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212 Oak Grove Church RdDavie County, NC r Tax Parcel Report 1 1 V � Wednesday, October 5, 2016 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: H50000003002 Township: Mocksville NCPIN Number: 5749374529 Municipality: Account Number: 8300591 Census Tract: 37059-805 Listed Owner 1: WILKERSON JENNIFER L Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 212 OAK GROVE CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: �14 0�11 Voluntary Ag. District: J Legal Description: /r149 Fire Response District: MOCKSVILLE Assessed Acreage: 4.05 ��191 MOCKSVILLE Deed Date: 2049 2038 f�173 165 219 Deed Book / Page: 2035 F _._, -1 2030 143/1'5 �, ,1T � � 6 20 - -) PaD,WeC,WeB -�----2122T ��- 38 -_-__ s?n?rl _34 ' `��269 Flood Zone: 2021 2015218 2006 Plat Page: 264 r r Watershed Overlay: 11tt---���' 2005999 1 1994 /20 0_3 -1986 ,977 r G 317 ^ n S 3 �p 47200.00 128 1975 126---1 8670.00 -_ -1 r' 47700.00 179 R 4 0 12511111 I, ---1949 q asp 103570.00 324 f 344 343 ` , _ f f r ? f,'. 103570.00 4l1?1951J-11938 1I-{'` ac:3 1925`1930 1917 f?; �61f 9 19031 __ __ _ - --/", WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: H50000003002 Township: Mocksville NCPIN Number: 5749374529 Municipality: Account Number: 8300591 Census Tract: 37059-805 Listed Owner 1: WILKERSON JENNIFER L Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 212 OAK GROVE CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028 Voluntary Ag. District: No Legal Description: 4.125 AC OAK GROVE CHURCH Fire Response District: MOCKSVILLE Assessed Acreage: 4.05 Elementary School Zone: MOCKSVILLE Deed Date: 1/2012 Middle School Zone: SOUTH DAVIE Deed Book / Page: 008790089 Soil Types: PaD,WeC,WeB Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 47200.00 Outbuilding & Extra Freatures Value: 8670.00 Land Value: 47700.00 Total Market Value: 103570.00 Total Assessed Value: 103570.00 9 t uI� pU N� Davie County, NC All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied including but not limited to the Implied warranties of merchantability orfltness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this websHe. AU'THORI&TION NO: 199,6 DAVIE COUNTY HEALTH DEPARTMENT /2 Environmental Health Section PROPERTY INFORMATION Permidee P.O. Box 848 Names I/1��,/•!�"t?f Mocksville, NC 27028 Subdivision Name: �; Phone # 336-751-8760 Directions to property: C✓ <''r` r / / , l ' Section: Lot: AUTHORIZATION FOR WASTEWATER .-.�? �'? t� SYSTEM CONSTRUCTION Tax Office PIN:#.3"i ' � .�,�1 Road Name:=�j"��r�?�"`�tZp:�� fir: **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. Chapter 130A, Wastewater Systems, Section.] 900 Sewage Treatment and Disposal Systems) ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED sa A a 'DAVIE C 3UNTY HEALTH DEPA , T, 19 NT/� •. _? ®: " IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION _ P Itf ee's� Directions to property: %✓ ' ' ' IMPROVEMENT PERMIT Subdivision Name: Section: Lot: Tax Office PIN:#-'' `+ Road Name.'F!'^ ": t` ,F • ip. ti **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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) ***NOTICE*** TI -IIS PERMIT IS SUBJECT TO REVOCATION IF SITE '? f ' ;'�' PLANS OR THIS INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE r INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE M q # BEDROOMS .1 # BATHS -7 # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZETYPE WATER SUPPLY �J DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE ODD GAL. PUMP fT�ANK/� __—GAL. TRENCH WIDTH -7el, /ROCK DEPTH LINEAR FT. f� OTHER���� J✓t'r� /JG�` O� ` �':G,�(!