303 Main Church Road Lot 1 78V MEN
'k
4
NOTE: {
This pro"eW 14 subject to all easements, right—of—trays,
' streets and ainiewrxtrtbst'if arpti 4w the some may appear of
record in the Mee bf t#se-Rsgislsr of Deeds, Clark of Court,
Town"or Colbtty tion Offias M which may haw been acquired by
Pr'Mcriptiw use ondx*v foo visible at the tkm of this
survWy, Thle•aUF Wy A Subject to arty facts that may be
disobWsA by a full aW accurate No ssssoh, NOT furnished
t. as of fhb dab.
1
1 1 •3
This mop Or{h0allr and arty
nt�� sitedooumenb ore Turr►ishsd
tell named
thereon mid noalts.ar we by atMrs PRELIMINARY � ' •
in permilbd unless,eldixrrlrsd by sloee fond slrwyrnq Co.
CWrtified copies of We survey map vdN not be Issued :
brAnd ninoty(00)days of the original survey date.
NOT FOR RECORDATION.
k Map not for recordlod".
DEEDS. OR BUILDING
Precision 1:10.000+ RB 348 ® PG 133 Vicinity Map (Not to Scale)
i
3/4" EIP Fnd
PROPERTY LINE CALL TABLE
COURSE BEARING DISTANCE
L-1 S 07*1W20'W 314.25'
L-2 S 07r36'26"W 520.08'
L-3 N 89003'27'W 277.24'
L-4 N 03'00'40"E 1020.81' Total A to B
K L-5 S 61'07'09"E 24.53' J'? 800 Tax Lot 18.02 0
L-6 S 60.3733"F 81.70' + Tax Map G-5 810
L-7 S 59037'05"E 91.61' F n/f Brady L M oil Estate + 82
g
L-•8 S 58°54'39"E 102.02' DB 102 O PG 137 % 'Al
F . L-9 S 58.15'19"E 62.63' j 3
L-10 S 58.18'23'E 24.75' Q` .,a
790
I �
f ! /
Q
TIE Us�NE CALL TABLE _
Plonted Stone Fnd (Flagged) i L 4 Total A to B
COURSE BEIRHVG DISTANCE 528.52' 459.06'
Point A
TL-1 S 12.10'24'W 24.73' 7�os�TL-2 N 89.17'31"W 40.68' -_ _ - --- - __ 1�S' MBL
" 790-- - - - - - Tse un. +/TL-3 S 86 23 t 7 E 200.11 _____ _ _TL-4 S 03.12'17"W 13.60• _� Tn. un. +/- Tres fine /
A�/ A,
i 1.051 Acres +/
1 �
I + 15 MBL c /
OD -
�o
15' MBL Of
.✓s
3.245 Acres � / Main Church Road •
Lot 19 �/ i - °�C' � / b r
FARMLAND ACRES _ • B�
Section 4 T-707 Al- .�/ ��� / S.R. 1405
R PB50PG201
1.054 Acres +/- °4 PP
1 \ / 60' Public R/W claimed by NCDOT
- 15 MBL /
_ — - _ _ 20'+/- Pavement
_� -_ 450.67 /V
Tres t,ne +/ 15' MBL - --- �
/ T-706
w ------- __ 3 /
Planted Stone Fnd / --_ _ '---_`__ 1.063 Acres +/- �Q / A.
(Pointed & Flogged) __- - --_ ______- L _ _ \L..
y-_ --- 150.00' T-8qr w ca0 mix
�'_p f?ct! - tS--- _ o� ,
a _____--- _ --- --- - --- - -_ -------
%
"
1� etc`-'_ ----- ----_--�_ _ ruse use +/- - --�_ _ ^ 292.70'
T-Bar w/cap Fnd \ L-2 `--- ------_- _ -------------------------------
T-Bar
-------------------- --------
- - ---` - PP -27.40' ,O w ��
71
— - /
10'+/- Gravel Drive Meanders I /
Tax Map Tax Lot 1G-5
with Property Line
n/f John Lee Bowles \`\� Tax Lot 17 /
and wife
Pauline M. Bowles \� Tax Ma G-5
n f Ann Wall Sain.
