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155 E Robin Drive Lot 8IMPROV *NOkE: Issued in Compliant Sewage Treatment Name Location DAVIE� f ; COUNTY HEALTH DEPARTMENT. , •" '' RENTS' PERMIT AND CERTIFICATE OF:',COMPLETION a with G.S. ofNorth Carolina -Chapter 130 Article. 13c �r r I'd Disposal Rules'(10,NCAC 10A .1934=.1968).._• r• r Permit Number 42, bate �`�f�'4'y rti� 25 `. 1. Permit F 2. Address -77axj- -,? AM/ APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 66 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone Business Phone 3. Property Owner if Different than Above Address 4. Permit To: a) Install °- Alter Repair b) Privy Conventional Other Type ivr" Ground Absorption /ts� -Ile c) Sub -Division li-106d -LE A Sec. - Lot No. e-7-10- L o % f 5. System used to serve what type facility: House Mobile Home Business Industry41 Other b) Number of people 6. a) If house or mobile home stpte �sizef home and number of rooms. House Dimen�ygns (� Bed Rooms�_ Bath Rooms_ Den w/Closet b) If Business, Ind ry or Other, State: Number of persons served What type business, etc Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes Z� urinals garbage disposal lavatory Z� showersy washing machine dishwasher sinks 8. a) Type water supply: Public Private Community b) Has the water supply system been approved? Yes No 9. a) Property Dimensions / f457%x z }d b) Land area designated to building site 1Crp1 ✓T_ c) Sewage Disposal Contractor 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve. /1f c� ✓ What type? This is to certify that the information is correc to the best of my knowledge. Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: kj,oto DCHD (6-82) s' -77 'i 4 'i 4 18) f20) p8. (SEC. 15 16 17 19 229. cr- 19 N 1) N c)) 26 j ��' i i 2 It r_ r2i 22 2G. 17% H 6) .._(20) (21) 1 1 0 -� (SEC. J = 15 16 1 17 ? T ! Iq) - 19 !f1) Address DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section, R O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date Lot Size����� FACTORS AREA 1 ARFA 9 ARFA 3 AREA A I) Topography/ Landscape Position S S PS U S PS U ?) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay)(P�S S ff S PS U S PS U 3) Soil Structure (12-36 in.) Clayey Soils S S a S PS U S PS U 1) Soil Depth (inches) S !�) S PS U S PS U i) Soil Drainage: Internal S� S V U/ �t,1/ S PS U S PS U External (/PSS S PS U S PS U i) Restrictive Horizons Available Space S PS(P5� i! S PS U S PS U 1) Other (Specify) S PS U S PS U S PS U S PS U 1) Site Classification R U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: zi'� Described by Title SITE DIAGRAM it /Z DCHD (6 82) W Date 01IS-7 Davie Caz( iy NeallIf Dyarlmenf and Na Nalt M en me e y cy 210 HOSPITAL STREET/ P.O. BOX 665 MOCKSVILLE, N.C. 27028 PHONE: (704) 634-5985 October 6, 1987 Mr. Roy Potts P. 0. Box 11 Advance, NC 27006 Re: Site Evaluation Woodlee/Sec. 1 -Lot 8 Dear Mr. Potts: On September 30, 1987, this office evaluated Lot 8 of Section 1 in Woodlee. On that date the lot was classified provisionally suitable providing the following conditions are met: 1) The left side of lot needs to have an underground interceptor drain installed to divert any ground water from the system. 2) The lot must be graded to remove all surface water from the system. If you have any questions, feel free to call this office. Sincerely, &WOX 0 �, / Robert B. Hall, Jr., R.S. Environmental Health Enclosure RH/wd APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone 1. Permit Reques By R/�:6: Business Phone 2. Address ©� U 3. Property Owner if Different than Above 4. 