�S REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT *APPROVED FILTEnt *12ISER(S) U FIIII6112-1)` GRADE* S�� QDOdr� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM 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: �� 114" elio�- % ve AS b 3 -I r L/ 4, F AUTHORIZATION NO. OPERATION PERMIT BY: < DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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 05/96 (Revised) APPl1CAIION FOR SITE EVALUATION/IMPROVEMENT PERMIT & 7 Davie County Health Department u EnWimmenfal Health SmWon FEB 10 10 r �P.O. BOX 848/210 Hospital street e Mockaville, NC 27028 (336) 751-8760 E11VIROWENTAL HEALTH DAVIE COUNTY ***nwoRT ** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. name to be Billed<<_�jr�_A,% -m, Q t4pontact person VAor-,�E5s� a �v,r -5, Hailing Address 4'1-7_8 Q c57 n t�Q Q 1 Home Phone I C6_ Business Phone X336 OS 2. name on Permit/ATC if Different than Above Hailing Address City/State/Zip 3. Application For: .Id Site Evaluation 0 Improvement Permit/ATC 0 Both 4. system to service: 0 House U-190bile Home O Business 0 Industry 0 Other s. If Residence: #People #Bedrooms_ # Bathrooms pr/Dishwasher t] Garbage Disposal ® Hashing Hachine 0 Basement/Plumbing 0 Basement/Ho Plumbing 6. If Business/Industry/other: Specify type # People # sinks # Commodes # Showers # Urinals # Nater Coolers IF FOODSERVICE: -# Seats Estimated water Usage (gallons per day) 7. Type of water supply:County/City 0 well 0 Community e. Do you anticipate additions or expansions of the facility this system is intended to serve! 0 Yes 0 No If yes, what type' ***1MP0RTAN7*** CLIENTS AIUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBAHZTED by the client with THIS APPLICATION. Property Dimensions: W�Un DIRECTIONS (from Mocksville) to PROPERTY: �/ D� p Tax Office PIN: # �7� 9 � 7 � /tel/. ��ll � Ao cy —h-�- Property Address: Road Name e ct k(It 7s e &Q 1, ( h o L4se Q ., �-}- DO Citv/Zi(R�Oey'S'1A\0 re k. 1' o;©oe1:1, nJ If in a Subdivision provide information, as follows: hyi. 01 Name: r , J n/.) Section: Block: �a�t�Date Property Flagged: / �� �cr This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 I ani responsiblejor all charges incurred frons this application. 1, hereby, give consent to the Authorized Representative or 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 2— (0— TJ SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PIAN (Include all of the following: Existing and proposed property lines and dimensions, structure: setbacks, and septic locations). Revised DCHD (07/98) Account No. A d Invoice No. �/ 4 .5 / 57 m O B. ler— PG.Z` 1 MAGNETIC I ` Lu O m n h C V, fV (,.)too Q i NIP 3 0 0 0 0 v - m z PIP I LEGEND - EIP : EXISTING IRON PIN NIP z NEW IRON PLACED PIP - PLACED IRON PIN 805.54 P JAMES M. SUMMERS D.B. 92 PG. 627 883.74 S O4•.43' 11'• W 1197.87 TOTAL LEE H. MCCULLOH D.B. 179 PG. 385 �►� � F I�L i �+ � i 4.�•`����CqR��''••.,. 1. GRADY L. TUTTEROW , CERTIFY THAT UNDER O ;••Q6%STfgfo :: MY DIRECTION AND SUPERVISION. THIS MAP : Z ; SEAL WAS DRAWN FROM AN ACTUAL FIELD SURVEY L-2527 MADE T TUjEROW S VEYING FOMPANY. Cl�yO $l1Rv�,OQC 1 II 11 , 0 Qn-r o, ° �. 10 h Nr4 O q - ►Z.O LF / 2 m• r1E ev. 3 ROq� / M7 SCALEC.s ? � 026048., 0 O} �Q P s39 k J<< / opj. � 33 - FSA JAMES M. SUMMERS � AREA = 4�'fz� -NIP (INCLUDES SR 1642 MICHAEL P. BARNHARDT D.B. 182 PG. 540 `30 ori y� 14.49 PIj UNMARKED POINT / /IN (t OF ROAD REVEISE_ SURVEY FOR : JAMES M. SUMP SCALE: r - 100• APPROVED BY DRAW DATE: 05/08/98 GILT BEING 4.125 ACRES TAKEN FROM THE JAMES M. SUMMERS PROPERTY (D.B. 92 PG. 627) LYING IN THE MOCKSVILLE TOWNSHIP DAVIE COUNTY I R ` DAVIE COUNTY HEALTH DEPARTMENT �1 Environmental Health Section SECTION LOT _ Soil/Site Evaluation APPLICANT'S NAME Ir OX- 1441� PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring r?l Pit DATE EVALUATED ` 2/� &_// PROPERTY SIZE Zir, 8 XJ! 5� Xi��X-?62Y ROAD NAME 5'X 41 Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Z- Slo e % C HORIZON I DEPTH •� t Texture groupC AL Consistence Structure o ' Mineralogy 0 I HORIZON 11 DEPTH /'(f 'r Texture group Consistence �r 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:_ LONG-TERM ACCEPTANCE RATE: T REMARKS: DCHD (01-90) LEGEND Landscape Position EVALUATION BY: ,1� ,�� OTHER(S) PRESENT: -y -ce-1 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 DAME COUNTY HEALTH DE -PART: ENT ENVIRONMENTAL HEALTH SECTION P.O. Sox 848/210 Hospital Street Courier #09-40-06 Mocksville, NC 27025 Phone #: (336)751-8760 March 8, 1999 Victory Homes Attn: Ron Jessup 4175 North Patterson Avenue Winston-Salem, NC 27105 Re: 2 Site Evaluations/4.125 Acre Tract Approximately 2 Acres Each Site Oak Grove Church Road Tax PIN: #5749-37-2131 Dear Client(s): As requested through your applications, Robert B. Hall, Jr., R.S., Environmental Health Specialist(s) with this office, visited the aforementioned sites on March 2, 1999. The purpose of said evaluations were to determine the soil/site suitability for the installation of an on-site sewage system on each site. The results of the evaluations, copies of which are attached, indicate the sites are unsuitable for the installation of on-site sewage systems for the following reason(s): Rule(s) .1941 Soil Characteristics (2) (B) - Soil Structure (3) (B) -Expansive Clay .1943 (a) - Soil Depth .1944 (a) - Restrictive Horizons Due to the limitation(s) on your sites, this office is not aware of any modifications or alternative measures which can be implemented at the present time to upgrade the classifications from "unsuitable" to "provisionally suitable." Your applications for Improvement Permits/Authorizations to Construct must, therefore, be denied. You have the right to an informal review of these decisions by the Environmental Health Director of this office and also by the regional staff of the Department of Environment and Health. You should contact this office to arrange for this further review. Page 2 Victory Homes March 8, 1999 You may also wish to obtain the services of a private consultant to collect site-specific data and submit data and system design for each site to this office for technical review. A site may be reclassified provisionally suitable provided written documentation, including engineering, hydrogeologic, geologic or soil studies indicate to this office that a proposed on-site sewage system or a proposed alternative system can reasonably be expected to function satisfactorily on said site. The substantiating data from these studies must indicate that: A. The effluent (wastewater) will receive adequate treatment; B. The effluent (wastewater) will not contaminate any ground water or surface water, and C. The effluent (wastewater) will not be exposed on the ground surface or be discharged to surface waters where it could come into contact with people, animals or vectors. Finally, you have the right to a formal appeal of these decisions if you file a petition for a contested case hearing with the Office of Administrative Hearings, P. O. Drawer 27447, Raleigh, NC 27611-7447. A copy of a petition form can be provided to you upon request. The petition must be received by the Office of Administrative Hearings within thirty (30) days of the date of this notice. The hearing may be held in Davie County. If you file a petition for a hearing, you must send a copy of the petition to Mr. Richard Whisnant, DENR, Office of General Counsel, P. O. Box 27686, Raleigh, NC 27611-7687. As stated, this office finds these two proposed sites unsuitable as described on the applications; however, if the two sites are combined this classification could change to provisionally suitable. A modified septic system could be designed at a 0.2 gallon(s) per day application rate with shallow placement. 