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233 Stony Brook Trail Lot 37 Permittees .,• r► c!' DAVIE COUNTY HEALTH DEPARTMENT ` Name:-, Environmental Health Section PROPERTY INFORMATION ' P.O. Box 848 Directions to property: r;, ;1 N 'IG j? eMu . c71� ' Iw= t P Pe rty� Mocksville,NC 27028. Subdivision Name: ► Phone#:336-751-8760t Section: �._` Lot: rw AUTHORIZATION FOR 01, WASTEWATER -fit : Tax Office PIN:# SYSTEM CONSTRUCTION - 'AUTHORIZATION NO: 2493 A Road Name " <:`I� `t'ziip �t,e�� **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article th"Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) y r-.***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �, r r IS VALID FOR A PERIOD OF FIVE YEARS. �ERVIRQfVMENTA0--- TH SPtdA ST DATE I§SUEb RESIDENTIAL SPECIFICATION:BUILDING TYPE t #BEDROOMS _`� #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE , #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZE!`"Z r I YE WATER SUPPLY ' `+ DESIGN WASTEWATER FLOW(GPD) 1�' NEW SITE " REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH „ LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: �' ' �`I-�- O� -*-7r`��ta 1l-�� A'1 IMPROVEMENT PERMIT LAYOUT' ~ PI`i' .. �tj y Xi 1.0 c l --- cat -7 V **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEP MENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE I�A'i 6F INSTALLATION.TELEPHONE#IS (336)751-8760. OPERATION PERMIT !�-hG�- SYSTEM INSTALLED BY: r � i Int p' ]7Jc Nuc) 1...� '..1�, C17 TO-,3 &P 9 AUTHORIZATION NO. OPERATION PERMI BY: DATE: �'/k **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT T STEM DESCRIBED AB E 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 GIVEN PERIOD OF TIME. ocnn ovoi cxevi:tet // L C�Q'.rl Z (b Sy Pe1�`'ttee's DAVIE COUNTY HEALTH DEPARTMENT y -`lam. `t'• Environmental Health Section PROPERTY INFORMATION- . P.O.Box 848 ieeon5'to ro ert C.1 til �{ ,�t�, .�. P P Y Mocksville,NC 27028 Subdivision Name: Phone#:336-751-8760 , ` - Section: Lot: !/ AUTHORIZATION FOR WASTEWATER • It ..'� -� r ;. .» Tax Office PIN:# SYSTEM CONSTRUCTION - - -AUTHORIZATION NO: 4 A Road Name Zip. ? - r` **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S.Cha 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS'AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. �'1 NVIRQIMENTAL�.HEALTH SPECIALIST) DATE+SSUED RESIDENTIAL SPECIFICATION:BUILDING TYPE, �r #BEDROOMS #BATHS " ` #OCCUPANTS - GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION:FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZE I TYPE WATER SUPPLY t I °�"" DESIGN WASTEWATER FLOW('GPD)':-(--Pt-(---Pt" NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH - ROCK DEPTH I LINEAR FT. OTHER 1 G-' ?l/ REQUIRED SITE MODIFICATIONS/CONDITIONS: �" �-* .JM•11'� i�l+�, i"1 4 IlL�-:fa,� 1�. i:� + "+{` IMPROVEMENT PERMIT LAYOUT t y 1� CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM 1 BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY-OF INSTALLATION.TELEPHONE#IS (336)751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: { CL 1."—t DI i t L IQ C)c) ' ,—) AUTHORIZATION NO. OPERATION PERM DATE: �7 0> **THE ISSUANCE OF THIS OPERATION,,PERMIT SHALL INDICATE TH T STEM DESCRIBED A E 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 GIVEN PERIOD OF TIME. DCHD 02/02(Revised) _ a 1C6 DAVIE COUNTY HEALTH DEPARTMENT /— Environmental Health Section P.O.Boa 848/210 Hospital Street MockrAlle,NC 27028 (336)751-8760 Account #: 990002516 Tax PIN/EH#: 5820-23-5398.37EM Billed To: Eric Myers Subdivision Info: North Brook Lot#373 s7 'jK Reference Name: Location/Address: Stoney Brook Trail-27028 ATC Number: 3756 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 WAST CO ION I VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur - Date: 23 �Y 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 a ion. `Sewage Treatment and Disposal Systems,"but shall in-NO WAbeTdmi-,tb a-guarantet that the ystem will ction satisfactorily for any given period of time. MACE -r Imo' �q ,ems Septic System Installed By: L L114jQ, N Environmental Health Specialist's Signature: ate: v K DCHD 05/99(Revised) r ,y i DAVIE COUNTY HEALTH DEPARTMENT •.; Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002516 Tax PIN/EH#: 5820-23-5398.37EM Billed To: Eric Myers Subdivision Info: North Brook Lot#37 Reference Name: Location/Address: Stoney Brook Trail-27028 Proposed Facility: Residence Property Size: see map ATC Number: 3756 **NOTE**This Improvement/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 permit1(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 ��J-% #People 3 #Bedrooms �J #Baths 3 Dishwasher: Gtl1 Garbage Disposal: ❑ Washing Machine: 66 Basement w/Plumbing: 13� Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size S4 Type Water Supply ` 9, Design Wastewater Flow(GPD) 3(Po Site: New M/ Repair❑ '- u System Specifications: Tank Size I�iAL. Pump Tank GAL. Trench Width 3,d?Rock Depth �ZLinear Ft. Other: 4 -Nsme)yr►n-� " Required Site Modifications/Conditions: 1"�-TALL D,J C-'j 10Je-_ KC�k � � , �kA6, Jl 002TS 1VIAC-2- IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS)IF 6 11 BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30aa m.to V0 in. or WO p.m.to 1:30 p.m.on the day of installation. Telepho #is(336)751-8760.**** M�'�• °6P' 3 BR u � ��o, �S k ./ X42" ' , o PaeP L-1 .16 o' ire N Environmental Health Speci list's I ignature: Date: 4 o DCHD 05/99(Revised) A . APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&AT D �. Davie County Health Department Q nn EnvironmelltalHealthSection �0 U ,`►Ov ��N: P.O. Box 848/210 Hospital Street �? / '9 Mocksville, NC 27028 /R UtiR��'�EC� (336)751-8760 Oiy ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQU INFORMATION IS PROVIDEED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed tf;c M,le,5 Contact Person �C1G t 1 1S(tA S l Mailing Address Q. C/Home Phone '�qnd'.J1,� H City/State/ZIP ;���� /V� `1702 ' c�siness,Phone 7L.I,-7331 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Site Evaluation ❑ Improvement erm�t/ATC L7 Both 4. System to service: k House ❑ Mobile Home 1-1 Other If Residence # People. 3 # Bedrooms 3 # Bathrooms 13 4(Dishwasher U. Garbage Disposal 4Washing Machine J)KBasement/Plumbing 1:1 Basement/No Plumbing ro e "- 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: #, Seats Estimated Water Usage (gallons per day) 7. Type of water supply: County/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes J�'No If yes,what type? ***IMPORTANT***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. { Property Dimensions: QPH X nt47X HH..Xi .?X t30 WRITE DIRECTIONS(from Mocksville)to PROPERTY:b _Tax Office PIN: # 6noy_+!s-3ge, 3 7 C— fl'\ &o w 4* Shah o a,a &o 11 ,1 p Property Address: Road Name �J nw Quek Tr411 5 m ile Noh r i•h City/Zip Ir1Wz; su Ale,, . W 17095 bT1 �a on 5 t�ne� �cco Tr-r..%1 If in a Subdivision provide information,as follows: 1n-� 3-7 3^ c,Wr\ f" a� Name: Nat-iti Sttok �to►�-T �i� "cn1,e_. 431'U'Lly Ib 'Ac.,"A Section: Block: Lot: 37 Date Property Flagged:T 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. I, also,understand that 1 ain responsible for all charges incurred from this application. 1,hereby,give consent to the Authorized Representative of the Davie County Hcalth Department to enter upon above described property located in Davie County and owned by inm X ktii�rw b4'4Kr4 q 9y!—A to conduct all testing procedures as necessary to determine the site Sul ability. eo A tAxl4r. 4.rdh-s• DATE ,�I-D 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 7C // .31 w � Client Notification Date: 5i g j EHS• Account No. Revised DCHD(07/99) Invoice No. lh FILLY G. MURPHY, et al D.B. 112 Pg. 335 DICKIE. D.B. 82 Pg. 532. D•B• 133 F ILL I D.13. 148: Pg. S 87-51'37' E —.-.. - 467.88 S 84.29.330 W W 299,93 N o . z � LOT 377 �0. IS S9. 59,33'`— O S9 L4 cz oJ N Q In co C2, 2LOT #36 (5.302 AC.) • v as Z fi coI 3 I J er LaJ ON W m W w S 8610'30' E .956TA� ' Q 4 — �o 00 uj I 0 �C 30.15 . .. N � W dl c l • • � m� > LOT . #4 2 ,LAJ F- l F= (5.425 AC.' Oh CL I ml _ ._.. ;' LOT ;#35 z ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990002516 Tax PIN/EH#: 5820-23-5398.37EM Billed To: Eric Myers Subdivision Info: North Brook Lot#37 Reference Name: Location/Address: Stoney Brook Trail- 7028 Proposed Facility: Residence Property Size: see map Date Evaluated: l 2� e�. 