I iN Adua&ce- w6-cdd like �o die 4ketc a 'nr 'F ..t_ _g..-. ....... -.m'..r- "s�-'"t�t4^'q,o •A"q,,,'.x"i"'rSiarG-w .. DAVIE COUNTY HEALTH DEPARTMENT txXa IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Snitary Sewage Systems Permit Number Name i c".9r%/f�✓�f� `/t, )vr.� �%�T%`` xJ J r✓ Date /c ` i'/ `A� No tJ Location ��i'�%t'��� ,✓ rf f`Y1 fi1� ;!�<, l r�' _ Subdivision Name ����r'� f' Lot No. 0/ Sec. or Block No. Lot Size House ` Mobile Home Business __ Speculation No. Bedrooms No. Baths e2 No. in Family _ Garbage Disposal YES ❑ NO ©'- Specifications for System: Auto Dish Washer YES p NO ❑ - Auto Wash Ma thine YES [[j NO ❑ ' � �l Type Water Supply'+' *This permit Void if'sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans ar,,the intended use change. i,: Improvements permit by — Ila *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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by LA JJ 2/G �a„! Je Certificate of Completion Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function a.1:1.1-1.may — `.!.w- ,., •. DAVIE COUNTY HEALTH DEPARTMENT ` IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION * NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a S nitary -S/ewwa e Systems / / Permit Number Name iCJ /4,�1.Y.<r�or/.��7/c!�o2 Date c�lc` i� N2 70,44 LocationC��P Subdivision Name U��l' (' !r r' Lot No. / Sec. or Block No. Lot Size House Mobile Home _T Business __ Speculation No. Bedrooms Z No. Baths Q No, in Family _ Garbage Disposal YES ❑ NO p'- Specifications for System: Auto Dish Washer YES NO ❑ Auto Wash Ma ;pine YES L'J NO ❑ I v �X.o �X 'y Type Water Supply & *This permit Void if'Sewage system described below is not installed within 5 -years from date of issue. This permit is subject to revocation if site plan�the intended use c�iange. // ;1'ft I /G J/ /store Improvements permit by Al // *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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram 00 be System Installed by 5� 1/0 f0"V G`?v IDw: k Certificate of Completion Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. DAVIE COUNTY HEALTH DEPARTMENT ;( IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems f Permkt( �iuTber Name /� �' r;f,,l ,L Date %,� �' '� NO r �t Location �'�"�/�cf'zd� Subdivision Name t, ` �^ Lot No. �t Sec. or Block No. -'i i Lot Size House Mobile Home Business -- Speculation c! No. Bedrooms No. Baths No. in Family — Garbage Disposal YES ❑ NO p' Specifications for System: Auto Dish Washer YES ❑i NO ❑ �7 ."J., � 'X ✓� / Auto Wash Ma shine YES p NO ❑ Type Water Supply__— 'This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans-or,the intended use change. Improvements permit by '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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: I System Installed by s' 41 i i 1-� Certificate of Completion Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. -'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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: I System Installed by s' 41 i i 1-� Certificate of Completion Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. TO 4 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION A dv.�,,�-,,, *I`,j0TE: Issued in Compfiance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number ii`' /�' •' ?;=1' ,� i '`. it Np Name ,r% fi , ,� Date - _ Location ,., ;i>> - r' ;-;r r3 -C Subdivision Name 00 d b L.�- F Lot No. - Sec. or Block No. Lot Size House __S,!<___ Mobile Home _ Business Speculation No, Bedrooms No. Baths 2 No. in Family'_ Garbage Disposal YES p NO p- Specifications for System: Auto Dish Washer YES NO ❑ ;. , _ , Auto Wash Machine YES NO p Type Water Supply �' _ :�!''.%c;•',� �. *This permit Void if sewage system described below is not install�d within 36 months from date of issue. \_ \ Irr)provements permit by ` *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\ n 'd�y `of completian. Telephone Number: 704-634-5985. �i Final Installation Diagram: \ System Installed by -- S �j`�'��1 t r 1. a Certificate of Completion / Date *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily, for any given period of time. DAVIE COUNTY HEALTH DEPARTMENT (Septic, Tank)' Improvements Permit and Certificate of Completion (Ground Absorp ion Sewa]g�,,e�$ Disposal System - G -. ..Chap ter 130 Ar;ticler :13C) �WNER OR CONTRACTORS f.¢,�. a '' "'DATE PERMIT' .�_ N� 364 LOCATION S.R. NO. `SUBDIVISION NAME , [ LOT NO. SECTION OR BLOCK N0. HOUSE M MOBILE HOME C3 BUSINESS ❑ j House Trailer ^800 Gal.. 400 Sq. Ft.' N0.'. BE OOMS, , NO. BATHROOMS `mss, Two Bedroom House 809 Ft. GARBAGE DISPOSAL UNIT YES NO ❑ Three Bedroom House AUTO. DISHWASHER. '�.: YES C3 NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO*". WASH. MACHINE ' YES [3,.. NO ❑ SITE SUITABLE YES ❑ 0 13SIZE OF TANK 9040 gal;. NITRIFICATION FIELD ! 41� q. ft. (� DEPTH OF STONE' 'IN LINES: WATER SUPPLY: ,• Individual Public ❑ x IMPROVEMENTS PERMIT• BY :. •�`•':� INSTALLED BY� CERTIFICATE OF COMPLETION gy'$ `. Date (8/16/73) *Construction.must com y with all other applicable State and local regulations LOT'.AREA ' .r ';_ . ;, _�� �..:�aa+a,..�:.u:.�,;w.:.!�.:;w, _�,..: _. :... .,.�,w.�+^•,= ..sew„,,,. - , ; ...y..,,,,,,�,„�,,,w .,, a+.a....v.. g.....,.,,,. a-n.°.,r%(:.rx,mwr. .;s.„y.,.;.:: ,....,e,..n., .w • � • LA,n,3E • r Daae County Neaki Department and .dome Nealtl ffyency 210 HOSPITAL STREET/ P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634-5985 April 8, 1993 Linda Tomkinson Rt. 4, Box 232 Advance, NC 27006 Dear Mr. Tomkinson: The house located on Lot 9, Section 1 of the Woodlee subdivision in Davie County has experienced septic tank trouble in the past. The septic system was repaired on April 16, 1989. No sewage system check was requested at the time of sale. If the house had been vacant for an extended period of time; a septic tank failure would have been hard to detect. Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd r Dam? County NealtF D,e /1 .doartml 79 and m�lealtFr e cy 210 HOSPITAL STREET I P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634.5985 August .2, 1993 Richard Tomkinson Rt. 4, Box 232 Advance, HC 27006 Dear Mr. Tomkinson: This letter is regarding the septic tank system that serves your residence located on lot 9, section 1 in the Woodlee Subdivision in Davie County. The original system was installed in the backyard on September 27, 1974. A repair was done on the existing system in June 1985 and another in April 1989. The backyard has been dissected with several drainfields and also contains some fill material, which does not disperse the effluent well. A pit could be used in the backyard; however, it would have a limited life span. The best way to correct the problem is to set an additional tank in the backyard with an effluent pump and pump to the front yard. To do this, the well in the front must be filled in. If you have any questions, feel free to call. Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Specialist RH/wd