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2245 Milling RdI AW . a HEALTH. DEPARTMENT RELEASE ems' Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Ben Bradford Address: 2722 B Emmanul Road City: Greensboro State2ip: NC 27407 Phone #: (336) 623-8856 For Office Use Only 'CDP File Number 190788-1 County ID Number: valuated For: EXISTING PERMIT VAUD 0 a / 1 1/ a 0 a 0 I IAITtI Property Owner: Ray and Stephanie Address: 2245 Milling Rd City: Mocksville State0p: NC Phone #: 27028 I--- Property Location & Site Information Address2245 Milling Rd Subdivision: Phase: Lot Road # Mocksville NG 27028 *Structure: SINGLE FAMILY # of Bedrooms: *Water Supply: N/A Basement: n Yes o No 'Proposed Improvement: Pool # of People: Township: Directions Hwy 158, right on Milling Rd Type of Business: Total sq. Footage: No. Of Employees: The pool must not be closer than 15 feet from the existing septic system. This release in no way expresses or implies that the existing subsurface sewage treatment and disposal system serving the site will continue to function for any period of time. Applicant/Legal Reps. Signature Required? Oyes ONo Applicant/Legal Reps. Signature,• 'Date: 'Issued By: 2140 -Nations, Robert *Date of Issue: 0 2/ 1 1/ a 0 1 5 Authorized State Agent: r **Site Plan/Drawing attached.** Id Hand Drawing Olmport Drawing Davie County Health Department 4 1836 Environmental Health Section e y P.O. Box 848 °0 C"' 210 Hospital Street Courier # : 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680 (Check One) Replacement Remodeling Reconnection Name: X"") xt-'a/ Phone Number "3 3G (,,P- ?Y5&_(Home) Mailing Address:7� // (Work) l w✓2)4" i(/G a� y-1 Email Address: 6l�•d c�MA,,OQ00S401­ Detailed Directions To Site: Mp,n �'� TI ,n. -o Property Address: 1 (N %2 1 Please Fill In The Following Information About The EXISTING Facility: g�aq �l Name System Installed Under: ' `' 6 o t �� r �` (t �� Type Of Facility: Date System Installed (Month/Date/Year): �� U`� Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes No If Yes, For How Long? Any Known Problems? Yes No If Yes, Explain: Please Fill In The Followin�formation About The NEW Facility: Type Of Facility: (7 Number Of Bedrooms: Number of People For Environmental Health Office Use Only Approved Disapproved Comments: Environmental Health Specialist Date: *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Check Money Order # Amount:$ ! Date: -� Paid By: Received By:_ Account #: 0 Invoice #: 727' SCALET'= 90' Appraisal Card Page 1 of 1 1/29/2015 6:32:35 AM :HANDLER DANNY R Rehr'/Appeal Notes: Peroel: F9-000-00-036 10 UNDERPASS RD PLAT: / UNIQ ID 9939 4816000 D376 -P25 ID NO: 5880458105 COUNTY TAX (100), FIRE TAX (100) CARD N0. 1 of 1 evel Veer: 2013 Taz Year: 2015 1.00 AC OFF UNDERPASS RD 1.000 AC 50.C- Owner ra lsed M1 19 on 11/03/2008 0]003 PEOPLES CREEK RD TW -0] Cl- FR -01 EX- AT- LAST ACTION 20110112 CONSTRUCTION DETAIL N.A.- VALUE DEPRECIATION CORRELATION OF VALUE ounEaUon-3 n In5.0c USE OD EM Area < UA BASE AAT' RCN EYe StaneerE 0.2500 AYBREDENCE TO MARKET uO FIOor System -1 01 01 2 028 118 82.60 169]63 1988 1988 %GOOD 5.0 EPR. BUILDING VALUE -CARD 12] 32 o00 8.0 z^enor Walls -16 Me[Ic Stone 33.0 EPR.OB/XF VALUE - CARD TYPE: Slnqle Family Res16en0al Single Famlly ReslOantlal MARKET LAND VALUE- CARD 14,85 oormq StmOure-03 ahla STYLE: 2 - 3.5 stones OTAL MARKET VALUE -CARD 142,1] ooB'q Cover - 03 tenorwen Co'structlo' • 5 't"'­11 wall/Sheetrock 26.0 OTAI APPRAISED VALUE - CARD 142,17 DIAL APPRAISED VALUE - PARCEL 142,17 'tenor Wall Co..