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 B. Hall, Jr. Environmental Health Specialist RH/wd Enclosure(s): Soil -Site Reports Invoice $ #Gj re�grS APPLICATION FOR SIZE EVAUlAHON/1MPROVEMENI PE11MII & AIC a �� 1 �2 Davie County Health Department ..; Environmental Health Section P.O. Box 848/210 Hospital Street FEB 10 19N Mockaville, NC 27028 (336)751-8760 EP{VIRDNPAENTAL HEALTH DAV. COUN`� F***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE 1W06IRM INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. name to be Billed l a j�a Q_S Jnr. 1 � - 4fontact ,'e gfir Nailing Address tS J n P�!J (2 ma _ HaPhone city/State/ZIP t�; , 5A ` J ., c (1{ Business Phone 33to I )S 2. name on Permit/ATC It Different than Above Mailing Address City/State/Zip 3. Application For: .Mite Evaluation 0 Improvement Permit/ATC ❑ Both 4. system to service: ❑ House Mobile Home ❑ Business 0 Industry 0 Other S. If Residence: tt People # Bedrooms -_ # Bathrooms Di ¢�ahwasher 0 Garbage Disposal ® / Hashing Machine 6. If Business/Industry/other: Specify type 0 Basement/Plumbing U Basement/No Plumbing / Commodes f Showers # Urinals f People # Sims / Hater Coolers IP FOODSERVICE: 11 Seats y/ Estimated Water Usage (gallons per day) _ 7. Type of water supply: {,t County/City 0 Well 0 Community S. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes 0 No If yes, what type' ***IMPORTANT*** CLIENTSDIUSTcvAfPLE1ETilE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: ��✓t�c��/-ca = ��� /' W TE DIRECTIONS (from Mocksville) to PROPERTY: Tai Office PIN: # o� 7"r' 1 ''c� %'vS f'1(' v�� S �i -I- p Property Address: Road Name oc��i'T-c.�� e or r - City/Zig O c\:S'A�0_ I\J . C ` -?L)Zf j h T'r t) �•2z If in a Subdivision provide information, as follows: -K Q . Name: 04 I Section: Block: Date Property Flagged: G This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) Issued hereafter are subject to suspension or revocation, if the site plans or Intended use change, or if the inrormation submitted In this application Is falsified or changed. I, also, understand that I am responsiblefor all charges Incurred from this application. I, hereby, give consent to the Authorized Representative or 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 �� I O ^� t 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). Revised DCIID (07198) Account No. 'rota Invoice No. ��� w � o m ar> QZ tD N Z m �C 1� QD U Q i NIP � � 3 I� n 0 0 m o 0 0 CD 2 PIP 1 I D.B. 18�Z `-1 MAGNETIC I ` — LEGEND — EIP - EXISTING IRON PIN NIP = NEW IRON PLACED PIP - PLACED IRON PIN I �e �•V A A -R cti me c� "p04� / ANO SCALE v icffi 1 JAMES M. SUMMERS ? A� sO48., O� Oy D.B. 92 PG. 627 Q F J3 Q i N 04' 43' II" E �a 805.54 S - '`/ 883.74 S O4•.43' IP' W 1197.87 TOTgL 0 LEE H. MCCULLOH D.B. 179 PG.385 7 -Sl X 7`j11 T ► ct it �S-Q g ,.•` � ,......Rod '•,, 1. GRADY L. TUTTEROW ,CERTIFY THAT UNDER 0j. Q� D •� '9 MY DIRECTION AND SUPERVISION. THIS MAP = Z ; SEA L :. WAS DRAWN FROM AN ACTUAL FIELD SURVEY L•2527 MADE Y TU EROW S VEYING OMPANYQ T� . v 3 A,(? ob. p.. O hh 0 � 2 AR EA = e NIP ^ \tel (INCLUDES SR (642 O NIP 299.64 MICHAEL P. BARNHARDT D.B. 182 PG. 540 JAMES M. SUMMERS 3e• ti � / A, F/A 0 -o h �o ACRES �� v Inn co ` ten.? JoOco � l n. 14.49 PI/ UNMARKED POINT / /IN t OF ROAD REVEISE: SURVEY FOR : JAMES M. SUMI SCALE: r-ioo' APPROVED BY DRAN DATE: 05/08/98 GLT BEING 4.12:5 ACRES TAKEN FROM THE JAMES M. SUMMERS PROPERTY (D.B. 92 PG. 627) LYING IN THE MOCKSVILLE TOWNSHIP AVIE COUNTY. NORTH CAROLINA DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION—Ler— Soil/Site ECTIONLeer Soil/Site Evaluation APPLICANT'S NAMEr 1 eG���, ��� DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE —.D., SUBDIVISION ROAD NAME e<11pall /OBJ/ �h Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position G .L Slope % C% HORIZON I DEPTH Texture groupS Consistence Structure S, Mineralogy HORIZON 11 DEPTH Texture group Consistence Structure /C' /� Mineralogy; l 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: &S EVALUATION BY: Ila G/ LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: /-V Wle/,e9-2.