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182 Tara Ct Lot 7 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section r ~W P.O.Boz 848/210 Hospital Street r Mocksville,NC 27028 (336)7.51-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001651 Tax PIN/EH#: 5726-57-3924 Billed To: Phil Martin Subdivision Info: Meadowood Lot#7 Reference Name: Location/Address: Tara Court-27028 Proposed Facility: Residence Property Size: see map N s jr: 2762 **N ** is mprovement/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 11 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 ///l/ #People T #Bedrooms #Baths 2 Dishwasher:7< Garbage Disposal: ❑ Washing Machine-All' achine; Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type n #People #People/Shift #Seats Industrial 13al Waste: Lot Size�� Type Water Supply C a Design Wastewater Flow(GPD) c�d Site: Newel Repair❑ System Specifications: Tank Size&�_GAL. Pump Tank GAL. Trench Width c-��"'Rock Depth JJ Linear Ft ADD/ Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County 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 of installation. Telephone#is(336)751-8760.**** h AaS t Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street MockrAlle,NC 27028 (336)751-8760 Account M 990001651 Tax PIN/EH#: 5726-57-3924 Billed To: Phil Martin Subdivision Info: Meadowood Lot#7 Reference Name: Location/Address: Tara Court-27028 Proposed Facility: Residence Property Size: see map ATC Number: 2762 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: s Date: -Z� Ux CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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 he system will function satisfactorily for any given period of time. � q . Septic System Installed By: Environmental Health Specialist's Signature Date: ' DCHD 05/99(Revised) APPUCATION FOR SITE EVAWATION/IMPROVEMFM PERMIT&ATC p Davie County Health Department Env3ron1nenta/Me ift SeWon �p P.O. Boa 848/210 Hospital Street 2 3 Mocksville, NC 27028 (336)751-8760 ENVIR01V41E1VTA(HEALTH DAVIE COU ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed / {/�!/ ,` '+fir/ " 1 Contact Person P417// ZIQY \,-) Mailing Address I ! a"A. �'" �1 Home Phone ��{� 22./� city/state/ZIP Si}o !!e /`y.(., a-i oBusiness Phone 2. Name on Permit/ATC if Different than Above Hailing Address city/state/Zip 3. Application For: ❑ Site Evaluation !'Improvement Permit/ATC ❑ Both a. system to service: ❑ House sobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People _ # Bedrooms _3 # Bathrooms Wtishxasher n Garbage Disposal L1.Kashi.v Machine U Basement/Plumbing ❑ Basement/No Plumbing 6. if Business/Zndustry/Other: specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of Mater supply: QIdounty/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑Yes 94fr__ If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT ,�orrSITE PLAN MUST/BE SUBMITTED by the client 'With THIS APPLICATION. 