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% 22 / HORIZON I DEPTH . JD - 0-17-- -/ TexturegroupCL C(_ Consistence 0,!-7 r 5 _T, -� Structure C(Z L2 C2 -Mineralogy F HORIZON 11 DEPTH ©• J 2 -I -27, Texture group (� G Consistence 14 Structure : S S Mineralogy 1" 1 HORIZON III DEPTH 1 - 3Z Z Texturegroup- G G Consistence ;S Structure MineralogyI•`I HORIZON IV DEPTH t Texture groupa Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE .3 S SITE CLASSIFICATION: EVALUATION BY- LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: REMARKS: Z� IL P-, 1� df( tn(� 2(i�'t Q2,y SGL 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 EF1-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) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■ MEMMEMMEMMEMMMEMEMONMEMEmommomMENNEN MEMEME ■■■■■e■■■■■��■■■■■■■■■■■■■■■■■■■■ [■■■e■■■■■■■■■ee■■'■■e■■■e■■■■e■■■ ■■■■■■e■■■■■■■■■■■■■■■■■■■■■e■■■ ■■■■■s■■■■■■■■■■■■iia■■■e■■■ee■■■ ■■■■s■■■■■■i■■■■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■■■■■�■■■■■■■■■■■■■ ■■■■■■■■■■pie■■■■■e■■■■■■■e■■■■■■■■■■■■■e■■■■■e■■■■■e■,�■■■■■■■■■■■■ ■■■■■■■■■■■owe■■■■■■■■■■■■■■■■■■�i■■■■■■e■■■■■■■■■■■■��■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■e■■■■■■■■■■■ee■■■■■■e■■■■B/1■■■e■■■■■■■■ ■t■■■ ■e■■■■■■■e■■■■■►•■■■■■■■■■■■■■■■■I,i�'arw►\e■■ee■■■■e■��ee■e■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■\■■■■■■■■■■■■■■E�lcif/F`,"vri■■IIR�■■■■■■■'■■■■■■■■■■■ ■■■ee■■■■■■■■■■■■■■■■■■■■\■■■■■■■■■■■■■9■.�i►_I■■■■■■■■■elf■■■■■■■■■■ ■■■■■e■■■■■■■■■■■■■■■■■■■■■■►■■� ■we■r�■i■■■■■■tee■■e■■■■i■■■■■■■■■■ tiff ty APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC C d Davie County Health Department �a. d Enbdronmetrfa/HesIW Secdoa PIAN 1 9 2000 10 P.O. Box 648/210 Hospital Street Mockaville, NC 27028 (336)751-8760 ENVIRONMENTAL HEALTH DAVIE COUNTY ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION 18 PR/O-VZDED. Refer to the INSOMaTION BULLETIN for instructions. 1. N . to be Billed Gy 9 f>NL 98Wh e Y K contact Person ,S m Epi Nailing Address 101 A101%24 a Al 0, soe» Phone 2�f d�'T Z'j City/state/$=V ,A60c ks v,de-,, N, ��'02� wmin se Phone 2. Mass on Perch/ATC if Different than Above Nailing Address City/Stag/sip 3. Application For: ff/Site xvaivation ❑ Improvement Permit/ATC ❑ Both 4. systes to service: 0 House ❑ Mobile Rome ❑ Business ❑ Industry ❑ Other 5. If Residence: # people # Bedrooms # Bathrooms 2 vDishxasher O Garbage Disposal dr/washing machine O Basnsnt/Pluebing O BasdentMo Pluabing 6. If Business/industry/Other: specify type # People # sinks # # showers # Urinals # Nater Coolers IF FOODSERVICE: # Seats Estimated lister Usage (dons per day) 7. Type of water supply: ❑ County/City ❑ Wall ❑ Communi't/y e. Do yon anticipate additions or expansions of the facility this system Is Intended to serve? ❑Yes ❑'No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED i BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: re S WRITE DIRECTIONS(from MoclaMlle)to PROPERTY: Tax Office PIN: # L• a lY A II to l{r tj CLcj—p. Property Address: Road Named;a. M G S of ora U/V No yr gr0ol-- L ON P—,q)V S/ Stuffy ero6h Jrczil CIty/ZIp A Aack s iPRM. :-70 22r _ RrOo f� T a, 1 If in a Subdivision provide information,as follows: Name: Nat'Kh Crook Section: 1/b Block: Lot: 37 Date Property Flagged: /"l q- o O 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 plana or intended use change,or if the Information submitted In this application is falsified or changed I,also,understand that I am responsible for all charges Incurred from this application. I,hereby,give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located In Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE ' /—! R- O D SIGNATURE .U�,lirtP.wrr THIS AREA MAY BE USED FOR DRAWING YOUR STTE 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. BILLY 6. MURPHY. et of D.B. 112 Pg. 335 pICKIE3g ,P Pg ILBERT D.B. 82 Pg. 532 3 . 784 H. SHERRILL I D.B. 148 Pg, 319 I D.B. 165 Pg. 695 808B --———— -- -- .