-a ©/al vP .. e'�b Y24z2 1�te �f� e` %4 v 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 Mineraloa 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 (01-90) DAME couN Y HEALTH DEPARTMEM ENVIRONMENTAL HEALTH SECTION P.O. Box 848/210 Hospital Street Courier #09-40-06 llocksville, NC 27023 Phone #: (336)751-8760 March 8, 1999 Victory Homes Attn: Ron Jessup 4175 North Patterson Avenue Winston-Salem, NC 27105 Re: 2 Site Evaluations/4.125 Acre Tract Approximately 2 Acres Each Site Oak Grove Church Road Tax PIN: #5749-37-2131 Dear Client(s): As requested through your applications, Robert B. Hall, Jr., R.S., Environmental Health Specialist(s) with this office, visited the aforementioned sites on March 2, 1999. The purpose of said evaluations were to determine the soil/site suitability for the installation of an on-site sewage system on each site. The results of the evaluations, copies of which are attached, indicate the sites are unsuitable for the installation of on-site sewage systems for the following reason(s): Rule(s) .1941 Soil Characteristics (2) (B) - Soil Structure (3) (B) -Expansive Clay .1943 (a) - Soil Depth .1944 (a) - Restrictive Horizons Due to the limitation(s) on your sites, this office is not aware of any modifications or alternative measures which can be implemented at the present time to upgrade the classifications from "unsuitable" to "provisionally suitable." Your applications for Improvement Permits/Authorizations to Construct must, therefore, be denied. You have the right to an informal review of these decisions by the Environmental Health Director of this office and also by the regional staff of the Department of Environment and Health. You should contact this office to arrange for this further review. V, Page 2 Victory Homes March 8, 1999 You may also wish to obtain the services of a private consultant to collect site-specific data and submit data and system design for each site to this office for technical review. A site may be reclassified provisionally suitable provided written documentation, including engineering, hydrogeologic, geologic or soil studies indicate to this office that a proposed on-site sewage system or a proposed alternative system can reasonably be expected to function satisfactorily on said site. The substantiating data from these studies must indicate that: A. The effluent (wastewater) will receive adequate treatment; B. The effluent (wastewater) will not contaminate any ground water or surface water, and C. The effluent (wastewater) will not be exposed on the ground surface or be discharged to surface waters where it could come into contact with people, animals or vectors. Finally, you have the right to a formal appeal of these decisions if you file a petition for a contested case hearing with the Office of Administrative Hearings, P. O. Drawer 27447, Raleigh, NC 27611-7447. A copy of a petition form can be provided to you upon request. The petition must be received by the Office of Administrative Hearings within thirty (30) days of the date of this notice. The hearing may be held in Davie County. If you file a petition for a hearing, you must send a copy of the petition to Mr. Richard Whisnant, DENR, Office of General Counsel, P. O. Box 27686, Raleigh, NC 27611-7687. As stated, this office finds these two proposed sites unsuitable as described on the applications; however, if the two sites are combined this classification could change to provisionally suitable. A modified septic system could be designed at a 0.2 gallon(s) per day application rate with shallow placement. 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 B. Hall, Jr. Environmental Health Specialist RH/wd Enclosure(s): Soil -Site Reports Invoice (, �.'O-) V . APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department f Environmenta/Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 VI'(? (336) 751-8760 n� A p AUG — 6 1998 ENVIRD VIEEfl.TAL Y�T11 I ***IP1PORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Contact Person Mailing Address A' Wee1(_ f 11-6 ��-�J �",�� Oj ((� Some Phone ` (�„ �� fJ City/State/ZIP , , -Y) C , rjd Business Phone 2. Name on Permit/ATC if Different than Ab -me &Y-ry\ � Q O Mailing Address City/State/Zip 3. Application For: X Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. system to Service: ❑ House 1z. 11 Mobile Home 11 Business ❑ Industry EJ other 5. If Residence: # People c) # Bedrooms # Bathrooms ❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing 0 Basement/No Plumbing 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 S. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? 'IMPORTANT' CLIENTS MUST COriPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBAHTTED by the client with THIS APPLICATION. Property Dimensions: Tax Office PIN: # ��� .�4_ 3 7_ 2.1,2- 1 Property Address: Road Name City/Zip 'P 7 0 1 �/7 If in a Subdivision provide information, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (from Mocksville) to PROPERTY: 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 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 Drn- to conduct all testing procedures as necessary to determine the site suitability. n DATE 9-C - � SIGNATURE � THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN: t,L 1 N Account No. Revised DCHD (07/98) Invoice No. _ D.B. 182 PG. 540 `-1 MAGNETIC I PIP I I I- LEGEND - EIP . EXISTING IRON PIN NIP . NEW IRON PLACED PIP . PLACED IRON PIN T>;1Stgrb'EY1COANY" ?27 LBER'TY C#KATCH #MW CSI 411 MM �e ID 0-4 SfTE 0 A OJ O /e Ado pSR cy /�so7,Y �arK+U,xev. � IYlev 1� o° Mti�`6g2Rcy � �0.q / AID SCALE o b0 p4i 4Q N 3JO / VIC"Ty M4P JAMES M. SUMMERS r� O?s04e" �9c%Q / D.B. 92 PG. 627 �¢ %} 'y;cp< 33 FGGY tv JAMES M. SUMMERS \08DOE4CC DSC 6yDCC � 8 APv� 3326 \ � 7aI.7 �0 9C 303 w'P� 09. `lis 2 N S 0 N _D443-jr- .0 E AREA '' = 4.y25 NIP ACRES Q b�bN hNCLUDES SR 1642 Rllkj 40 ya P 4' NbC 883.74 bOv0. 3 O A.* 04. 43' IP' W 1197.87 TOTAL NIP 299.64 14.9 �J Y PIIP UNMARKED POINT I / QJ 0. OF ROAD LEE H. McCULLOH D.8.179 PG. 385 MICHAEL P. BARNHARDT D.B. 182 PG. 540 / REVEISED 06/15/96 MEC I SURVEY FOR ..,����"""'�•�•••. JAMES M. SUMMERS 1. GRADY L. TUTTEROW . CERTIFY THAT UNDER Q ; OSTfgf•. Q O•� f' .100' APPROVED Br SCALE: DRAWN BY MY DIRECTION AND SUPERVISION , THIS MAP ' 'Z 2 SEAL - DATE: 05/06/98 GLT MEC WAS DRAWN FROM AN ACTUAL FIELD SURVEY L-2527 ' BEING 4.123 ACRES MADE BY TUTTEROW SURVEYING COMPANY. Q '9,3.•i��t %,0 TAKEN FROM THE .LAMES M SUMMERS PROPERTY (D.B. 92 PG. 627) LYING IN THE MOCKSVILLE TOWNSHIP QjI $UR DAVIE COUNTY. NORTH CAROLINA Oyr L.' IU•�• DRAWING NUMBER REGISTERED. LAND , SURVEYOR L-2327 TAX MAP REF : H-5 A PORTION OF PARCEL 30 10498-2 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME L'ywzal' PROPOSED FACILITY SUBDIVISION Water Supply: Evaluation By: On -Site Well Community Auger Boring Pit SECTION LOT. DATE EVALUATED PROPERTY SIZE ROAD NAME Public 7 Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH < $ Texture group Consistence Structure Mineralogy HORIZON II DEPTH l Texture group Consistence i Structure 4 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:____ �✓ /!'Gc tl �G�' EVALUATION BY: & // LONG-TERM ACCEPTANCE RATE: t. �2_ OTHER(S) PRESENT: REMARKS: ✓kyr yZ E'!' !Z` �, IAL l 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 Mineralogv 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 (01.90) ENVIRONMENTAL HEALTH SECTION P. 0. Box 848/210 Hospital Street Courier #09-40.06 Mocksville, NC 27028 August 26,1998 James M. Summers 138 Oak Grove Church Rd. Mocksville, NC 27028 Re: Site Evaluation/4.125 Acres Tax PIN: #5749-37-2131 Oak Grove Church Road Dear Client(s): As requested, a representative from this office visited the aforementioned site on August 25, 1998. Based upon the information provided on the application for site evaluation and after an evaluation was completed, the site was found to be provisionally suitable for the installation of a modified, oversized on-site sewage disposal system. Before a representative of our 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, please feel free to contact this office. Sincerely, AIIIAAO�)� Robert B. Hall, Jr., R.S. Environmental Health Specialist RH/wd Enclosure(s)