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124 Oak Leaf Ct Lot 14 DAVIE COUNTY HEALTH DEPARTMENT Pu- Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900063 Tax PIN/EH M 5708-06-7210.14 Billed To: Lary McDaniel Subdivision Info: Oak Crest Sec.2 Lot# 14 Reference Name: Janice McDaniel Location/Address: Davie Academy Road-27028 Proposed Facility: Residence Property Size: See Map **NOTE**'Tliibgmproveement/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 Holst-�, #People #Bedrooms ----3 — #Baths 2 Dishwasher: 19'/' Garbage Disposal: ❑ Washing Machine: Ise" Basement w/Plumbing:.❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size () "Type Water Supply`s W_ Design Wastewater Flow(GPD) Site: New Repair❑ r � 1 System Specifications: Tank Sizelh_A AL. Pump Tank GAL. Trench Widtht Rock Depth If' Linear Ft. Other: )Is -LatJiIO.J 1 Required Site Modifications/Conditions: L p.l C&"j 1 --S C� Zr63a-c� oFF 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;�jn. or 1:00 p.m.to 1:30 p.m.on the day of installar* . Telephone#is(336)751-8760.**** %00 p6 I lit Environmental Health Specialist's Signature Date: 912J610 DCHD 05/99(Revised) • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 989900063 Tax PIN/EH#: 5708-06-7210.14 Billed To: Larry McDaniel Subdivision Info: Oak Crest Sec. 2 Lot#14 Reference Name: Janice McDaniel Location/Address: Davie Academy Road-27028 Proposed Facility: Residence Property Size: See Map ATC Number: 2537 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 WASTEWA CO ION I ALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur . Date: 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 the system will function satisfactorily for any given period of time. r�z o G j 4 �r V Septic System Installed By: Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) ` APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERM do ATC Davie County Health Department ` Env,F Founts/Hes/th S'eWan EDG 2 2 2000 P.O. Bos 048/210 Hospital Street Mookaville, MC 27029 (336)751-8760 - AVIE COUNTRY LTH ***zwcazum*** THIS APPLZCRTIOK CUMT in PROC:Bfiw MQXS8 ]ILL To RZQO M 1DT7mmZON IS PROVIDZD. Rehr to the ZHIMB►TION BIILLZTIN for instruotious.�� 1. xalme eo b. sul.d contact Pace n y1 OUn i cp2.pI V/L Msilinq aadss* .a.. shoo. city/saa/:u Ma Y,SV I Ile-, Mc, a-7G408 su.in..s sin. /���(0- -151 - qac- �& s. nese on semit/uc sr/a�i�sr sent than q wo... �1Qhhl^ ►��', I�(.�i OC�hn� �r1 G. ULtLU hddsese X�_1 l vitt:/d�taa/spa �11 112 . IJC. c�'10 a. ]►pplioatioa tors l7 Site =valuation X zmprovesoeut Persi0 Both a. Rete s to &*wine$ House 0 stabile eosin 0 Business 0 Zodustry 0 Other s. u RSSideaoe: #/#``People i Bedrooms i Bathrooms *htrYh.r 0 Oasb" Oisposal O aaeer*nt/91=biaq 0 smaew.nt/xo phab aq .. _! Business/Iad"UT/others speoiip type i teopi* i sick* i commodes i shower* i Urinals i water cow a s zIr >f=SSRnCi: 6 Seats Zstimated Nater Osage (gallons per daw) 7. Type of Water SUPPLY: YCouaty/City 0 Well 0 Cosuwnity I. Do you anticipate addidons or expansions of the facility this system is intended to serve? 0 Yes 0 No If yes,what type? ***IMPORTANT***CLIENTS MWCOMPl.MTHE REQLQRF.D PROPERTY INFORMATION REQUESTED BELOW. FA&w a PLAT or SITE PLAN MU8TBESUBMITTED by the dint with THIS APPLICATION. Property Dbunsloss: SQ.,' MD WRrM DUMMIONS Mus Modu4b)is PROPERTY: Tu Office PIN: * T- 1 1�-3Cb��(1 P5'lC,$� blp-,a�o •�`� Property Addrm: iLoadName���'Ve- �CA�eXr , y citymp 60%x,i Il e, A'1003 1 e If In s Subdivision provide Information,as follows: r)ak .Y t'�-� r)n 7 O,I�r d loo - Name: �`1C.YQo�� j J ACA: 'I'Y� C mile- . Section: / Block; Lots _ Date Property Flagged: This Is to certify that the information provided Is correct to the but of my knowledge. I understand that any permit(s) Issued bereafter are subject to suspension or revocation,If the site plans or Intended use change,or If the information submitted in this application Is Milled or changed, It slap,undeMend that I art rrapondble for sU cbangm kaundfrom IAds apPllca6m Is hereby,Sive consent to the Authorized Representative of the Dav�ie, c4an ROM lkpac en4 to enter upon above described property located in Davie County and owned by.�A�.