DB 66 O PG 256 \_- Dor*" Wall Shoff~
I
Po* Wall Younts. /
\ \ & James Hayward Wall, Jr.
PRELIMINARY
NOT FOR RECMDATON,
DWS, OR B UING
R/W — Right—of—Way LE6EM0 FC — Face of Curb
EIP — ptlsttpg bon Pipe W — Back of Curb
OR 0 bon Rebar LP — Power Pole
ole 1.Georg,Robs!Stan.Proles" Lad Surveyor,L-3162,certify to as
P — pod— cancnsee Monument MW — Man a the foke'"°er e"^ ® or �' Concept Sketch #2 3-23-2005
IRS —Iron Reber Set CH — Chord Distance a Mvt this plat I,a a survey oat-notes a subdivision of iard within
P/L-Pn*orty Una P/0 — Part of
C/A—Cantrollyd Access DS — Deed Book as avec a r owntt or muniafPal4 1hd has on adbanes thou
CP —Concrsb Plpb PS — Pkit Book ��d 1004 �� Project
r a
CMP—corrugated Metal P1 RB — Record Book ° --Denotes Test Hole #700 (Typical) C] b. TIM V&plat Is of a surrey that M board in rich portion a a
CPP n OWrnt Med Plastic Pipe PC — Pope T-700 Red & White Flogging �b or�P�b shat M wospMAW w to en wdhm w Tax Lot 118
�.. —F— 100 Year Flood SeurZfy Ce — Cafcb Basin thrt r•pllrar p ewe d vend
'1 « -0- overhead uti11t3es -S- Sewer Une Tax Mop G-=5
-•x- Fens WM Water Mater a. ,0 wt Is a a«try d anally paras avow Record.QoOic 348 d Rage 133
,R FM.- Fpund WV — Water Volvo of WA
10-Mort a Formerly BM — Bench Marie
NAND Mendmurr ntsd Point "M —T Bench Mark
. d tt,at tnM Net r w a�a damn awaoay.rich a tM 6.579 Acres +�- by chordinute°computatign ,�.
" CL._Cpttpr lino MRS — 1lopdyspilw noombbsllsrr d.ante v«twa,s seek ad wp wnsy or Other r (lnclusk*vt AreO within S.R. 1405 R/W)
�r
BCALF tOMlrtlIMIP COUNTY STAlt DAK
` * Els- at'ttowrnsta CTV - Cobb Television norPodB ai .te.pNen to ma eseA�lrrraf■rOdNislsrx I deals1" 50' Modcsvllla i3ovie' North Carolina 3-2$-2004
V.-Y Pedestal �Tg Elachic Tronsrorrrlr Box N i
-W—wotr►� CO —sahltary Serer Clean Out � . tl1.t I am
rr1aEM '
1 4
we sw
r, 50 0 50 100 150 ' ' Ncrr'floR REOol�ap►noN ; Sto-ne Land Surveying Company Joe s»a . *.
Geo % R. RECMATI0N SCI.CW RloDifr!stogy P1S t.-stria .4304 P2.,
' �
G tsAPf�pe 113 Drum Lane Phone (336) "S-4733 13114 q0.
( HIC SCALE - Fi_Er , to GRS' Mocksviile, M.C' -271)28 4304 P2
•
r
.)7
• DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760 Fax#(336)751-8786
OPERATION PERMIT
Account #: 990003346 Tax PIN,EH#: 5749-09-1360 r
Billed To: Southern Showcase Subdivision Info: PWM Re-lc �
Reference Name: Location/Address: 303 Main Church Road-27028
Proposed Facility: Residence Property Size: 1.05 Acre
ATC Number: 4983
**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 any given period of
time.
System Type: _S.T.Manufacturer �Ua�Tank Date-7 Tank Size !
Pump Tank Size-% �—
System Installed By: J✓ S E.H.Specialist: � Date:
Wow Permi-f
; n C h
e
.I
Q
a
40 c
i
�r
CJ.
