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127 Southern Magnolia Dr Lot 2 r _ DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Fax#(336)751-8786 OPERATION PERMIT Account #: 989900241 Tax PIN/EH#: 5880-40-9914.02 Billed To: Craig Carter Builders, Inc. Subdivision Info: Magnolia Acres Lot#2 Reference Name: Location/Address: S.Magnolia Ave.-27006 Proposed Facility: Residence Property Size: 231x178x2.19x ATC Number: 4719 **NOTE**The issuance 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 y given period of time. System Type: S.T.Manufacturer jp Tank Date c Tank Size Pump Tank Size ZI System Installed By:Tc o-vK6E.H.Specialist: LCI 0 Date: y�d a v � _ q X04 RI o /.'c- DCHD 11/06(RT?1s ee"'4& r a � DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Fax#(336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 989900241 Tax PIN/EH#: 5880-40-9914.02 Billed To: Craig Carter Builders, Inc. Subdivision Info: Magnolia Acres Lot#2 Reference Name: Location/Address: S.Magnolia Ave.-27006 Proposed Facility: Residence Property Size: 23lx178x219x ATC Number: 4719 // Site Type: C ew ❑Repair ❑Expansion **NOTE**This 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 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. U Residential Specifications: #Bedrooms 7 #Bathrooms-3 #People Basement❑ Basement plumbing❑ Non=Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) Lot Size . �( ire. Type of Water Supply: ❑County/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow(GPD) 1490 Tank SizeI-TcXX'AL.Pump Tank flffi- GAL. Trench Width _ Max.Trench Depth Rock D6pth_IIL Linear Ft.! o Q Site Modifications/Conditions/Other: As stated in 15A NC AC 18A.1969(5) a5-1 k ectc LJ`4 d 14 seeepted Systems-may-atso- Contact the Davie County Environmental Health Section for final inspection of this system between 8:30-9:30a.m.on the day of inst 1 ion. Telephone#(336)751-8760. v�f 4. U.) �' d 3 aI cr k3 Envir6n.mental healthpecia ist Date: 1—f?_0 DCHD 11/06(Revised) :: APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O.Box 848/210 Hospital Street lS Mocksville,NC 27028 Q _ (336)751-8760/Fax(336)751-8786 A c onSWLAA Aatio m vement Permit ❑ Authorization To Construct(ATC) th T o pplication: ❑New Syste epair to Existing System ❑Expansion/Modification of Existing System ility * *IMPOR PI'S A ON CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED OVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed Contact Person �1.✓ r�. Billing Address . e Home Phone 4 City/State/ZIP Business Phone Name on Permit/ATC if Different than Abovei"� Mailing Address City/State/Zip PROPERTY INFORMATION *Date House/Facility,Corners F gged NOTE: A survey plat or site plan must accompany this application. Include a Plan lat(to scale) (Permit is valid for 60 months with site plan,no expiration with complete plat.) Owner's Name Phone Number Owner's Address City/State/Zip Property Address 7 t, n o , r City ��« Lot Size Tax PIN# 2- Subdivision Subdivision Name(if applicable) ;r a G!" Section`/Lot# Directions To Site: �1/ r�n r S CJ�"C C •F If the answer to any of the following questions is"yes",supporting documentatio ust be attached. Are there any existing wastewater systems on the site? ❑Yes o Does the site contain jurisdictional wetlands? ❑Y s o Are there any easements or right-of-ways on the site? ❑Yes o Is the site subject to approval by another public agency?. ❑Yes .0 Will wastewater other than domestic sewage be generated? ❑Yes o IF RESIDENC FILL OUT THE BOX BE #People = #Bedrooms #BathCooms Garden Tub/Whirlpo Yes ❑No Basement: Dyes _ Basement Plumbing: ❑Yes o IF NON-RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building #People #Sinks #Commodes #Showers #Urinals Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: #Seats Type system requested;Xnventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type. County/City Water ❑New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑No If yes,what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I under and that any permit(s)or ATC(s)is reafter a subject to suspension or revocation if the site is altered,the intended use�reslntative hanes,or if the informatio