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Howell Rd Lot 9 APPLICATION FOR SITE EVAWATION/IMPROVEMENT PERMIT&ATC I Davie County Health Department � NOV 1 7 1999 i' ? Envimmental HaM Sef►on1.'� 4' P.O. box 049/210 Hospital Btreet Vbakaville, 110 27028 1I�VlfplE Cl]l PITY LTH 1336)751-11760 *"necbtum" ma "nic 1011 cmum BB ==Irm Unwas TILL Til! R>cQU2RED =1010=10H 19 nOKID11D. ReAar to the, ItOr4lMOZON SULI+IGTIH !or inntruations. i. ttaaa to b. Billed er-Y � 1�. Jc contact parson C.6,rr i S 6 ro ce- k;eMN•y c� WLIUq *ddra.s 3. ✓oV1,?acA �nsone (tone 376— 466-44,41 AVC, `7o7 cies/state/aza T411A-.z s ... _3 a 6- 6 w?R- 8'$l 0 a. was* oa hrs iwsxa is Di=fs.nt umuksbot.�� G'� e�y t"'' MailitigGhddreis '�e 6 6 /b�.� 4 c� p A d v {'� _7., _ e7:/state/ai a. Imrt�.Q�r, ft Xate. B+raivation O improvement Permit/= O Both +. Rates to services ROU24 KQbile Home © Business O industry O Other a. It Residence: i people E Bedrooms 70/ 3 1 Bathrooms a Dishttasher O Oasbag. Disposal a washing waohio. O sassment/pludAng 0 asse■mt/No plumbing i. 29 twin ee/2ndustrslOthert sp.oifY type I "to # sb*o ! comtrod e i shorts 1 llriaals ! water cool-arm It 7=8Tt mcx t d Beats =stimated Rater Usage, Mous par ",I 7. Type of water supply: County/City C wle t] Community I. Do you anticipate additions or expansions of the hellity this system Is intended to serve? 0 Yes ACNO U yes,what type? 1***IMPORTANT***CLWTFS H=C1pMPL="E REQUIRED PROPERTY INFORMATION REQUESTED 11EI.,OW. Eliker a PLAT or SITE PLAN HUS2'BESVBJlff1 D by the client with THIS APP1.10mr!0N. t Property Dimenslons: .S�� _ '�'� •W=x.Z:;1R=nCNSy(nom blockville)to PROPERTY: r.•rt�e� S-91-w- WGI/ �� ��� � U�✓ lr"�'lRs►✓ 1��..K i G � /'ter^ Property Addresit Rad Name cttyrzip��''�"'' C&"'`4 � f..�.<<..1 w a� Uin a Subdivision provide information,as follows lf7J w� Name: �e.-We-f Section: Blocks Lott Date Property Fbaedt TMb Is to certify that the information provided Is correct to the but of my inowledge. I understand that any permit(s) Issued bemfter are subject to suspension or revocation,If the site plans or Intended no change,or If the Information submitted in this applies"is hbilled or changed 1,also,understand that I an rMan lbie for all charges lncsrred jhorn til:apppcedon. 1,hereby,SW*consent to the Authorized Representative of the Davie County Health Deps en to enter upon above described property bested In Davie County and owned by T_Z Zk to conduct all testing procedures as necessary to determine the site saltablilly. DAYR Al �"� ��� SIGNATURE /n�z THIS AREA MAY BE USED FOR DRAWING YOUR STM PLAN(Include all of the followings Lfzbdng and proposed property lines and dimensions, structures, setbacla, and septic locations). Site Revisit charge Please complete the highlighted area(s)and Date(�)t return. Client Notification Date: EHs: Account No. 4 Revised DCHD(07/99) Invoice No. 42 S HOWELL ROAD MERRY SR 1419 346 I � 1 R R Spill S 0111.50'5W W 57,68' Tis I 48 2- (A .2 u 7,128 sq.ft. 0.1636 acres m � � ri I N N O u CLAY HUNTER w N96E-241 �+ m ;e,4 °D I � g b 3-33' .01' S g4.p3,38„ E 26a.ss' (D512.02' N W r WILLA HICKS DB 81 PG 431 103.386 sq.ft. —` 2.3734 acres N 8ro3._• w N :- 290.58• 0 Une y / 768.78. of 24.42. O 3/4'. 