8� Property Dimensions:OyI W, ack__J WRITE DIRECTIONS(from Mocksvilie)to PROPERTY: Tax Office PIN: # 1A (0 9 7 2li' cu d� o Gc�Ct1$ro� Property Address: Road Name �t .s r Q, C 4 City/Zip CICSO1 2 0,28 If in a Subdivision provide information,as follows: Name: I w 1 e, '- 4 61J6o l Section: Block: Lot: Date Property Flagged: This Is to certify that the Information provided is correct to the best of my knowledge. I understand that any permit(s) Issued hereafter are subject to suspension or revocation,If the site plans or intended use change,or if the information submitted in this application is falsified or changed. 1,also,understand that I am responsible for all charges incurred from this application. I,hereby,give consent to the Authorized Representative of the Davi2/7iyy��ty�e 1t Dr"1ep,�rtment to enter upon above described property located in Davie County and owned by `1'1 to conduct all testing procedures as necessary to determine the site suite II DATE SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. Revised DCHD(07/99) Invoice No. 42.1 5 z, r.. t r a .. lV )�7 .,•.S'y y.. �<. t.,:t e ? ..•r'�y«y,"i..s. ,,�1�•t y�.. 1-�s.ri •..�1 �F rt •��„ ';t�:: •. '•fir Y 4 _it i5;,rflG"' '! Y' _�:. i _�:'�''• +.� :�r .>.cM.� i•• .1FJ`"' �,rx,. .. t. ._. I iI 1 JOANNE -D.* 7VELSON' MYRON S. NELSON r D.B. 133, PC. 227 > I t;?•FXISTING _ - NO SC&E T. IP.ON W s 87.27 I6• E VICINITY MAP `t 332.29 O ——D Z n m' O IRON EXISTWG —————— t.VAilN c-r 6 1. ,\ 0. � I cu 0 Q IU V)vi \ AREA= 0.834 AC. , iv f3 l\ —-- — c '- .09 T 69 b ^ �x,c•Ie[ 3p. '�� 352• �, �\` QO I .. tp p_,hh0g6 -Rp\fxlSTl"G I, GRADY L. TUTTEROW, CERTIFY THAT UNDER MY DIRECTION AND SUPERVISION, THIS MAP a - S WAS DRAWN FROM AN ACTUAL FIELD SURVEY 0 CD o ��"-, ;4�N•fklr MADE BY T TTE V SU EYING COMPANY. i. cv _ 20'?AVEC FE z TARA COURT ( PROSS NALAND SURVEYOR L-2527 'c • ——— — _-' —————————� TUTTEROW SURVEYING COMPANY 124 SOUTH SALISBURY ST. ( MOCKSVILLE, N.C. 27028 (336) 751-5616 ( PLAT OF SURVEY FORT -E SE1 HACKS RHOBER P. MARTIN I -- FROI,'= 40' S,DES= t,' REvtsiwutCALE, 1' = 50' wraovm 1n G.L.TUTTERDW ��' S do J R ak- <C' FEB-28-2001 mom,FiUeMEADOW7 BEING LOT #7 OF THE MEADOW SUBDIVISION , 550 25 0 50 100 150 (PL.BK. 7•.PG. 136) LYING IN THE MOCKSVILLE TOWNSHIP DAVIE COUNTY, NORTH CAROLINA f SCALE IN FEET TAX MAP REF.: L-3 n�WtNc 6101-2 NJ1 .., . uunsION t011 811E LVAUTAIION/IMPROVEMENT PERMIT&A J R T N -q T � —" Davie County Health Department D Environmentallfea/th SecHon �r. P.O. Box 848/210 Hospital Street JUN — 4 1999 Mockaville, NC 27028 (336)751-8760 ENVIRONMENTAL HEALTH DAVIE COUNTY ***nVORTANT*** THIS APPLICATION CANMW BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. Name to be milled ! r tib` \c7• ��a/1� Contact Person nailing Address l I,A t. oh. ci=`�-. n=e Phone