�o
V V
v �
DCHD.11/06(Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH C)
P.O.Box 848/210 Hospital Street 3 '
Mocksville,NC 27028
(336)751-8760 Fax#(336)751-8786
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990003346 Tax PIN:EH#: 5749-09-1360
Billed To: Southern Showcase Subdivision Info: pVied. L
Reference Narne: LocationiAddress: 303 Main Church Road-27028
Proposed Facility: Residence Property Size: 1.05 Acre
ATC Number: 4983 11
Site Type: t7New ❑Repair ❑Expansion
**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 change.
Residential Specifications: #Bedrooms 3 #Bathrooms 2 #People Basement❑ Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Lot Size_ �S Type of Water Supply: ❑County/City M'Well ❑Community Well
System Specifications: Design Wastewater Flow(GPD),�Q(_Tank Size GAL.Pump Tank GAL.
Trench Width Max.Trench Depth_? �, Rock Depth Linear Ft.
Site Modifications/Conditions/Other: As stated In 15A NCAC 18A.1969(5'
aeee7ited Sy—....' .-y.1c r�,o-77SETr
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30—9:30a.m.on the day of installation. Telephone#(336)751-8760.
4540
61ineS 8'®' X3'
315 Awa
S
5
Environmental Health Specialist Date: _/ 0
DCHD 11/06(Revised)
Davie County Environmental Health
P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760/Fax(336)751-8786
IMPROVEMENT PERMIT
Account M 990003346 Tax PIN/EH M 5749-09-1360
Billed To: Southern Showcase Subdivision Info: Fe*ffr hod 1b4 l
Address: 3856 N. Patterson Avenue Location/Address: 303 Main Church Road-27028
City: Winston Salem Property Size: 1.05 Acre
Reference Name:
Proposed Facility: Residence
**NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from thiroffice 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: Rf,;ew ❑Repair ❑Expansion Permit Valid for: Years ❑No Expiration
Residential Specifications: #Bedrooms _ #Bathrooms 2 #People Basement❑ Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD): -?2kO Type of Water Supply: ❑County/City [14ell ❑Community Well
Site Modifications/Permit Conditions:
System Type LTAR
Initial , ?--15-
Repair R air ,L7
Sit Pla
VJJ &A
� 38�
1 It�sE
S
Sim so' nr►1n CYt�m
d w
Environmental Health Specialist Lti Date /Oq
i.p.11-06
APPLIC SITE EVALUATION/IlvIl'ROVEN ENT PERMIT & ATC
O Davie County Environmental Health
P.O. Box 846/210 Hospital Street.
�:.,. .(336)751-87601, ax)336)751-$786:...: .. ...;:;. . . :,. ... :..::
App tptron For: 0 yalt on/I vcment Permit "uthorization To Construct(ATC) 13-11&h
Type in ORepair to Existing System dExpansion/Modification of Existing System or Facility
«««J PO «+THIS APPLICATION CANNOT BE PROCIiSSEt�UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Rcfer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed . uCi Q7 Contai~t Person
Billing Address . Home Phone
City/Statc/ZIP / - ! Business Phone
• \ lr 2' Ql.�S�v
Name on Pcrmit/ATC if Dffercnt than Above \
Mailing Address ` City/Stat;/Zip
PROPERTY 1NF&MATION *Date Housc/FacilityComers Fla&S24 0
NOTE: A survey plat onsite plan must accompany this application. Included: 0 SitC Plan OPlat(to scale)
(Permit is valid for 60 ntontlis with site plan,no ex irttion with complete plata
Owner's Nanic c,/ 1 >' Phone Number
City/State/ZiA��(j jOwncr'sAddress . d"
Property Address U 1( X 2c City fy.4.1°hk Owl f� .. �
Lot Size 1. 06 Tax PIN#/ 15"1490
Subdivision Namc(i£applicable) I . Section/LoO
Directions To Site: r-,-,Y-4- l 7b Ja IC4) - r kr, j (.',)C*)
-
If the to any of the following questions is"ycs",supporting documentation must be attach .
