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Howell Rd Lot 8 c F._. r APPUCAl1oti Fun ant wALmpoN/impnow I im PEAMR&An Davie County Health Department � vrJ NOV 17 1999 i 4 Envim menta/HMO Section 8.0. Box 8418/210.11ospital 8tr•et Moakaville, HC 27029 LJJVb-UAVIE COl NTY (556)751-8760 ***XPARZMM** TRIS ANIMICR21011 C71tMT IN PM=SMD UNLZ88 71LL TIIE PXQUIRED 2Nx014MION i8 nOVIDRD.DRotor to the IN1nO1:MION BULLZ21H for Lustruatiions. 1. flame to be allied .d►''V !J. Contact "aeonC_.WY'i S 61 YO law. Mailing aces... eavv 1.7e 7eZd some shone 46 IVa X75J citsr/aaa/szsZG . Fav�l�ci�n swinea. whom 3 6-- a. wama on asci an Is 01220t 4L6 'a"rACitylot..t./sip a. losnt!•aot. or. *�� 1LtE. gra:toation 0 twprovemut Perait/ATC 0 Both 4. system, to sarvioat Boos• fXltobile Home © Business 0 Industry 0 Other 7 a. It eeeidenost / people + Bedrooms 700" 3 s Batbrooms 0 Oiehwash" O Gasbag. niepoeal O Washing Naohins 0 Daaemeat/Olu Ang 0 sasementhto Vlvmbing io It sua"Wes/InewtsY/others tpealty typo 0 **Oils a Sime i commodes I shomme 1 Orinale a wates coolasa IT 8'OOD813MC11s # Seats Rstimated Nater Osage iganone per day) 7. Type of water supply: County/City C Nell 0 Commuaity a. Do you anticipate addition or expansions of the 4cWty this system Is Intended to serve? 0 Ya )q-No If yes,what type? ***IMPORTANT***CUE?M KWrCDIIInMTHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE AN MUST BESUBJfir=by the ellent wilk T1,19�►oPs•!C!TiON PL . , Property Dlmensloust .S�,- /0/ * � (nem Mocla wdle)to PROPERTY: Tax OHics PINI M M : d Ard-11-1 s � 4 ! Property Addreat Road Name 90d 5,4 e U w K CityylZipZ".,✓ C,,4 If In a Subdivision provide Information,u followst flZl w�U J Names �`'••+��� �'�D' G /y Sections Bloch Lott O Date Property Thaids This Is to certify that the Inknution provided Is correct to the but of my knowledge. 1 understand that any permit(:) Issued bereatter are subject to suspension or revocation,if the site plans or Intended we change,or If the information submitted in this application Is folBiQed or changed 1,also,understand that I ass nsponssibie for ail ckarges lncamd fio n chis appUcadoa. 16 hereby,gWo consent to the Aathosized Representative of the lis a County Reallb paytmen to enter upon above described property located In Davie County and owned by, .>�-y a to conduct*0 testing procedures as accessary to determine the site suitability. DA-1-9 Al r'� �1r�9 SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(include all of the followings xistins and proposed property Hoes and dimensions, structures, setbacln, and septic locations Site Revisit Charge Please complete the highlighted area(s)and Dah(s)s return. Client NotiUcadou Dates EHSs Account No. Revised DCHD(07M) invoice No. HOWELL ROAD YBERRY SR 1419 346 1 — — R R Spill S 01.50'5w w 57.60• T1s 4' 48. 2- L; 7,128 sq.ft. IR R 0.1636 acre m ri I � � N t a 3 u y CLAY HUNTER a N 96E-241 �+ ofto I 0. nb M 3.33' .01'• 1 264.55' S a4*o3-, 805.90,E � 512.02, g � 1 WILLIAM HICKS $ O DB 81 PG 431 103,386 sq.ft. FF 2.3734 acres N 8p��,, w N :- Y90.a8• 0 n 1101w urw 8 / 769.76. -_ of O 3/4- 106,927 sq.ft. 1� 2.4547 acres S aV35'Od' E �n $ 745.32, Fi a 35'OOr e � 2so.oO' 1t. _ o 10 3 124.804 eq,ft. �! 49,499 94 2.8661 acres 'a 1.1363 acrts N 224.64• O ; N 451.84• z g� 85'3S'Opl' yy 676.47' / 7 Rebar r LOT 1 Spike\ LOT 2 LOT 3 TM WL CER9FY 7W JK AS w � COUNTRYSHIRE WAY '/ Kir± t roses. as 2W Pu.. r - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990000872 Tax PIN/EH#: 5822-62-1818.08 Billed To: Grady Beck Subdivision Info: Mary Beck Estates Lot#8 Reference Name: Grady Beck, Executor Location/Address: Howell Road-27028 Proposed Facility: Residence Property Size: 2.45 Acres Date Evaluated: Water Supply: On-Site Well I/ Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position S' Slope% 1p HORIZON I DEPTH Texture group Consistence Structure Mineralogy 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 f SITE CLASSIFICATION: `/� EVALUATION BY: LONG-TERM ACCEPTANCE RATE: v OTHER(S)PRESENT: REMARKS: i e'� ry 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 DCHD 05/99(Revised)