106,927 sq,tL 2.4547 acres IS, 35'oar E �cnV 1 s 746 1 ��� e IL [� 250.00• I j e. l/ 9 _ a3 0 124,804 sq.ft. el �• y 2.6651 acres409 94A Ik 1.1363 acres 224.64• � �z N 8535'00" yy 451.84• •-( 678.47' 7 Rebar LOT 1 41 \�, Sp,ke LOT 2 LOT 3 M5 MtL CUM m 111E AS w \� COUNTRYSHIRE WAY '/ _ m L ►tuna vis sees DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990000872 Tax PIN/EH#: 5822-62-1818.09 Billed To: Grady Beck Subdivision Info: Mary Beck Estates Lot#9 Reference Name: Grady Beck, Executor Location/Address: Howell Road 27028 Proposed Facility: Residence Property Size: 2.86 Acres Date Evaluated: //-_2 Water Supply: On-Site Well �� Community Public Evaluation By: Auger Boring Pit , / Cut FACTORS 1 2 3 4 5 6 7 Landscape position �. Sloe% 2 HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence i Structure s 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: f 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 DCHD 05/99(Revised) �30'r14A,c e� 7.8 8 Ac 79 a �.6 o X45.01 f 2Ac N 645 00 2937. 66 ro �F `' � . Cb 47 r ry: 11.04Ac td 7.685Ac. ti 27.5.88 417.12LO ... Q� F 478 �' ti N y ,4Ac. F - k v . , e 14�. Y 0 rt L �45 4 .06 AO' Pn 417. 12308:22° . S.R• M 3.72Ac - m -725-34 376 ti 4 45.03 N 9 w 2 rn --. �. 0, ;� 88, 75 Ac. 9 a cv 3.72 Ac ..,. +.e t N , 392.96 y h844.�g 60 1038.848G.46 101.64 * , OD OD � M 4222° m (1.55) � ,� 4w - OD13.27 Ac . 2�6°`�-- a I sl,s h. (28.3Ac.) r 264 Q, m 5J0 6a '$ F 554.6 '` 00. OD ] c0 �k 53 3 V1 30.83 Ac 1 702.9 (6.2-Ac-) V-5.3. t A 3 • .. .... Of � I �53. Cl) X83Cli ' *� c>� C P' n� 5.47Ac 927.3 174.71 - 'b8.18 pp 528. 1532.7 1 503 6 '5 (I.2.3A z� Y � R k ITO (om x v N N Ah �<.�155 V) 04 ro.�1 "s 0Af. 5 610 NO. h� s"r 984 b ,. ., 0. Mc.) a� (25.57A0 � 660 ° k r� co 660 rn '- 1372,8 2 1607.1 x'22 2 A c. ti , r a 44 � CO % `r. 363 (50 Ac . ) I f 1-0 � (23.75 Ac. ) 3 DAME COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION P. 0. Box 848/210 Hospital Street Courier #09.40-06 Mocksville, NC 27028 Phone #: (336)751-8760 November 29, 1999 Mary B. Beck Estate C/O Grady Beck, Executor 4266 Hwy. 801 Mocksville,NC 27028 Re: Site Evaluations—9 Sites Howell Road&Eaton Church Road Tax Office PIN: #5822-62-1818 Dear Client(s): As requested, a representative from this office visited the aforementioned sites on November 24, 1999. Based upon the information provided on the Application(s)for Site Evaluation(s) and after evaluations were completed, sites 1-7&9 were found to be provisionally suitable for the installation of an on-site sewage system. Lot 8 was found to be unsuitable, unless combined with Lot 7 or Lot 9. Before an Improvement Permit/Authorization to Construct can be issued the appropriate application must be filled out and the house/mobile home location staked on each site. If you have any questions, please feel free to contact this office. Sincerely, X �t� �• Robert B. Hall,Jr., R.S. Environmental Health Specialist RH/mp Enclosure(s)