—io'-6 'stom Interior 0.0 OTAI PRESENT USE VALUE - PARCEL OTAI VALUE DEFERRED • PARCEL DIAL TAXABLE VALUE - PARCEL 142,17 + - - - 28 'tenor Floor Cover - 12 manor Floor Cover -14 ea0nq Fuel - 04 IeRnc IDC I U B M I PRIOR 2 2 UILDING VALUE 134,43 0 O BXF VALUE I I AND VALUE 1{,85 +4 RESENT USE VALUE I I EFERRED VALUE I I OTAL VALUE 149 28 ea0nq Typa- SO ea[ Pum /.0 Ir —did om'q Type - 03 4 111+ edrooms/Bathrooms/Half- athmome 2 Z 4 4 1 1 I I +- 10 ---+ PERM edroome AS-IPUS -2LL- 0 athrooms AS -IPUS -ILL-O -Bathrooms L - US -OL -0 +10 - + #---28---•+12•+ +10+ +30+ I B A S IFO P I IF U S B OUT: wTRSHD: 2 2 2 1 +--20-+ SALES DATA Nice OTAL POINT VALUE ]15.00 BUILDING 3 Size 0.980 'uali 0 0 0 6 B FF. 3 V .000 M1a Deai n < FACTORO 1.050 I I I +10+ ECOR. ATE DEED NDICATE SALE + +12 -♦ OOK AGE R TYPE PRICE I I 0 33 38] 9B WD OTAL ADJUSTMENT FACTOR 1.03 OTA- QUALITY INDEX 11 I 1 2 2 4 4 11 I I + - - - 3 0 - - - - + HEATED AREA 1,640 8FOP8 +---30----+ NOTES WNER ROM LILLIAN MATTHEWS AT.1.OFT/1-OBXF.NV OLD SE IN BACK OF PROPERTY SUBAREA UNZT ORIG Mo SIZE. ANN DEP % OB/XFDEPR GS. OD UA ESCRIPTION OUN TH NTT PRICE GOND L... FAtt Y EV RATE V CON. VALU TYPEOTAL OB XF VALUE AS 128 ]0 10572 OP 38 US 1 3640942676 5M 1 4 REPLACE 3- 1 Story 2,2S Sin le UBARE^ OTALS 3,90 169,]6 UILDING DIMENSIONS FOP=WI2BAS-W38S20W1S34 FOP.SBE30NBW30T E30N24W1N205520EI2N20SPTR=N20 UBM-24-20W-20W3524— S20E15FUS-FION4EID5 ElOS8W2OS8WION16$W155. AND INFORMATION THER D3USTMENTS IGHESTNO ND BEST USE LOCAL FRON DEPTH/ LND NOTES COND RF AC': LC TO OAD LAND UNIT TOTAL 'LAND. UNT TOTAL ADJUSTED LA ND OVERRIDE LAND SE CODE 20NING TACE EPTH SIZE MOD FAR OT PE PRICE UNITS TYP ADJST UNIT PRICE VALUE '.VALUE NOTES URAL AC 0120 0 D 1 2-5000 1 4 0.6000 1q -15100-O5 10 PO 9,900.0 1.00 1.50 34,650.0 1485 0 OTAL MARKET UND DATA JACO].0 14 850 OTAL PRESENT USE DATA Owner: CHANDLER DANNY R http://66.226.39.229//ITSNet/AppraisalCard.aspx?parcel=F900000036 1/29/2015 • DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax #(336)751-8786 OPERATION PERMIT Account #: 990002125 Billed To: Mac Byrum Reference Name: Proposed Facility: Residence ATC Number: 4746 Tax PIN/EH #: 5769-07-9606 Subdivision Info: Location/Address: 2245 Milling Road -27028 Property Size: 23 Acres **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 an given period of time. I ( -) —OW System Type. S.T. Manufacturer i(�(�t Tank Date f Tank Size / Pump Tank S� —� G o System Installed By: ���' .H. Specialist: tl ��G Date: 0— • DAVIE COUNTY ENVIRONMENTAL HEALTH • P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 1 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account M 990002125 Billed To: Mac Byrum Reference Name: Proposed Facility: Residence ATC Number: 4746 Tax PIN/EH #: 5769-07-9606 Subdivision Info: Location/Address: 2215 Milling Road -27028 Property Size: 23 Acres Site Type: CYNew ❑Repair ❑Expansion P d' `C�li 1/c1 **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 chance. Residential Specifications: # Bedrooms # Bathrooms, # People 5 Basement❑ Basement plumbing(] Non=Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size �3 �C Type of Water Supply: 2eounty/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow (GPD)+10 Tank Size iAL. Pump Tank ��AL. M;n - Trench Width 34 N%r, Trench Depth 0 Rock Depth 17` Linear Ft.T Site r'cb 1 itinnc/ntberr i�, Stated in-15A_NC�,C 18A.1.960oocoo€' 5T-evri the Davie County Environmental Health Section for final i 8:30 — 9:30a.m. on the day of installation. Tele honf '33•x3 - O 30 �S L^ p�as guK 1Wr 5- G^f -AS -'01 Environmental Health Specialist DCHD 11/06 (Revised) ln'p- IA4d ,BILA redXCif0e- 's ection of this system between c o"how # (3361751-8760. _ ,e V-' d'L,t Ll 6T 7' j G ate: r �1z1/6� aw \�V' API TION FOR SITE EVALUATION/IMPROVEMENT PERMITAh Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 �l Sitefivaluation/Improvement Permit ❑ Authorization To Construct(ATC) ❑fpplication: RNew System ❑Repair to Existing System ❑Expansion/Modification of Existing S ***IMPORTANT*** THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed w C 844,4j,-- - ContacPerson tM- 64(W (-- Billing Address I 1 Tvil RO&W G i Home Phone City/State/ZIP 0 G S V 1 k, A/C 7,7o -2,X Basiness Phone Name on Permit/ATC if Different than Above Mailing Address PROPERTY INFORMATION *Date House/Facility Comers FJst'gged ZJZ 710 7 NOTE: A survey plat or site plan must accompany this application. Included: 56ite Plan lat(to scale)�— (Permit is valid for 6Q in As with site plan, no expiration with Owner's Name M4 (, A `1u — complete plat.) Phone Nmber ?36-013 Owner's Address ( /fin/ Gi Qty/State/ZiphleCVSVit((-,n/ Property Address 221„x, .ttSA/G 1Z1 CivM_oC-KSJsu(F Lot Size 23 0 L -Ex PIN# 5 L� &O& Subdivision Name(if applicable) Sectmn/Lot# Directions To Site: F'&RDA-& %4 3S goGA P -&O OtV Mzc t.=MG rLp JyS i i>AS.7- 00t,3:K Z.Q. If the answer to any of the following questions is "yes", supporting documentatiopp must be attached. Are there any existing wastewater systems on the site? ❑Yes f;?No Does the site contain jurisdictional wetlands? . ❑Yes ❑ o Are there any easements or right-of-ways on the site? ''. '- .- ©Yes INo Is the site subject to approval by another public agency? ❑Yeso Will wastewater other than domestic sewage be generated? []Yes�o IF RESIDENCE FILL OUT THE BOX BELOW # People 3 # Bedrooms t -f # Bathrooms Garden Tub/Whirlpool es ❑No Basement: ❑Yes GNo Basement Plumbing: ❑Yes ❑No 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: I166nventional ❑Accepted ❑Innovative ❑Altemative ❑Other Water Supply Type: Rf 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 Q 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 understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and comers and locating and flaggin or staking the house/facility location, proposed well location and the location of any other amenities. -M Site Revisit Charge Property o per's or er's legal representative signature Date(s): %I Zy IO'7 Client Notification Date: Date EHS: Sign given ❑Yes ❑No Account# e2i/02/ Revised 11/06 Invoice # GoMAPS - Davie County NC Public Access ***WARNING: THIS IS NOT A SURVEY!*** • This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the information contained on this map. The County and mapping company assume no legal responsibility for the information contained on this map. Wednesday, July 25 2007 WATER D4gND Q COUNTY�SOUNDARY STREETS RALLROAkCENTERLINE (� PARCELS t -1 CITY-UMMS BERMUDA RUN COOLEEMEE DAVIE COUNTY MOCKSVILLE Wednesday, July 25 2007 C-'ir)MAP(; - n;;x/ip Cniinh/ NIC Piihlir Arriocc Cz-07r., .&.I\ ***WARNING: THIS IS NOT A SURVEY! *** This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the information contained on this map. The County and mapping company assume no legal responsibility for the information contained on this map. Wednesday, July 25 2007 WATER_84WND F-1 COUNTY -BOUNDARY ADDRESS E)RrVES STREETS RAILROAD -CENTERLINE PARCELS AERIAL- PHOTOGRA PHY-2 004 CITY-LIMMS BERMUDA RUN COOLEEMEE DAVIE COUNTY 41OCKSVILLE Wednesday, July 25 2007 Map Frame uavie Louniy, 14L - .40 O a9 �F �0 0 jib/ mapping bysrem Click Here To Start Over Active Layer. P Use Map Tps PARCELS (Map Tips Available) Page 1 of 1 Quick Search:{County ID c GIs Map Layers I Results i http://maps.co.davie.nc.us/GoMaps/map/mapframe.cfin?CFID=4129&CFTOKEN=616408... 