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111 Idlewild Rd Lot 12 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990003354 Tax PIN/EH#: 5862-34-9883.12 Billed To: H&V Construction Subdivision Info: Idlewild Lot#12 Reference Name: Location/Address: Gordon Drive-27006 Mqp ATC Number: 4208 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:� �iC�f Date: CERTIFICAT OF COMPLETION **NOTE** The issuance of this Certificate of Completion sh 1 indi to t system described on Improvement/Operation Permit has been installed in compliance with Article 11 o G.S. japt 130A,Section.1900"Sewage Treatment and Disposal Systems,"but shall in NO WAY be tak as a gu ant that the system will function satisfactorily for any given period of time. Ilb q� 95� to Septic System Installed By: G Environmental Health Specialist's Signature: / Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street _ s Mocksville,NC 27028 o l (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003354 Tax PIN/EH#: 5862-34-9883.12 Billed To: H&V Construction Subdivision Info: Idlewild Lot#12 Reference Name: Location/Address: Gordon Drive-27006 Proposed Facility Residence Property Size: see map **N(ff&OYMPT&pro4veme nt/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 I 1 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 -2 #Baths J%2 Garbage Disposa Washing Machine: Basement w/Plumbing: Basement/No Plumbingy Dishwasher: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply Design Wastewater Flow(GPD) Site: NewZl Repair❑ System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width Kock Depth./2 �Linear Ft.,?J2�> Other: As stated In 15A NCAC 18A.1969(5) aeveePted Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFF E T FILTER. RISER(S)IF 6"BELOW FINISHED GRADE. ""NOTICE: Contact a representative of the Davie 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 s Illation. Telephone#is(336)751-8760.**** to Environmental Health Specialist's Signature: Date: !` A- DCHD 05/99(Revised) mar 06 01 101478 awl•sounar onvllNltn 376 7131 6766 P.m I; AMOJ•M W*C0 imutnxse 1 1.0,sic ils(s:tl A*w street rOtlDt1116,K 21Mi IUi)1JL•i1i0 • TKIDIl17'SOM e7 PeDYD7CD. ltntat to tib bll�YifiOlt I041ilLf kr+,infbl�13iEl54.� �.:..�.. t, w to i.t»st.n �1 V LOuSTRuG(coli Co. tw.c1 aTT. f 6 +t6d' . hAr ' aartudha�i�t•.u.Selu�t .11�,a?t03 eut..�T1e.1 3b•7A ��?5 1.am a T.slTtm u nuts„►tw. ' iouJoluantt_��(r ayh„� S •. ��': .,l.: �. 1. nlpueuieaArc� aiiGirQweim QLmuTeaatthlaitJdPC :.�;�•tl� ....�, .• I. >rm of*Rim eLft a matt,tew a aenluu a uutrt .a e 1. hlo g7te ae+t1G1�i[Qwstlle��,,iq a=wdtrt:.eittl.t a tdo..itn t'i i t. 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SIItRerlslCl�rio Dace: • a�ctntaaour;D,te � too- leeoeuYs� � T 0'd £I£TTZ19££ . + + A9H WU 9C:10 60-1•t-d>iS a fa • DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990003354 Tax PIN/EH#: 5862-34-9883.12 Billed To: H&V Construction Subdivision Info: Idlewild Lot# 12 Reference Name: Location/Address: Gordon Drive-27006 Proposed Facility: Residence Property Size: see map Date Evaluated. 2 1 Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH Texture group Consistence Structure Mineralogy ' HORIZON II DEPTH o Texture groupc , 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: Y EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: REMARKS: LEGEND 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 \HD 05/99(Revised) r — e - 1 f 4,aj i z q�. 6 F 9 2 0 `- n M ri „ fJ' cy.f N p y Q* F a p ti , cF N � lu u) 1 N (�1 .A 0 N A q Q J_ r4 o M H r 1 0 V #1 3 3 �' N A u1 O AV Q V v i M 1A J d 24 1 23 1 i ! J I 22 i J BT 1411 72 I I J 19 1 . '8 2U90 4 G. FEST 24g.3E n 83.3 1 w et 4.66 , PG. 793VJ1 .g9 I _ v 238`99 Exrs ryNo - - - LOT 8 N$ - - iTE _ 0.738 ACRES s� LOT 7 R RAI' FEST 0.738 ACRES LOT 6 R 204, PC. 799 "r s 0.735 ACRES �o �! LOT 5 1.222 ACRES TYo LOT 9 204, PG.AfARXLIN 0.723 ACRES 796 LOT 4 1.172 ACRES � LIE n WEST LOT 10 �a gyp, W 185, P(,, 801 0.738 ACRES LOT 11 J�'� ,F ► 330.y7 0.741 ACRES u_ LOT 3 v J INg 0.738 ACRES ^ z 7 S 84.44' 321.41 " S 86'OB'�• E 6493 _ LOT 12I < s: ^ I LES'TER IV. HILTUIV D.B. a 0.693 ACRES S I � , I J� LOT'2 62, PG. 450 32c-.94 a 0.694 44CRES ZONED R-20 LOT 13 f a 0.930 ACRES �i a o LOT 1 30753 SQ. FT Id _ �w�;;^�� ' °• EXCLUDING R/W al `� 0:926 ACRES NEGAINE ACESS EASEMENT 1� 3061.5 SQ. FT 324.9 — — '- — __I " 1 EXCLUDING R/W yr� _... —.. — _!ffCAt'NE ACES$ EASEMENT L E%SLANG DAME �.. `�."" ......�� ""_ $ 85'29'00• .