[. i ,1 -- aMers Inc. to ended all tesdag procedures as necessary to determine the site suitability, DATE� aa� SIGNATURE-P1 r V 1 THIS AREA MAY BE USED FOR DRAVWNG YOUR SITE PLAN(Include aU of the following: Ezkft and proposed property Hues and dimensions, structures, setbacks, and septic locadoru). kQ; 't�.C,�LQQ(� Site Revisit charge Date(s): Meat Nodfleadon Date: EAS: 3� Account No. (p (- 3 Revised DCHD(07/99) Invoke No. mrwy r bA.a t4;lt d swud or*�w d tlr Rgitlrr d 0106►Arfagt - _/ - - - _ - _ Cor.TaDldr '. `Mw•r rAit�l veiny Arsve• E -dw#*vd 4 _ *k"MV41W 4 wAi.a b.oy tom.awe m y COURSE•. BEAt m DfST/WCE, ,dl wq i.auvt..nar:.ae�.NOf MiA•d' f - - - -- - • OAK CREST" 88.48"03•M1 '�ST 'CGlond 'Roc J P 1 L 2 S 43*W51"iN -3873` CAord Roc d ani arn.aoo�rtide,!yi`,q ^ .. - - '+trato d" •) on" ; C0114o1 Comdr PB 7 e PC 82 :L 3 N O4.31'29"E 34.73' Chord J Rac �i�by come '/`' 11'r EIR V v r 1j2�.oa / M7 ,p°zet.46• � � •' 1%2=OR. N t ti y� �+ Propoe r w. L, 13 r 41 . cREsr Phase r - APPLICATION FOR SITE EVALUATION IMPROVEMENT PERMIT&ATC a � / D ` • ` Davie County Health Department EnVM007 nenfRI MOM SeCNon SEP 2 1999 P.O. Boz 848/210 Hospital Street Mockeville, NC 27028 (336)751-8760 Q ***I1�ORTl11tT*** THIS AIP>?LICATION CA1tItOT BE PROCE88ED t�liLE$$ ALL TAE R,EQIIIRED INFORMATION IS PROM ZD. Refer to the nVORM 1010 BU=19W for instructions.-� n i. slam to be Billed I Ma contact person .,n', ,.epp�C�IJail Hailing Address mom Phone 33�o- Opp LAU city/state/:zp _M(x h'rw i Ile, Mr, a-70-q8 so.iness phone 3a D- 151 - q0'lel" s. Naas on permit/ATC it,,Different than Abovs o n h h t 4 d- 11.1 0 0 I A1',�c,U Q1dQJ1/1)� 'nnc- lalling Address 0{"JU I. l City/state/sip oc 'E' ]1 1� e-, { �V�c�"10o`� 3. Application for: �Site 3valuation 0 improvement Permit/ATC 0 Both e. system to service: House 0 Mobile Home 0 Business 0 Industry 0 Other S. If Residence: !#`people # Bedrooms # Bathrooms 1 Dishwasher 0 Garbage Disposal q Washing machine 0 basement/Plumbing 0 Basement/Ho plumbing 6. If Business/industry/otherI specify tno # people # sinks # Commodes # showers # Urinals # Yater coolers If FOODSERVICE: # Seats Estimated (tater Usage (gallons per day) 7. Type of water supply: County/City 0 Well 0 Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes 0 No If yes,what type? ***IMPORTANT***CWENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPWCATION. -1 Property Dimensions: SZc1� �� WRITE DIRECTIONS(from MockrAlle)to PROPERTY: Tax O®ce PIN: NT 1� A W41'S�1C Culp` Property Address% RoadName \{'If_ � 1 PXY\U Citylzip �C, \I I ��Z O�� J �-C—A 6f\TCkye'2 PM0 _ If in a Subdivision provide information,as follows: ��,Y P.�„ nn a1 X� - Name: 6aY\cn,6+ L4 �C&tm l� md-e-- Section: oZ Block: Lou 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) tuned 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 incamd from tills appllcadom I,hereby,give consent to the Authorized Representative of the Davie Conn Hea1W Depa ent to enter upon above described property located In Davie County and by La YYII �C,�CI_Xl iel�U 16crs I no. to conduct all testing procedures as necessary to determine the site tab DATE 'c9 q I SIGNATURE G� / THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN elude all of the foAowing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). k Qp o ( Site Revisit Charge �'"" Date(s): Client Notification Date: EHS: Account No. QK-3 Revised DCHD(07/99) Invoice No. - 1 .9 it Tax Lot 38 6.4 Acres +/— Angle Iron Stake Found 4 1°{O 30•p0 I 352.3 N 36 34 o2,W 222.34. �' .00, ,()0.00' 3 1/2" EIR .00 ►r1 N !.'�j i tn I � 30,000 SF + N 30,000 SF + 0� 17 k,�oh 30,000 SF + 14 30,000 SF + 34.73 .tf A F 19e�j, '`� rw 40'� 212•g8, 31.36' cn cn cj 53.00' 39.53' 18 23.72 23.72' 13 0 30,000 SF + o, O � 30,000 SF + 12�� EJP � `O snt N 18.40'28,W 172.68' 15.00' � N 23054'23'W 192.35' � g g ' 30,000 SF + 30,000 SF + N V N 35.69 1/2" EIR cn 50.00' 116.82' 102.50 30.54' S ~— 22°26'21"E S 2302 !. IRS 30.02' r� `--— 291.95' P 96. 1' _ _ -- _ - Davie .Academy 1 RR Spike Found • r-.r n 4 _4_ A n DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900063 Tax PIN/EH#: 5708-06-7210.14 Billed To: Larry McDaniel Subdivision Info: Oak Crest Sec. 2 Lot#14 Reference Name: Janice McDaniel Location/Address: Davie Academy o d-270 8 Proposed Facility: Residence Property Size: See Map Date Evaluated: A Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit J._� Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group �i 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 SITE CLASSIFICATION: P,L EVALUATION BY: LONG-TERM ACCEPTANCE RATE: i Z 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 Mineralog 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)