7/27/2007 GoMaps GIS Page I of 6 http://maps.co.davie.nc.us/GoMaps/map/map.cf n?CFID=4129&CFTOKEN=61640881 7/27/2007 APPLICANT INFORMATION Account #: 990002125 Billed To: Mac Byrum Reference Name: Proposed Facility: Residence Water Supply: • On -Site Well DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5769-07-9606 Subdivision Info: Location/Address: 2215 Milling Road -27028 Property Size: 23 Acres Date Evaluated: S— <K — 0-7 Community Evaluation By: Auger Boring Pit Public Cut V FACTORS 1 2 3 4 5 6 7 Landscape position L'L rt. a� :/ Slope % : 2 Zt. 2 HORIZON I DEPTH D -- O 0^ -- i 0' 6 r t Texture group$ SL L :5,1— L. `- Consistence Consistence Structure Za•. t C H.. C��-�- -.-, Mineralogy HORIZON H DEPTH '}_p - 11 1 Texture group C L L C_ Consistence If rf;r y - Structure ,,J ju sAk Mineralogy I HORIZON III DEPTH �- Texture groupL Consistence Structure Mineralogy(• HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS — yg' Y ` — RESTRICTIVE HORIZON '), 1 q--777 / SAPROLITE 4 - L( CLASSIFICATION U Lk 400 w LONG-TERM ACCEPTANCE RATE Ij 1 0 - SITE CLASSIFICATION: l /ice 1 cx �J LONG-TERM ACCEPTANCE RATE: (4 - REMARKS: EVALUATION BY:�© OTHERS) PRESENT: u LEGEND J,andscape 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 Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm Y&t 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 NDIM Horizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) ,..�� tF Soil wetness - Inches from land surface to free water or inches from land surf eL ;;, otl C10'rs With chroma 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 D(14D 05/05 (Revigerl) DAME COUNTY HEALTH DEPARTMENT Environmental Health Section �, P.O. Box 848/210 Hospital Street Courier 409-40-06 Mocksville. NC 27028 Phonek (336) 751-8760 Fax#: (336) 751-8786 August 17, 2007 Mac Byrum 129 Fox Horn Court Mocksville, NC 27028 Re: Site Evaluation Tax PIN: 5769-07-9606 Dear Byrum: As requested, Robert M. Nations, RS; Environmental Health Specialist with this office on August 8, 2007, evaluated the above -referenced property at the site designated on the plat/site plan that accompanied your improvement permit application. The evaluation was done in accordance with the laws and rules governing wastewater systems in North Carolina General Statute 130A-333 and related statutes and Title 15A, Subchapter 18A, of the North Carolina Administrative Code, Rule .1900 and related rules. Based on the criteria set out in 15A, Subchapter 18A, of the North Carolina Administrative Code, Rules .1940 through .1948, the evaluation indicated that the site is UNSUITABLE for a ground absorption sewage system. Therefore, your request for an improvement permit is DENIED. A copy of the site evaluation is enclosed. The site is unsuitable based on the following: Rule .1940 Topography and Landscape Position Rule .1941 Soil Characteristics Rule .1942 Soil Wetness Rule .1943 Soil Depth These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, in surface waters, directly into ground water or inside your structure. The site evaluation included consideration of possible site modifications, and modified, innovative or alternative systems. However, this office has determined that none of the above options will overcome the severe conditions on this site. A possible option might be a system designed to dispose of sewage to another area of suitable soil or off-site to additional property. For the reasons set out above, the property is currently classified UNSUITABLE, and an improvement permit shall not be