The URL can be used to link to this page

3197 Cornatzer Rd (2) 19Z) i0 DAVIE COUNTY HEALTH DEPARTMENTt IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION * 4OTE:Issued in Compliance With Article II of G.S.Chapter 130a Sanitary Sewage Systems Permit Number Name �� c� ,��• .�. @c cs, ,} •:, Date —� , N2 6 49, 8 Location ' ' 7, I , .a r ,, �'► l �) 0�r Subdivision Nam V A of No �A Sec. or Block No. Lot Size ti A " House Mobile Home —fie/ Business Speculation .t. No. Bedroomsj �_•No. Baths �•, ; No. in Family Garbage Disposal., YES.,❑ NO Q/ Specifications for Systeme Auto Dish Washer ' ' YES El .NO p/ Auto Wash Ma^hine YES Fjj' NO p \, Type Water Supply h '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 o'r the intended use change. T 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: System Installed by CLQ.cy e r .. 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. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER Davie County Health Department �o •L r'/ Environmental Health Section JUN 0 7 P. O. Box 665 Mockoville, NC 27028 ----------- -- 1 . Application/Permit Requested By Mailing Address R)MC " G{.�7� �e� _. �1�_ _ _0`)-7[ t'1Cn Home Phone qqT &A-04 Business Phone (oS - Irl,14 2. Name on Permit if Different than Above (hP- 141PL e -4 lVLLIL�CaKcJnn 3. Property Owner if Different than Above , 1�Me-- k-)Lla 6. \,6m/A-4`/ 4. Application/Permit For: lC) General Evaluation S/Tank Installation 5. System to Serve: [) House Mobile Home (] Business lL] Industry u Other 0 Unknown 6. If house, mobile home: Subdivision Sec. Lot# No. of People �nDwelling Dimensions \A '4- No. No. of Bedrooms Basement/Plumbing No. of Bathrooms _ Basement/No Plumbing Washing Machine 0 Dishwasher 0 Garbage Disposai 7. If business, industry, other: Specify type No. `of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers 8. Type of water supply: 'u- Public 0 Private 0 Community 9. Property Dimensions / `Se-• 10. Sewage Disposal Contractor Aetagnl N • 11 . Do you anticipate additions/e pansions of the facility this system is intended to serve? 0 Yes No If yes, what type? *NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. This is to certify that the information provided is correct to tri E_ best of my knowledge, and I understand I am responsible for all charges incurred from this application. Date U Sign ure Q avr-,0L 4ono A-h 4 O-h Ll a AtuaF Z°V_c o rn AW pi L'i c Directions to Property : -� DCHD (10-89) ^- DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Q Soil/Site Evaluation NAME C�� DATE EVALUATED to ADDRESS �1 M�@ PROPERTY SIZE • S C � PROPOSED FACIILTY LOCATION OF SITE C o�t� Nz'noQ. Water Supply: On-Site Well Community Public 10 Evaluation Bye Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position _S Sloe % O - Fr' HORIZON I DEPTH Texture group S S Consistence Fri 1 91 Structure Mineralogy HORIZON II DEPTH Texture group Consistence IF T Structure rA TS k Mineralogy I; HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS 55 S S RESTRICTIVE HORIZON — -' SAPROLITE CLASSIFICATION IYS S LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: CC S EVALUATED BY: LONG-TERM ACCEPTANCE RATE: �� - qu OTHER(S) PRESENT: �¢ REMARKS: N It% LEGErb Landscape Position 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 DCHD(01-901 ■eI�M■■■lee■■■■■■.■■...■s■■s.■■■■■■■e■■■■.■■■■■■■■■■■■.■■■11■■■■■■■■r� ■els■■.■..■■■■■■■■■■■■■�•e.■■■■■■■■■■■■■■■■■s■■■■■■■■■.■■.�■■■■■■e■ MENEENE ONION ENE 0 ■■Il[ci■■u■■■■■■■■lu■■'��i■■■1177■■■1�1�■�.7■■■■■■■■■■■■■■■■■■■■�■■■■I1�0■.■ ■■1■■i..I■....■.■.I■■./tll■e.■.Ihii■■■1.1 �;!�I■■■■■■■■■�■■■■■■■.■ea■■el\i!®E■■ .L�leal..■■.\it■..■■■. ■■■■■■lira■i■i■■■..■..■■■■■■■■■■■.el■■■■■■./i■ ��i��Il��iiiiiii�.■■..�.■■■e■..■iiiii■■■...■.■■■.■.■■....■I■■■■■■■tl■ ■■�■■ 1■.■■.■■.■■...■■■■■..■■...iiia.■■■eM■■■ ■..■■■■■�.e■I�■■■■■er■■ ■..■.�1....■...■..■■■■■.■■■■■\ ��,.■■■■......�■■■■■■■■■■.r.■■■■NI■■ ■■■■■■II►e�lv��■■■■...._■■■■■■■.■■r;w e■■■■■■■..■■■■■■.M■■..e..■■■■■I■■ ■ MENNEN ■E■.■MMEMe .■..■■..■.■..e■.....................■......... ■E■NNE■ moon MM ■■■■■...■■■■■■■■■■............................... ■NEEM■ ■■■■■ ■■N■■■ ■■■■■■ ■■■■■■ ■■N■■■ ■■NOME ■■E■M■ ■■■■■■■■■■■■■■■MEM■■■■■■■■■■■■■■ ■■■■■■E■■■■M■■■■■■■■■■■■■■■M■■■■ ■ISM■■■EE■■■.■■M■■■■■■■■■■■■■.■■■■■■■N■■■■■■■■■■N■■■■■.■■■■■■.N.■■■ ■.■E■■■■■.■■.■M■.uM■■■■.■■■■N■■■■■M■■■■■■■E■■M■■■■■■■■■NEM■.■■■■ ■■._.■■...■...■e■e■.■■■■■.e■■■.■�■■■■.■■■■■■■■■E■■■■■■EON■■■■■■■ ■■■ ■■■E■■■NNE.NNNN■■■■■■■■■■■■■■■■■■■NM■■NNN■NN■N■■NE■■■■■■NE■■■■ ................................................................. ■■■■.■■■.M■■■.■■■■MME■M■M■■■■■ME■■■■■■■■MME■■■■■■■■■■■■E■■■■N■■■■■ ■■■e■■■■....■■■■■....■.■■.......■.■■.■..■■.■■..e■■■■.■■■.■.e■■■■ ■■ ■■■■■■■■■■EEE■■■■■■■■■■■■■■■■■■■■■■MM■■■EE■■■■■■■MN■■■■■■■■■■MN■■■ ■■■E■■■■■■■■N■■■■NN■■■■■■■N■■■■■ ■■■■■■■N■■N■■■■■■■NEEM■■NEN■■■■■ ■■■■■■e■■■■■E■■■EE■■■EE■■E■■■E■■�E■■MN■■■MEN■N■■N■■■M■■■E■E■■E■N■