__ _=S._g7•51's7•-E--.,,,. _. - --- I I D.B. 154 Pg. 185 & BO f i` 467.88 - S 84.29'35• E—. I D.B.La 1 �N 299.93 S 84.28'16• E I n {1 � � 449.86 i i 1A sq N n o cu CD LOT #37 '� o .€ . (5.224 AC.), , �s ap LOT #38 - ti (5.649 AC.) co s s9•S �� A �� � STONY BROOKw Q — TRAIL _ Co ii L4 L3 cz a 4..4 o — � N L2 cu 3 ' 3I1 /�4 PRIVATE ROAD — z 0LOT #36 / j��P� 5rf0b• ` (5.302 AC.) 61D I LOT #41 (5.008 AC.) LOT #40 N �.. co! a (5.519 AC.) pN � o mos lr� ao w a S 86 10 30• E� 502.64 TOTAL tri 472.49 I 00y € l 30.1s �mom, Ld LOT #42 ` 'ss (5.425 AC.) o I ` CL DAME COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900214 Tax PIN/EH#: 5820-23-5398.37 Billed To: Eugene Bennett Subdivision Info: Northbrook 3 Lot#37 Reference Name: Eugene Bennett Location/Address: Ijames Church Road-27 28 Proposed Facility: Residence Property Size: 5.224 Acres Date Evaluated: ? dD Water Supply: On-Site Well / Community Public Evaluation By: Auger Boring / Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L- L Slope% 3120 2 J/Z HORIZON I DEPTH - n Texture group Consistence F 5-4�' c 5�5 P Structure s g(e S G4 MineralogyI • I I: HORIZON II DEPTH to -)_0 - 18 It, — 3o Texture group C, Consistence F c (=i S Structure < 'S Sr3'fe Mineralogy l: 1 Ii0 HORIZON III DEPTH 2 -3(0 - o Texture group G rSn Consistence so $5 Structure SQ fL 1543114 Mineralogy It'( HORIZON IV DEPTH 3 to i + Texture group Consistence Structure Mineralogy SOIL WETNESS 30 ,P RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION U S LONG-TERM ACCEPTANCE RATE 0.35- n SITE CLASSIFICATION: EVALUATION BY: � LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: Cta'o `A 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) rSoil 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) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■NOON■■■■s■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■NOON■■■■i■■■■■■■■�.�■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■�■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■NOON■■■■■■■u■■■■■■■■■■e■■■■■■■■ ■■■■■■■■■■■��■■■■■■■■■■■■■■■■■■■■■■NOON■■■■u■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■r■■■■■■■■■■■■■■�■■ ■NOON■■■u■■o■■NN■■■■■N■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■ii��■■■■■■■■■■■�i■■■■■■■■■■■■■■■■■■■■NONE NESE■■■N■■■■■■■■■■t►�■■■■■■rttra■■■■■■■■■■■�i■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■E■■N■■■■N■■■■■■�■■■■N■r�■■■■■■■■■■■■Ori■■■■■■■■■■■■■■■■■■■■■■■■■ e Dave County Aealth Department Environmental)Yealth Section PO Box 848/210 Hospital Street Mocksville,NC 27028 Phone: (336)751-8760 February 8,2000 Mr. Eugene Bennett 107 Nail Lane Mocksville,NC 27028 Re: Site Evaluation-5.224 Acre Tract North Brook III/Lot#37 Tax PIN#: 5820-23-5398 Dear Mr. Bennett: As requested,a representative from this office visited the above site on February 7, 2000. Based on the information provided on the Application for Site Evaluation and after the evaluation was completed,the site was found to be provisionally suitable for the installation of an on-site sewage disposal system.. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization to Construct the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, feel free to contact this office at(336)751-8760. Sincerel Jeff G.ieauchamp, R.S. Environmental Health Section enc(s) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville,NC 27028 Phone: (336) 751-8760/Fax: (336) 751-8786 November 26, 2002 Eric Myers 359 Ijames Church Road Mocksville,NC 27028 Re: Site Evaluation- Northbrook III/Lot 37 Tax PIN#: 5820-23-5398 Dear Mr. Myers: As requested, a representative from this office visited the above site on November 25, 2002 to perform a site evaluation. Based on the information provided on the Application for Site Evaluation and after the evaluation was completed,the site was found to be provisionally suitable for the installation of an on-site sewage disposal system. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization to Construct,the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, feel free to contact this office at 751-8760. Sincerely, Jeff G. Beauchamp,R.S. Environmental Health Section Enc(s)