issued for this site in accordance with Rule .1948(c). However, the site classified as UNSUITABLE may be reclassified as PROVIONALLY SUITABLE if written documentation is provided that meets the requirements of Rule .1948(d). A copy of this rule is enclosed. You may hire a consultant to assist you if you wish to try to develop a plan under which your site could be reclassified as PROVISIONALLY SUITABLE. You have a right to an informal review of this decision. You may request an informal review by the environmental health supervisor with this office. You may also request an informal review by the N.C. Department of Environment. and Natural Resources regional soil specialist. A request for informal review must be made in writing to the Davie County Health Department, Environmental Health Section. You also have a right to a formal appeal of this decision. To pursue a formal appeal, you must file a petition for a contested case hearing with the Office of Administrative Hearings, 6714 Mail Center, Raleigh, N.C. 27699-6714. To get a copy of a petition form, you may write the Office of Administrative Hearings or call the office at (919) 733-0926 or from the OAH web site at www.ncoah.com/forms.shtml. The petition for a contested case hearing must be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150-B-23 and all other applicable provisions of Chapter 150B. N.C. General Statute 130A-335 (g) provides that your hearing would be held in the county where your property is located. Please note: If you wish to pursue a formal appeal, you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. The date of this letter is (DATE). Meeting the 30 day deadline is critical to your right to a formal appeal. Beginning a formal appeal within 30 days will not interfere with any informal review that you might request. Do not wait for the outcome of any informal review if you wish to file a formal appeal. If you file a petition for a contested case hearing with the Office of Administrative Hearings, you are required by law (N.C. General Statute 15013-23) to send a copy of your petition to the North Carolina Department of Environment and Natural Resources. Send the copy to: Office of General Counsel, N.C. Department of Environment and Natural Resources, 1601 Mail Service Center, Raleigh, N.C. 27699-1601. Do NOT send the copy of the petition to Davie County Health Department. Sending a copy of your petition to Davie County Health Department will NOT satisfy the legal requirements in N.C. General Statute 150B-23 that you send a copy to the Office of General Counsel, NCDENR. Please call or write this office if you have any questions or need any additional assistance, as follows: Telephone number: (336) 751-8760 Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 Sincerely Robert M. Nations, RS Environmental Health Specialist /df Enclosure(s): Soil -Site Report Rule .1948 Invoice LAWS AND RULES FOR SEWAGE TREATMENT AND DISPOSAL SYSTEMS 15A NCAC 18A.1900 Rule .1948 .1948 SITE CLASSIFICATION (a) Sites classified as SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules. A suitable classification generally indicates soil and site conditions favorable for the operation of a ground absorption sewage treatment and disposal system or have slight limitations that are readily overcome by proper design and installation. (b) Sites classified as PROVISIONALLY SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules but have moderate limitations. Sites classified Provisionally Suitable require some modifications and careful planning, design, and installation in order for a ground