Arc there any existing Wasicwatcr systems on tlic site? OYcs 111 10
Docs\the site contain jurisdictional wetlands? [)Yes lido
Arc there any casements or right-of--ways on the site? -OYcs goo"
Is the site subject to approval by anotherpublic agency? OYcs
Will wastewater other than domestic sewage be generated?. OYcs OISo
IF RESIDENCE FILL OUT THE BOX BELOW
#/People 11 Bedrooms #/ Bathrooms _ Garden Tub/Whirlpool OYcs E No
Basement: OYcs Cho Basement Plumbing: OYcs DK
IF NON-RESIDENCE FILL,OUT THE BOX BELOW
Type of Facility/Business Total Square Footage of Building #/ People
#/Sinks I/ Commodes ## Showers H Urians
Estimated Water Usage(gallons\per day) (Attach documenLition of similar facility water consumption)
FOODSERVICE ONLY: # Scats
Type system requested: 06nvcntiot al OAcccptcd 01micnative OAltemativc OOthcr
Water Supply Type: 0 County/City W Ier l,Icw Ac1I OExisting`Wcll O Community Well
1
Do you anticipate additions or expansions of the facility this system is intended to serve?0 Yes O No
If yes,what type?
A
-
' Site Revisit Charge
Property ow cr's or otivncr's cga representative signature
Datc(s):
- 0� Client Notification Date:
•
Date EHS'
Sign given OYes UNo `� Account#
-jun vi u9 U5.31 p Davie County Enyimnmenta
3367518786 p.2
Tlwi
M
-M- C(w
FA
U
viftrimeMAI HealthP- Box 848/210
HOSOM Street
Cower 09-40.06
Pdocksvju
28
V
X14
Richard W.Bell
200 Channel Lane
Mocksville,NC 27029
Re; Site Evaluations/ -Potters Pield Estates
7'ax OjMce PIN. *5749-()9-2174 lots I thru 4
Dear Client(s):
As requested,a representative irOm our Office visited
29,2005. Based on the the e0rementioned site on August
'n-formatiOn Provided on the Application f
-valuation was cornpletcd on the S'te,it washound to be provisio an
-r an evaluation
or Site
the installation of an on-site sewage BvalugtiO. d
system. nallysuitable for
Before and ImprovementlAuthorizat,01.
to Construct
call be issued the off. to
'PP"taliOn must be filled out and the houselmob"C h...10catiOn staked off.
'fYou ha-ve anY questions,please feel f
ec to contact this office.
Sincerely, r
Robert 13, Hall,Jr.,R.S. •
EQvironmcntal Health specialist
RBIVdif
0'
SIGNATjnl.
• DAVIE COUNTY HEALTH DEPARTMENT
• • Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990003346 Tax PIN/EH#: 5749-09-1360
Billed To: Southern Showcase Subdivision Info:
Reference Name: Location/Address: 303 Main Church Rad 27028
Proposed Facility: Residence Property Size: 1.05 Acre Date Evaluated: r7 79
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 L
Slope% 7_ 1110 Z'o
HORIZON I DEPTH 41? 0-1/9p-yg
Texture grow G C
Consistence
Structure $
Mineralogy Sa(
HORIZON R DEPTH
Texture group
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 fsS
LONG-TERM ACCEPTANCE RATE -1
SITE CLASSIFICATION: P5 EVALUATION BY: �&n u �►'N an "
LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT:
REMARKS:
. LEGEND
LLandscape 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
�Ygt
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)
ITAR -I.nnP-term arrPntnnrP rate- onl/rlav/ft') l'%f TTT\ncInc in __��
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■/■■■■■■•ar■/■t■lid■■■/■■�■■Il■■■■/■■■■■■■■■/■■■■■■■■■■■■■■
■e■s■■■■■■■■■■■■■■■■■■■■i�■crate■■■■■■�■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
iiiiiiiiiiiiiiiiiiiiiiiiii:::si::�■■��■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
MENNENMENNEN MENNENiiiiiiiiiiiiONE ME
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
-E a ellb }�
CATION FORXITE EVALUATION/IAIPROVEAIENT PEI Al
APO 2 6 ��5 Davie County Health Department C Q �!
