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155 Maple Valley Rd Lot 17 DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital.Street Mocksville,NC 27028 Pd' (336)751-8760 Fax#(336)751-8786 Z /0-1 OPERATION PERMIT jr /6,5i►.7��Vf�II Account #: 990002285 Tax PIN/EH#: 5789-97-0344.17 Billed To: Dick Anderson Construction Subdivision Info: Marchwoods Phase 4 Lot 17 Reference Name: Location/Address: Maple Valley Road'-27006 Proposed Facility: Residence_ Property Size: see map ATC Number: 4642 **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 any.gw* en period of time. /� System Type: S.T.Manufacturer Tank Date= Tank Size�G Pump Tank Size L r System Installed By: E.H. Specialist: � 10 i l , 124 f c s►•vdoa.,s 4G C k —� 9 C4 \ cam DCHD 11/06(Revised) Pd l r ' " DAVIE COUNTY ENVIRONMENTAL HEALTH �1z"4(o P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Fax#(336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990002285 Tax PIN/EH#: 5789-97-0344.17 Billed To: Dick Anderson Construction Subdivision Info: Marchwoods Phase 4 Lot# 17 Reference Name: Location/Address: Maple Valley Road'-27006 Proposed Facility: Residence. Property Size: see map ATC Number: 4642 Site Type: ❑New ❑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. Residential Specifications: #Bedrooms 3 #Bathrooms #People Basement❑ Basement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) Lot Size 0 .7 3 Gtel- S Type.of Water Supply: ❑County/City ❑Well ❑Community Well System Specifications: . Design Wastewater Flow(GPD) Tank Size IiOOOGAL.Pump Tank AL. TrenchWidth3'(f Max.Trench Depth ` Rock Depth /'�— Linear Ft. 41 Site Modifications/Conditions/Other: As stated in 15Ain 15A N�`1�(5) Contact the Davie County Environmental Health Section for final inspection of this system between 8:30—9:30a.m.on thedav of installation. Telephone#(336)751-8760. Nm Y a 'S N K 1 W s j.S Y Environmental Health Specialist i7i '/ Date: DCHD 11/06(Revised) 1" N GJ -tj Vi Zi/N �1I 1.4r1 nil lAar zi Vro ,7J0 .7170 fir- (Qter 1 .. ..w w�•'ww.www ...... MAP 3)30�0� APPUCAI'ION EOR SM EYAI DATION/131PROVEMDa PERLNIT&ATC Davie County Health Depatttngnt tea T17 EnWivnmental Health SeWon P.a. Box nae/230 Hospital Street }tcrlca.i334. NC 2703 ' 1336)751-8760 •••Idt➢Wt7iN7••• %=S APPLIQLTI027 CAMMT BE RR0CS33ED MUXSS ALL = RS =RRD INPOIOtMM IS Y110. D. Refer to the XNMMV SION IIt7 JZTXH for inetructiono. ✓1. Mae. to be 2111.a / �"f7�t//�'tY��fjlJ -�+�tlS?'1.t/G(�eant.et s.r.— /D/C/LdA) ✓sr.lale,,ear... f tlia6-AWVZW CA/ c,,r—.leo:.. 519 —7579 ✓cltr/at.to/za /YIA(;=stltdz- a(- .2702$ ✓eoataw.*moa qqS-7at.747 y S. 14wee on P.tak/Arc 1r oL•t•rent than Above Ma11t.q sddrus City/stat*/zip IJV 1/YJ` «—i. application Yor: yxJ Sito i'valuatioP n 0 Improvement armit(ASC Both /V _-i. ey■tae to Bat•t•e: Cd IIouae 0 Mobile Sono 17 Suminess Cl Industry 0 Other ,I�1I11 n1� mss. Type ey.ta..rcgV"tad. 0 Coowontlo.al 0 couveatioaal rodMod 0 ieawatlw 1 Y t C �!. If Xoosidencer !People ! Bedroca w _ r Bathrooms Z` -1 idD!