absorption sewage treatment and disposal system to function satisfactorily. (c) Sites classified UNSUITABLE have severe limitations for the installation and use of a properly functioning ground absorption sewage treatment and disposal system. An improvement permit shall not be issued for a site which is classified as UNSUITABLE. However, where a site is UNSUITABLE, it may be reclassified PROVISIONALLY SUITABLE if a special investigation indicates that a modified or alternative system can be installed in accordance with Rules .1956 or .1957 or this Section. (d) A site classified as UNSUITABLE may be used for a ground absorption sewage treatment and disposal system specifically identified in Rules .1955, .1956 or .1957 of this Section or a system approved under Rule .1969 if written documentation, including engineering, hydrogeologic, geologic or soil studies, indicates to the local health department that the proposed system can be expected to function satisfactorily. Such sites shall be reclassified as PROVISIONALLY SUITABLE if the local health department determines that the substantiating data indicate that: (1) a ground absorption system can be installed so that the effluent will be non-pathogenic, non-infectious, non-toxic, and non -hazardous; (2) the effluent will not contaminate groundwater or surface water; and (3) the effluent will not be exposed on the ground surface or be discharged to surface waters where it could come in contact with people, animals, or vectors. The State shall review the substantiating data if requested by the local health department. History Note: Authority G.S. 130A -335(e); Eff. July 1 1982 Amended Eff. April 1, 1993; January 1, 1990. .APPLICANNT INFORMATION Account #: 990004370 Billed To: Linda Foster Reference Name: Proposed Facility: Residence Water Supply: Evaluation By: K Environmental Health SectionLl,l Soil/Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5860-10-3866 Subdivision Info: Location/Address: Pamela Lane -27028 // // /, Property Size: 4.20 Date Evaluated: g— "`l ^ U 7 On -Site Well ✓ Community Auger Boring I<Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position ( i L_ r Slope % Texture Z SSaand LS - Loamy sand SL - Sandy loam L - Loam SI - Silt Z HORIZON I DEPTH— SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE 0 lr� �0) ��oY Moist VFR -Very friable FR -Friable FI -Firm VFI -Very firm EFI firm Texture group 4 -Extremely lE Consistence It - AJP 11 v ' �e r" J ( It Structure NP - Non plastic SP -Slightly plastic P - Plastic VP - Very plastic l I � Cwa�ih 2 Cf-- 'o, ., Mineralogy (. / /- " SBK - Subangular blocky PL - Platy PR - Prismatic HORIZON II DEPTH tt - t. Texture groupeoa.� Consistence Structure Mineralogy HORIZON III DEPTH 5k Gfl, Texture group Consistence Structure a( V.(r Mineralogy HORIZON IV DEPTH "t Texture group C/4•,1" C4 EQ Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON It �� t 42 SAPROLITE CLASSIFICATION 5J t� LONG-TERM ACCEPTANCE RATE __5 SITE CLASSIFICATION: `A L� i t��� �— EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: -P ee �l 10.et/i-e cV M o ,n f 4, t. 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 SSaand LS - Loamy sand SL - Sandy loam L - Loam SI - Silt O SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE 0 lr� �0) ��oY Moist VFR -Very friable FR -Friable FI -Firm VFI -Very firm EFI firm -Extremely lE AA �e NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky \ G V� NP - Non plastic SP -Slightly plastic P - Plastic VP - Very plastic ✓ 2 Struct SSingle grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Min solo v 1:1, 2:I, Mixed Nut€a 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) I TAR - I -_t- —rentanrr rate - —1hi MO .........