City/state/zip _16ac a ,, W, %'-L'� Business Phone t. name on Pe=lt/ATC it Different than Above Mailing Address City/state/Lip L. , Application For: ff Site Evaluation 0 Iuprovement Permit/ATC ❑ Both a. system to service: I"House oY T"Mobile Home 0 Business 0 Industry ❑ Other S. If Residence: 'I People / Bedrooms 3 9 Bathrooms i lf'Dfishwasher wa'bage Disposal ?!'washing machine U Basement/Plumbing 0 Basement/No Plumbing S. if Business/industry/other: Specify type f People I sinks t Commodes / Showers # Urinals Nater Coolers IF FOODSERVICE: ii Seats Estimated Nater Usage (gallons per day) 7. Type of water supply: WICE-ounty/City 0 Nell 0 Community s. Do you anticipate additions or expansions of the facility this system Is intended to serve? (IYea "-0-- 11 yes,what type' ***1HMRTANT***CLIENTS MUST CVAIPLEIET)IE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eltber a PLAT or SITE PLAN AIt1ST BESUBAIITTED by the client with THIS APPLICATION. Property Dimensions: a 0�v-g-- `- WRITE DIRECTIONS(from Mocksvllle)to PROPERTY: Tai Office PIN: 6 4'Z'X.,L- -I 910/ `1 43 4 •off Te T 6 FT J"rJ T Property Address: Road Name X,,. . ti 040. 1 .. C�nr„�. Yl�. fie. tri City/Zip es V%k.A)t`.xlpa 1pe Fw". If in a Subdivision provide information,as follows: Name: ►� - t-t`tSye r d U'.✓woa C/ lL-ThSection: Block: Lot: _ 0 7 Date Property Flagged: S t` }'^°`P ' s:rr`.k"AL- This is is to certify that the information provided is correct to the best of my knowledge. 1 understand that any permit(s) Issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in ibis application is falsified or changed. I,also,understand that Ion reVensiblefor all charges Mcurred frons this appUcadon. 1,hereby,give consent to the Authorized Representative of the Davie fqunty Healib Department to enter upon above described property located in Davie County and owned by v•� � � ..r �� to conduct all testing procedures as necessary to determine the site suitability. �., leo �� w � "— DATE SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Includ all of the following: Existing and proposed property tines and dimensions, structures, setbacks, and septic locations). Account No. Ga Revised DCHD(07198) Invoice No. 7�3 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil!/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900606 Tax PIN/EH#: 7922-7843-7679.04 Billed To: Mel Jones Subdivision Info: Junction Acres Lot#A? Reference Name: Mel Jones Location/Address: Junction Road-27028 Proposed Facility: Residence Property Size: 1 Acre Date Evaluated: Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH % Texture groupG Consistence Structure /L -57< 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: ,�T! 