5. Address Permit To: a) Install -LZ -Alter— Repair b) Privy Conventional ter Type Ground AP sorption c) Sub -Division 111 0-4-- Lot No. Sec. System used to serve what type facility: House Mobile Home Business IndustryOther b) Number of people 6. a) If house or mobile home, state size o home and number of rooms. House Dimensions Bed Rooms Bath Rooms_ Den w/Closet b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes �- urinals garbage disposal lavatory showers washing machine dishwasher sinks 8. a) Type water supply: Public�Private Community b) Has the water supply system been approved? Yes No 9. a) Property Dimensions �"-,) 2( b) Land area designated to building site c) Sewage Disposal Contractor 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? What type? This is to certify that the information is c rre to the, est my knowledge. Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Directions to property: a o< Allow 5 days for processing F an DAVIE COUNTY HEALTH DEPARTMENT " Environmental Health Section R 0. Box 665 Mocksville, N.C. 27028 f SOIL/SITE EVALUATION Name �� Y� Date r Address Lot Size Ile FACTORS AREA 1 ARFA 9 ARFA 3 AREA d t) Topography/ Landscape Position S (EP dg�> S PS S PS U U U U 2) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) SS PS PS S PS 3) Soil Structure (12-36 in.) S S S S Clayey Soils (�rs > PS PS U U U 1) Soil Depth (inches) � f p/�7 S PS S PS S PS S PS U U U U i) Soil Drainage: Internal S S S S PS PS PS PS U U U U External S S S S PS PS PS PS U U U U i) Restrictive Horizons Available Space S 8i S _ S PS S PS U U U U i) Other (Specify) S S S S PS PS PS PS U U U U 1) Site Classification U—UNSUITABLE Recommendations/ Comments: S—SUITABLE PS—Provisionally Suitable Title Date Described by �� SITE DIAGRAM DCHD (6-82) ,ATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section c G P. 0. Box 665` Mocksville, N.C. 27028 )N SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. 1. Permit Requested By SNIPES & FERGUSON, INC. 2 Add POST OFFICE BOX 1681, CLEMMONS ress 3. Property Owner if Different than Above N/A Address Home Phone N/A Business Phone NORTH CAROLINA 27012 4. Permit To: a) Install X Alter Repair b) Privy Conventional X Other Type Ground Absorption c) Sub -Division WOODLEE Sec. 1 Lot No. 8 5. System used to serve what type facility: House X Mobile Home Business Industry Other 40 (919)998-7691 b) Number of people UnNnuwn 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions 40' x30' Bed Rooms 3 Bath Rooms 21-2 Den w/Closet b) If Business, Industry or Other, State: Number of persons served N/A What type business, etc. N/A Estimate amount of waste daily (24 hours) N/A 7. Number and type of water -using fixtures: commodes 3 urinals -0- garbage disposal -0- lavatory 3 showers 2 washing machine 1 dishwasher 1 sinks 1 8. a) Type water supply: Public X Private Community b) Has the water supply system been approved? Yes X No 9. a) Property Dimensions 110' x195' b) Land area designated to building site 1100 s . f . ± c) Sewage Disposal Contractor UNKNOWN 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? What type? N/A This is to certify that the information is correct to t")best JANUARY 14, 1988 Date OWNER IS SOLELY RESPONSIBLE FOR COMPLI6nCE WITHIALL Allow 5 days for processing Directions to property: Highway 801 West to Woodlee Subdivision Right on Robin Drive - Last lot on left. DCHD (6-82) er9, sident son 3T E A LOCAL LAWS NO 0 Davie County NealtFr De artment and .dome Nealtl Men 9 cY 21 O HOSPITAL STREET / P.O. BOX 665 MOCKSVILLE, N.C. 27028 PHONE: (704) 634-5985 June 21, 1988 Potts Realty Attn: Dianne Potts P. 0. Box 11 Advance, NC 27006 Re: Sewage System Installation Snipes and Ferguson Woodlee/Sec. 1 -Lot 8 Dear Realtor: The septic tank system that serves this residence was designed, inspected and approved by this office on June 14, 1988. This house has a county water meter installed. CL/wd With proper maintenance and use it should function properly. Sincerely, L. R'>� Charles E. Little, R.S. Environmental Health