��,�� ... .. GoMAPS - Davie County NC Public Access Page 1 of 1 Davie County, NC - GIS/Mapping System Click Here To Start Over Quick Search: (County ID c }+ -f`" ' fkctive Layer. r Use t+4ap Tps GIS �<-119U to E� F-1 01-' rPARCELS (Map Tips Available) - Map Layers I Results I a d+ 'k^ ♦ Dw w Y iI � i Ar 4 roc,. meq... a. Aj J. -47 Iti :..t°`�y . .. e � ' p�",�y�',.iT � • •'�` . �P'* +��`: � '-mow :a i r f ice: ,,..�y t r � ! �;�--x3" ,� .: A¢jyt� ,,gam y .�� z •,'Kt�",m, _ �, rte. " � , '�•� w''• «*f' ; i�'I. ;r •'�'� . `$ �a� r�. „ 4 �• kms. �i N a" �+ �- ` ���%�� + ' nN 2 Features Found Zoom In Buffer ':ie1,v PRC Reports Find Adjoiners Parcel [,.lumber PIN Number Account FJur1-1ber Lited Ow Zoom In Buffer Zoon In Buffer ',+i ea: F'F..0 Report ' iea; PF'.f- Report Find Adjoiners 6600000064 5769079606 Find Adj oiners 6600000064 5769079606 000027284000 FOSTER TF 000027284000 FOSTER TF ,1 1 _►1 I / ` �Gl (V\- C,�P http://maps.co.davie.nc.us/GoMaps/map/Index.cfin 9/4/2007 APPLICANT INFORMATION Account #: 990002125 Billed To: Mac Byrum Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation Property Size PROPERTY INFORMATION Tax PIN/EH #: 5769-ul-9 Subdivision Info: Location/Address: 2215 Milling Road -27028 23 Acres . Date Evaluated: 'a ^ 3 (-0_7 Water Supply: On -Site Well Community Public ` Y Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position l_ L L_ Slope % 3 - -3 - `� - HORIZON I DEPTH (j -z[ f G - e Texture groupR rc� 0- tf Consistence V Structure Mineralogy I A 6t -t j: HORIZON JI DEPTH f.7 Texture groupL L 5 �- Consistence P 1^/ Structure C'iawn(ti C"""Com.. Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE -1 1-70 -7-3 / CLASSIFICATION LONG-TERM ACCEPTANCE RATE t 6.3 v ' / c a -moi.." n SITE CLASSIFICATION: � (161-1. S LONG-TERM ACCEPTANCE RATE: Q5 REMARKS: LEGEND EVALUATION BY: k d b N Gt_ti d n S OTHER(S) PRESENT: M cP C r� P /lfJ �F cl k i,- 6ry ct A -t . 0 c4 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 RX� _ VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm M'eS 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 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 05/05 (Revicedl Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC '27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990002125 Billed To: Mac Byrum Address: 129 Fox Horn Court ,City: Mocksville Reference Name: Proposed Facility: Residence Tax PIN/EH M 5769-07-9606 Subdivision Info: Location/Address: 2215 Milling Road -27028 Property Size: 23 Acres **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: Lvew ❑Repair ❑Expansion Permit Valid for: 5l�Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms • # People 3 Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Design Flow(GPD): �C Type of Water Supply: Xounty/City ❑Well ❑Community Well As stated in 15A NCAC 18A.I.969(5� Site Modifications/Permit Conditions: _eccepted Systemey u Systems may also hse Site Plan System Type LTAR Initial A cc p Repair4'Q-t-- Environmental Health Specialist_ i.p.11-06 0 a he 1, Date Cj — q " 6-7 d 4-1 Environmental Health Specialist_ i.p.11-06 0 a he 1, Date Cj — q " 6-7 - - _ - —. -----___ __- -�-- - --------- _. �_- .. _ ___.__� a _____�.____ - - - ., _ -------- -------�,�,--T- - , _ � i _....�_..__.__._._........_.._._.._._._._.._._ -.__—� ._. ._._._.^. . i - — � ._,� o -- _._...,..._._..._..�.�.. I � � � � i z SITE � � � � � � � � �, %`';`;� %I`�,` � M/(��"�c I I � 'Qo,�'� I . 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