•1woMr t,�a.r3.s•Dtopaa*1 aaliay%.aW* ❑Yaa•wt/Plubisg Oau•r•t/»o aLv�Lieg 1.1h/✓IrJ' 1. it ausld•se/Industry/other: v*rify typo t People i Sinko I c:m.od.e a x]owera a mrlaale s Mater Coolers It T00D3IDtYIC3; N Soat• votim-94e4 Natter VF@Sg tyai.lons P-;4.0 gra. Type or 1.et•r oupply, w-atcounty/city 0 91.11 13 Community a. Do you anticipate addstions or expansions of the facility this system is intended to serve?0 Yes 01fla ..r lfyts,srhatt ____ LNPonAN2—atmi MMC0 PLEM THE REQUIRED PROPERTY INFORMATION REQUESTED IIEE.2A, ElrhtraPLAT orStTCPL r�TBESUdMf7TEDby rheellent wtth THIS APPLICATION. Lf;OropertyDimensions: S ._887r /y2,LF_ 'WRITEDiRE TioNstiminmocksvttte)toPROCERTY: , .—Tax office PIN: s3 78 7 d 3 V V 158 M &JI g Tv P1�PeF�Gr --Properly addrtsr Road Nus* A l�yP�S'jCX 4 .L � 1 Cflym�p 40 VAL tJ C,6- C j7a,?K f In d Subdivtston rovide laformatl=,w follows: Name: �/LCF1"04 C- ;7 S6; 4 Section: Block Lot: &-late horse cornets flagged: F61C� 7614- This is to cerilfy that the Information provided Is correct to the best of my knowledge.I understand that any permits) . issued hereafter are subject to suspension or revotatfou,If the slic plans or intended use change,or if the information submitted In this appllcatlon is fotsif:nl or d,amcctL I,also,rrndrrsrand the!/orm r volsiblefar all eharpes incnrrrd from Opts application. I,hereby,give ransent to the Authorized Reprtscntativc of the Davie County Health Department to enter upon above described propert,•located in Davie County and owned by to conduct all testing procedarm as accessary to determine the site cul lj DATE .�'a. -O S -IrCtVATURE /-!e- THIS AREA MAY BE MD FOR IMAWMG YOUR SIZE PLAN(Include all of the railoving: Existing and proposed property Goes and dimensions,structures,setbacks, and septic locations). She Revtxit Cturgc Dalc(s). Client Notification Date• EHS: Sign given Account No. Revised Dl.7tD(115/03 Invoice No. Q� �� 479 . DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation A1'PI,ICAqf (kN PRggW85 Tax PIN/EH#: 517R1bPtj1 4 llWoRMATION Billed To: Dick Anderson Construction Subdivision Info: Marchwoods Ohase 4 Lot#20 t:r Reference Dame: Location/Address: Peoples Creek Rd.-27006 Proposed Facility: Residence Property Size: see map Date Evaluated: '�— �—07 Water Supply: On-Site Well I ! Community ' Public t� Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position LL G C, Slope HORIZON I DEPTH . Texture group Consistence rV Structure Mineralogy1; l� HORIZON II DEPTH Texture group 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 OZE ,7 SITE CLASSIFICATION: EVALUATION BY: Z", LONG-TERM ACCEPTANCE RATE: ` 7 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 Gli-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prisrpatic ineralogX 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) `r LTAR-Long-term acceptance rate-gal/day/ft2 ■■■■■■■■■r■■■■■��!r■■■r■■■■■■■■■�■■■■■■■■■ ■■■■e■■err■■■■■ ■■ ■■C ■■■■■■■■r■■■■■■�■■■■■■■■■■■err/■ ■■■R■■■/■■■■■■■/■■ ■■■■■M■ ■ ■/■■/■■r■■r■rrr■■■■ramramr■■■Ra■ae■■■ma■m■■mr■M■■■a■■C■■r■■ ■ ■■■am■■■r■■■■■.