Envftnn ental Health Sectio
P.O. Box 848/210 Hospital S e
ENVIRONMENTAL HEALTH P PR
DAVIECOU10 Mocksville, NC 270 1" 6 ?445
(336)751-8760
ENV/R
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL (jy
INFORMATION IS PROOVIDED. Refer to the INFORMATION BULLETIN for inn�struc
1. Name to be Billed 1 C I.JA l.'V^ k/j , ru. Contact Person )2 o�cnZ S71) IJ L
Mailing Address ZW CAA1414 C L L,A1J C G6e 336" / ej2- 9(z)Ll-7
City/State/ZIP ��GIC.S41 LL-; N C, Z-10223 Business Phone 336` 998 8 - i l 733
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: a Site Evaluation ❑ Improvement Permit/ATC ❑ Both
4. System to service: OrH�o./use E3 Mobile Home E3 Business ❑ Industry El Other
S. Type system requested: EVConventional ❑ conventional modified ❑ innovative
6. If Residence: # People A- # Bedrooms # Bathrooms 2 Z
LJDishwasher ❑Garbage Disposal 13ashing Machine L�asement/Plumbing ❑Basement/No Plumbing
7. If Business/Industry /Other: verify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
8. Type of water supply: 13County/City M Well ❑ Community
9. Do you 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
BELOW. Either a PLAT or SITE PLANKMUST BESUBMITTED by the client with TIIIS APPLICATION.
Property Dimensions: _ Sr=.t` AA T WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Tax Office PIN: # 5-1Y 1 D 9 2 )igvs 1 5 TO Y0'A1 n( C)'4 9 J01
Property Address: Road Name_)MA-iN Cfly,,GH _SJ ri= )s cA—r I�
Cityizip )/I/10('u\/I tom= >� ( _ 1 Y)" La- y N L Z- i
2.7 023
If in a Subdivision provide information,as follows.
Name: �c�'f7�)2S (r )l.L0 LST4TE�
Section: Block:- Lot: Date home corners flagged: "3 — E )
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 am responsible for all charges incurred front
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. R I CJ442)O {, MiCH &"u,
to conduct all testing procedures as necessary to deterinine.the site itability.
DATE �I ��/—Q5 SIGNATURE �`. P&W
TIIIS 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
Datc(s):
Client Notification Date:
EHS•
Sign given Account No. d
Revised DCHD(05/03 Invoice No.
r
DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Agpqunt #: 990003603 Tax PIN/EH#: 5749-09-2174.01 RB
Billed To: Richard Bell Subdivision Info: Potters Field Estates Lot#01
Reference Name: Location/Address: Main Church Road- 028
Proposed Facility: Residence Property Size: see plat Date Evaluated:
.Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit l/ Cut
FACTORS 1 2 3 4 5 6 7
Landscape position .�
Slope% G o 0
HORIZON I DEPTH �� �!
Texturegroupf' ` L
Consistence r i-
Structure
Mineralogy ,-
HORIZON 11 DEPTH f f—
Texture group (i
Consistence
Structure / S'
MineralogyI -/
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: f EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: J 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
Mineralogy
1.1,2:1,Mixed
.ote
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
n('{in tK/og(Revise(l)
■■■■■■.■e.■.ee..e■...■■■t■■■.ee■■.■Mee.Mee/M.■e■eeeee.■eeeeNow
■e■■
■.■■■■■Mee■eee■e■■■■■■■■t■■e■■■■,�,■■■Mee■■■eee■■eee■■eee..e■.■ ■.■
■■■■.eeoe■eeeeM■■e■■■teee■.eeee■ ■■..eeeee.■ee....e../■■■■■C■ ONE
■■e.■...ee/e.e..■■■■e■e.ee/e■■.e■..■eee.MeeM.e.e.■.e■.e..■.■ ■ ■.■
mosommoommummommoom on Nos
■■■.■.■■.../..■■■■■..ee■■eee■.■.■■ee.e.ee■..■■.■..Me...■■■■■ ■ s ■
■■■■■■■er.■■M■■n■■■■tteM■■■■■■nntte.■ea■■■■■sns....■■eM■■■to Ct■
......ee/e..■e■■■■■e.e.Meee..■■.Macao/eee.■■n...../■o■n■.■■tC ...