ub s ap . ion' fal ' ied or changed I hereby grant right of entry to the Authorized R of the Davie o alt ep nt t n ct necessary inspections to determine compliance with applicable laws and rules. I understa r pon ' for a ro r identification and labeling of property lines and comers and locating and flagging or staki a e/ ility atio ,p p d well location and the location of any other amenities. Site Revisit Charge P ope s or er' a e esentative signature Date(s): Client Notification Date: ate / ,1 EHS: IUU . Sign given ❑Yes ❑No Account# Lql ' Revised 11/06 Invoice# DAVIE COUNTY HEALTH DEPARTMENT -� Environmental Health Section SECTION_LOT Soil/Site Evaluation APPLICANT'S NAME v�� r�� DATE EVALUATED PROPOSED FACILITY '/r_ PROPERTY SIZE SUBDIVISION ROAD NAME—7&4 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 groupS, Consistence Structure Mineralogy HORIZON II DEPTH r•' yds`" Texture groupG 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: (/ ) EVALUATION BY: LONG-TERM ACCEPTANCE RATE: ' OTHER(S)PRESENT: REMARKS: SfL'� rI2 v<✓ /�lt� eY L GEND 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(01-90) . � % �c �,I�.. (� 1 aQ.�t.o �.o Vc...� _ ` - . .i —� N 02°57'00"E 219.14' i i � 1 I � I i � i - - - � 30' NATURAL BUFFER I _' _---------$� ---- o�- -----__________ � ' I � , � � � � � � � � i N _ _ 15.00� � �'--- g ( ^ 70.96' �'----__ N ' 94.�1 � ^41.67' �1Q.33. ------------- ----- � g ---- i � -- �� 2 N �osEn g � N HousE � I � � Z I $ �E 3s.00• � � 95.55_ _____ __` N � '-------------- ---------�-'----1 _ � 73.4p� - ' " - - - - - _ _ 13.00' 10.00• 1 � �', � g i I / � " � i I / i � ' �• I I � �w ;� �� ► � _ �� I I — — — — — _ _ � � ____--1__ � I i � -' -- - L � 75•�►��,��,�-� ---------__ 1 �� ; - - i� � ,?'�� S 0 °09'21 "� 8 SOUTHERN MAGNOLIA DRIVE --- ____ .... � I � � � � P.B. 8 PG. 63 I .�_��_ �-� � � � � CREEFMEW DRNE � x �� '_--- __.,.� c '�'� �-�. �.�� 5TAR MAC.NOUA DRNE � � 3TUUP MAGNOUA DR I SITE �'� �� IPEOPLES CREEK RD LOCATION MAP I � I 0 23 � , �, Q ��N�t � ir�u�„�� % ---� I .�``�� '��... �.�' Ci �� % O :�Q?�oFESS�� `�y"',: C� ` =•�e SEa! y� Y - 'Q I ; �- � L-2:�:30 r-' _ � .:�c'y'y,�'• .�r`� � � . ". � � :;. " �''��`� � ��i�:��`�� , SITE PLAN ONLY I THIS WAS MAPPED FROM A DEED OR RECORD PLAT AND NOT FROM A SURVEY I BY ME. 2 2 �f'�-�.��,a..1 ' I � � 30 0 30 60 90 I � GRAPHIC SCALE — FEET MOR CRAIG CARTER BUILDER INC. SCALE OWNSHIP COUNTY STATE DATE,a 1" = 30' SHADY GROVE DAVIE N. C. 6-18-07 LOT 2 MAGNOUA ACRES PHASE 1 P.B. 8 PG. 63 HOWARD SURYEYING JOB N0. JOHN RICHARD HOWARD PLS 07052 P.O. BOX 276 ADVANCE, N.C. (336) 998-5396 i .. —� N 02°57'00"E 219.14' i � I � 1 I I I i � _ _ _ _ �i, r — — _ _ _ 30' NATURAL BUFFER I �i _'------------- i � �� i � � � � � � � � f � � N o15.00' I � 0 ^ - - � 16.33• � �.i.10' - - - - 4.67' w 31.83' n ,^� ----------------- �22_94� � � 3 ^5.t7',� -------------� �-- �"' $ I � o N PROPOSm o ///'�� N HOUSE � � I w 2 M I � �o g 35.00' 'u> NGARAGE i` n �------------------�23.58' � __ m 20.87• ,r � --------------1----' 13.00' � � I ' 45.54' - ' - - 10.00' t � � ; I I � , � , I I � , � ,� I 1 a �� 'm I 1 � - —_______�� _ ; I 1 i — — — — _ _ _ � � / � � 15' DRAINAGE � l!T}�,Ry �� - - - - - - - - I � � � � _ 'o� , S 0 'Q9'21 "W 230.68' SOUTHERN MAGNOLIA DRIVE x �� _ � � I � � � � P.B. 8 PG. 63 � I ,, /��`r �,-t� Pl��n --7 , ,�—G7 �v � co � � CREEIMEW DRNE � s �o� � -- .__ o ' '�� --� STAR MAGNOUA DRNE � Z TULJP MAGNOUA DR I SITE �� w p� � z� 0 �� IPEOPLES CREEK RD LOCATION MAP I � I 0 2 3 .,,,�,, ,,,,,,,,, I . ��:��,. � i ��//i Q /i .� . ( �i J � , ` ' �i .' � �� O I � � � 't. � z `.' ` '. _ c.J cc <� � _ �` . _ \ -�` �Q I :�',� ,� �r �o� :? �" �,�i` ` �� I '',' rinrii�iUN��"d Q —_— __ � � — SITE PLAN ONLY � THIS WAS MAPPED FROM A DEED OR RECORD PLAT AND NOT FROM A SURVEY I BY M E. 2 2 , y' � ".' �� ,i s'� „�4.�a. ,�� `�`r. - � m""` , � a�,�".�/ , I � 30 0 30 6Q 90 I ' GRAPHIC SCALE — FEEf FOR CRAIG CARTER BUILDER INC. SCALE TOWNSHIP COUMY STATE DATE,s 1"= 30' SHADY GROVE DAVIE N. C. 6-18-07 LOT 2 MAGNOLIA ACRES PHASE 1 P.B. 8 PG. 63 HOWARD SURVEYING JOB N0. JOHN RICHARD HOWARD PLS 07052 P. O. B O X 2 7 6 A D V A N C E, N. C. ( 3 3 6) 9 9 8- 5 3 9 6 0