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 Mineraloay 1:1,2:1,Mixed Notes Horizon depth-In inches Depth of 611-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 DCHb (Revised 05/99) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■/■■■■■■■■■■■■■■■■■■■ NOON■ ■■■■■■■■■■■■■■/■■■■■/■/■■■■■■NOON/■■■■■■■■■■■■■■■■■■■■■■■■�■ NOON■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■/NOON NONE ■■■■■NN■■EE/NENN■■■■N■■■■■■■■■■■�■■■■■■■/■■■■■■■■■■■■■■■■■■■ NONE ■■■■■■■■■■■/■■■■■■■■O■■■■■■■■■■■■■■■■■■■■■■■■■■■E■■O■■E■■■N■■ NONE ■■■■■■■■■Ott■E■■■■■■O■■■■■■■■O■NOON■/NOON■N■■■■■N■■■■■■O■■■■O■ ■■■ ■■■■■■■■■■■■■■■E■■■E■■■■■//■■■■■/NOON■■N■NN■■■■O■■■ENNN■NN■NE■ ■■■ ■NNNNNE■NE■NNNN■NEN■■■■■■■■■■■■■■■■■/■/■■■■■■■■■/■■/■■■■■■■■/■/�■■ ■■■■■■■■■■■■■■■/■■■■■■■■■■/■■■■■■■■■■■E■N■■O■■■NEVE■■■NN■■■■■N■■E■ ■NOON■■O■■■■■■■■■■■E■■NNNEN■■NN■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■H■ ■■NNN■■■NNN■■■■■■■E■■■■NNN■■■■NNN■ENE■■■■■■NNNNN■■E■■■NE■■E■■■■N/■ ■■■■■/■■■■■O■E■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■NON■■■■■■■■O■■■ ■■NNE■■■■■■O■■NN■NEE■■■■■■■■■E■■O■■■■■■■■■■■■■■■■■■■■■■■E■■■■■■■■■ ■■■■NN■■■■ENO■■■■ENNN■■■■■O■■N■■■■■■■■■■■■■■■■■■■/■■■■■■■■■■■■■■/■ ■■■■■/■■■■■NEE■■■■■■■■■■■■■■■■■■■■■■■■■■N■■■■■e■■■■■■■■■■■■■■■■N■■ ■EN■NNE■NEN/■E■■■■/■■■■■■/■■■■■■I�i■■■■■N■■E■■■■N■N■E■■■■■■■/■■■■■■ NOONNNE■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■E■■■/■■■■■■■■■■■■■■/■■■■■ ■■■■■■■■■■E■■E■■EN■■ENE■■■■■■■■■ ■■N■ENEENNENNNE■■■NE/■■/■■■■■■■■ ■■■NNN■■ENN■■E■■NN■■NNN■■NNNNNN■E■■■N■NN■N■■ENE■E■■■■■■■■■■/■/NOON ■■■■■■■■■■■■E■/■■■■E■E■■■■■■O■■■■■■NOON/E■■■E■■■■ON■■■■N■■N■■■■■■■ /EN■■■■ENEE/■N■■EE■■N■N■NE■NEN/■■■■■■E/■E■NE■■■E■NE■N/■■■■N■E■E■■■ ■■■N■■E■■■E■■N■E■■N■E■ENNEENNEN■ ■■EE■EN■NNN■■O■NNE■N■■■N■■■NEE■■ ■/■NNNNNNENNNN■■N■■■NNE■■■E■■/■■■■■■■E/■N■EN■E■E■E■■O/E■■■■■■■E■■■ ■■■■■■■■■■■■E■■■■■■■■■E■■■O■■O■■■■■■i�/l`111►LII■■■EN■■/■N/■■■■NN■■■■■■■ MENNENMOMMMEMOKEEM ' iii AMEN MENNENMENNENMEN ME ■■■■■■■E■■■■■�1■■■■■■■■■■■■r�■ria■■■■■/■■■■■■■■■■■■E■■■N■■■■■■■E■■ ■■■■E■■E■■■■■ ■■■■■■■■■■■■r�■■..rig■■■■■■EN■EN■■E■■■/■■■■■■/■■■/■■■■■ ■■E■■NONENEO■■O■■■■N■■■■■■r/■■■■■■■NOON■N■■■■■■■■■■■■■■■■■O■■■■■■■ ■■■■E■■■■■■■■/■N/■ON■N■■■■■■■■■■ ■NOON■N■■■■■■■■■■■■■■■■■■■■■■■■■ ■�■■■■NOON■■■E■■■■■E■NO■■N■■N■■■■■■E■■■NON■■■■■N■■■■■ENE■■■■■■■N■ ■ ■■■■■■■■■■IiE/■rGii�i/iiiiiiii�.=.7/=C==:�CC�CC�C�C/��:�■■■/■■■■■■■■ ■■■■■■■■■■O■■11■■■NOE■NEN■■■■■■NNNNE■■�■O■■■■NNEN■■■■NIIN■■NN■■NNNE■ ■■■■E■■NNN■■MINE■■NN■NNN■N■■■NN■ ■■/■■■■■■■■■■■■■■■■11■■■■■■■■■■■■ ■■■■■�/■■■■■■/1■■■■■■■O■/■■■■■/■NOON■■■O■■■■■EE■E■N■■N11■E■■■E■■NEE■ ■■■O■■ENN■■■■IINE■■■■■■■■■■N■■■E■■E■■NOON■E■■EO■■E■■■■11■■■■■/■■N■■■ ■■■■■■O■■N■■■11■■■■■■■■■■E■■■■■■■■■■■■■■■■■E■■■■■E■■■OIIE■E/NEE■■■E■ ■■■N■■■■■/■■■��/■■■/■/■■■■■/■■■■■■■■■■■■//■■/■■■■■■ONIIEE■■■N■NEVE■ ■■■■■■■■O■■■■■■■ANO■■■E■■■■NNN■■■■■■■ENE■NN■NNNNNNE■N11■NENNNENENE■ ■■NNNNN■■N/NN■■E■■■Era/■■■E■■E■■■■N■■■EEE■NE■E■NE■■■E■1�■NEN■NN■ENN■ ■NOON■■N■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■/■/■■ ■■■■■/■■■/■■■■■■■■O■E■■N■N■■■NNE■■■■■■NNNN■N■N■N■NN■NNN■NNNNN■■NN■