■■■■e■.tM■■e■■n.s.■.et.■ae■■■.n■ ■te■ea■■■■n■aotM.o■ ■■ ■t■ .
tet..■■■■■■■M.■■tts■...■..■n■C■t■r■..■.■.■.t■r■■■■■■..■t■.t■■ ■ ■
■.e..e■■■■■.■..se■eceeM..■■.■ s.../eeee■■aca...■.■e■■■notr■■ ■■ ■
■.■tee..ee.■c■■e■■■...c..■.■■ac.tc/■.e■.■■■■■■st.■■■.■..tet■ ■■ C■
noun■■■..■r■■■■■■■■■■■■■■■■■e■■,;ur�eeaM.e...et....■■■■nm..e■ ■ ■■
■....■■■er..ee■■■Meeeeee...■■r•eeeeee■■..ae■..//■■■■t.■ntte�= 0
_.■
se....e....■ee..e/ee.■■■■...■�u►�ee..■■■e■.■sce/e■■.e..sr./■ ■■
■.....Mee■■.■■ecce..■e■■..eco■,�.eeee.e.ee..e.e/■■e..■e.ttM■ ■■■
■e.■■■e.■eee..■■eeeeeee■■....■�,■a■■■■e.s■..tt.■■■■■a..■■■te.0 ■■■
■.■■■■ ■■■MeMe■ee.■e■■e■aeeeeM�i■ ■■..■eee■Mee.....■e.ee■ ■■ ■ C
■■■■■■■■■■■■■■■■e■■■■■■■Meee■■r�■ee■e..eeeee.....e■■■ce..se■.■ ■
■e■a■■rM■■■MMeee■.ee■■eee.■■.■►ae.s■■.eee■■s.e..■■■■..e■/ee..■ ■
■■■■■■■■Mae■■■■■e■■■■■■■■■eee■.+�e■■■.■aeceee..eeee.ee..■./■ ■■ ■
■ ■
■■■r../■■■ee■e/e■■■.■■■■a■.s/�7�e■......./..■..e..a/..■.■ ■
■.Meeeee..■se■■■■e■....eee■■es►�Yae■eae.eeeee...es.a.//ec/■ ■CC■ ■sta■
■■.■.■e■eeee..■■■■e..eee■■eweri►�J►]A.■r■eeMeeO...■eeee..ee■■
OEM-
No
■m■MM �i■
■.e.■ ■■eee.■e.■e■■ceee/ee...■uateece..■ec■■■ccnc.c■■n■■■■Mt
■■■■■C■■ecce■■..........■..■■■nreeeeete■■■■■e.mn■■..■e.mom a CC ■
■■
ss......e/.e■■e.s...■eee■....�-cr.�/eeeeee.e■■sea■■e...■■■.■ r■r■■■
■eee..■e.■e■■.■.■■■■.r.■■■■■a�n�r■ero■r■■■■.n■rt■ttt.■erM.■rr ■■ ■C
tt■■■t.■■.■■■M■■■.■■■■■■■■■n■►,��.�rtrre■.■■■■.ettttt.■e■.■rtr■CC■ ■■
■ .. ean ■■■ ■r■ ■
■ ■noon■e..e■u■■ME No
■■.■,ui■t.■■■...ee■,Iti■.e.e1■■..�1■ .n■no on Mie■■et■so on t■■■■�i
■ ■/..■■sec...■ate■■■■■.....��r�ir,■.■■■■■....ttt.t■■■..■rt■ ■ C
■ ■.■■■M..tt■■eee■■.■■.■■■.rt�i�■t■■■e.■■rtt■r■..■.■■■■.■ � ■
■■■ ■.M■■■■teee■■t■■■■..■■tt■■■t.M■■■■n...■tt.oMM■■■.mntt C■ ■C
■■. e■sos.■■■..t■■■s■■.■■t.■.ee■■■■■a■.ttet..e■t■osn.tetC■ ■C■■■■
■■■ ■.on.oe/t.tt■M■■e■ms■ne..��� ■.e..c...../ee...ecc..■ ■■ ■■■