■r■v��■�a��rte■■/■■._=====7■MM■r■■■■■■r■■ ■■■■■■■■■re■R■■■ ■■■■■■ea■■■■■�1■■■■■■■■m■Emlr■M■■M■■M■:O■■E■ ENRON CC:::C:::: MMMMM:C:iiMMMMMM:EC�'r:CC' .................Ir■■M■■M■■M■■■�t■■■■Coe■■■■■■►�...........■■C: ■E ■■■■■■■■a■■■■■r■■yrs■m■■■■em■e■�i�•••■■■■re■Men■■■■■■■■■M■■M■■ ■ Isom a:MOMMEMMENIVEMMENE ONO E ■■■■■■■■■■M■■O■e■■■■r■eM■irl/IE■MI■■r■■■■■■■,�3■■I■mer■■■■■■■■■EE ■ ■rae■Ra■■■ma■m■■■rr■■ee■■►■rimr��._-•■r�e■■�r■ir■■i■E■r■■r■■■■■ ■ ■■■■r■e■Rae■am■■m■ire■■■■■�r■■ra.:�ti��-�z■r■■■■■■■ir■■■■■■■■■■■■ a ■ ■ ■■■■■r■■ae■■em■■m■u■■ee■■r�■■■r�u,■rr►�r■■■■■■■■■■►r■■■r■r■■r■■rr�■ ■r� ■■■■■■■■■■■rrr■■m■ir■■R■■■rt■■■■�a■■a■aaea■■■a■i�■■■■■■■■r■■■ :s::CE:::s:::E::::ii:CisCr■.�'C:CECCC:CCC:C::CiiCC�C::::::MEN CME Ea ■rrrr■ ■rr/r■■r■■rr■■-::�a►rrcr■►.��-a� R■arm■a■R■me�m■Rm■ ■RR■ :E ■ ■■rrr/C■rrrrr■■r■rR.rr■r■►r■_•�rcr�r�iir/rr■ra■rr■r�>t/rr■r:rr■■ ■■ ■Rr/rr■rrrire■rrrrrrrrrrrri■rrr■■r/rr/rr■rr■Rirr�rr■ri■r■rr■■ ■■■R■■rrrrr/■■rr.'�'�!/■/r/!�■r!��..'_^====�====CCi:..:.i/r■ ■■ ■■ MEMNONMONO ■■■R■ ■■■■■■■■r■■i■■r■rr■rr/■■■■■■■■■■■■■■:■■■■■■■■a■■■■ ■/r■ ■rr■ir■rrrrrr/■■■rirrrrrr/rrmrrr/re■a■a■er■et■■ ■e■■r■ :::C:::r■aror■e■Rma■■ram■e■■■■■..................■aeC■■ECCCEaa ■■NMMMMM■. ..........eE■■■■■■■■■a■ee■■■mR■■a■maee■■MC■■Cr ■ ■■■■■■■■R■R■■RRm■■■■a■■■■reer■er■■■rrMM■EO■■Mrr■E■Mr■Ma C�aE CCC■■■ ■R■R■■ ■■■■■■ ■M■■■■ ' ■■ ONE ■■■■■■ Romano .......■■.................................. ...MEMO ■■r■R■■RR■e■■■aMe■■■■■■■Mr■M■■rr■rr■rr■EM■■■eC■■■M■■C C .�'C:CCCCCCEEEECECC:CCECCCECC�EEEECEEEECEECECCCEEECCEC■ rr rr■■■■EME■r■■rr■rMEE■■■r■■rE■■■■Mr■rE■■r■E■Er■■rr■■raa ■ on ■■EM■■M■■O■■r■■■r■eME■Mee■e■mE■ ■aRee■■■■r■M■rrr■oM■ ■ ■ ■■■C■■■■■■■■■ME■■■Entre■r■■ME■M■�E■Cr■■■■M■■Ma■M■err■ErMCC CC ■■ ■■■■ ■■C■■■■■■■■Me■■■■■■ee■■■r■■■e■■■■■rrma■mR■eeaeRR■■eR■ a■aa: M■■M■loon ■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■ mC ■■rersaa■■■■■aeea■■■e■R■rR■■■■/ cn .■■■■■a■■RR■■am■■■■arR■■R■■rC■m■a■■■■■■■■■■:emaaME now ■■■■■■ram■■■■ea■a■■■e■■■■■■M■e■M■■r■E■■rM■ M■■■Er■■ ■ CC ■CC'■aCC:C::CC:C'ECEC:CEECC: CCCEC::ECECC:C'::CC■C'CMC a ■■■■■ ■■■ ■■olio ■■■E�■rM■■■■■e■■s■Mr■:■e■e■■:■■r■■eE■MM■e■■M■■■MM■■■■C■e■■MM■r■■■M■e■e■■rC■■■e■ ■: ■ ■■■ ■ ■■■■■■■ ■ ■Mson MM■MMMMMME■■MRM■:M■MOMMMM■M■■MONOMER WEENNIMM ■■■ea �CCC■CC a'■C■ : MM ■M■ ■ e■■ ■r ■■■■MMMMMM■ ■■■■ MMM Now■■EMM■M■M■■■rr■ NEW ■■■eN■1111 MMMMMM■MM■■■o■■"Mo■o■o■OOEEEMEM■MMEMN■�E0 ■MMEM■E■a■ ■ ■■e■■E■M■■mr■m ■■■■■■■■■■ ■ ■■M■■■■ ■MMMMMMM■MMrmomNNW'�rCEECECCE:ECECMMMMHMCCCECENOMERE:CEEC'MM : ■ ■■■r■■.■■■m....■■NE■ENN■■■ON■■rMMENMEN■M■MMM■M ■MMMMEM■ ■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■ ■ E .../.rr/rr/rr/rr/rrr.../........................... ■. .�'. ■■■■■■M■■rrrr■■■■■ ■■ ■a■rri/■rr/ir/ir■rr/rrrr■./................■.■C►.....r�. ■ ...R.......■..■......■..... ■ ■ ■ ■ mum MMEMEMMEMMEM NNW ioCCie:CCCiiE:EEEECE:CC:Ea:C' e■■rCRr:■a■a■ae■■ C■ ■■ rr//■orr■r�ee■■■■R■■■■■e■■MEN C:CENe■■■r■a■ee■■■■■Cr■CC■R■ 0 Dick Anderson 336 999 7279 p. 1 J73 , I I�q�F AtiFA ZZI I Zo3 f `$6