ecce Ce■.Mr■e■■■ee.s■■■■eM■■■■oma ie■■■eeeeeee.ee.ee■e■.e.e.■C■C■en
■e■■■ ■■eeMMe■eee..e■eee.■../■enu./sse..e/eeee..sss..ecc■ee/es■ ■
■..■.. ■.■....eee.eeee.ace.■earn�eeeee.e■e■eeeee.■■.eeee.e■ ■■Cse
■■■■■C�i■e■e■■eee.■■■s.c.../■■■■�iee■■..■ttttr■■■M■■mtrt■ee■C �MMns■
■■... eta■■trM■■■■nnm■t■■.■■e.vssss.■eMMe■ee.■■■■■■■ce■e■ ■ ■
■■e■■■■MM■e■■■■.■■■■■■e■e■e■■■■.■e��...■e.te..e■.ntmrtrttr■■ ■MC C
■eee...■Cn■■■■■■■.M■■rrtt.■.M■■■G���►�s.s..eee/.e■ss■■ea...■■■■ C
Mason ■■ ■eaeessece.■../■eee■■■ � ■...oM■■M■■en■M■■■..■■ ■■
■man�e■.,�■■■■.■ant.see/..■■■■■■��'i'■■./...ee■■.nnnot■■■■■C■MC ■
■.s.snino■ ■■■m■o■■r■■et.■■■a■.itteteeettt■■■as...e/e.C■,�■■ ■ ■
mono ■ ■mo ■s■s■■.r.ee.e.e.e■■a��.....s.e■■■.nnttr■■r■ ■ ■■
nano Mason ■■■.ntrtetr■r■e■.■■ i�m■tttt.er.■nntt.o.e■t■■■ ■�n
■r■rne■■■■e■ not■.tett■ ■■■.■.'���tero■■■.■■.nnnt.ttr■ ■■ C ■
■■...■■■■■e■ ■■t....tet'��c::■■■e■■ :::•t■..nsottnr.MC■.CaCC t
■t■t.e ■..■■ ■ttt�■!_-.■■■■.Mneri�■tte.e■m::�•■■Me.s�■■■■as■■ ■
alta ■ ■■■■..t���i■■e.ee.■■■eIi/fyl /..■■■■■.■Irt..te■■ii■�!�/��1■ ��
■...C..e■■■ec�oC■■..■■■■■■■■���.�r��'it■■■■■■■mCttete■■■■■..�■■■
■ee/.■■■s.e■n.t.■.■■.■so■e.tCe■e...■.sa�■/.eee...■..trc...■■■■■■ss.o■ C
ce/..■ ■■■■■■s..Mt.o.e■e...snn..e.■■.■■■■■ ■t.■ ■
■/ee.■■e.tee..■.■ee.e.■.ant...etn■ee■ents■t.tt■M■■■n■ttreonC
C■ no
■■t■■.■tnt■■ttrt..■e■■■■nrettt.t■■■e■■...o././/.■■■....eo.e■ ■C■■
eeesseee■a.MMMeeeeee.■e■.ceee// ■■s■scee■■.■■■■■se■t■■■■er■■ now
/..essse..c■eee/■■■■■■■men.t■te,�' ■esss■■.././ee■■■es..■CCe gas■
■..ece.e.eeM■eee.eee.■■■■eeec■e.e.■■■■■.ee.e....■■■■mom ■ ■■■
■.■■■■e■eeeM■■■e.■■e..■■■■■■.ee...■■■■.eM..e/eees..e..■■.■ on
■■■■....■...e■ee....■0.■ne..ee.Me....■■t.■■e....■■.■O/ecce■ ��
■..e■e.■■■■■.ea■/.■s.■e■■eee/■..■.......toe..■■■■m■■■ ■ ■ ■
■potent.ett.■e■■t■■enrtoeert■■■ts■ ■s■.t.■■■■■■■s■.■ ntC C ■C
■ss.sse.■./ee..■■..■■ee/ec■/e.e ■C.../o../e■■s.s.■.C■ C ilia
■ss.■r.s.e/■ee■■eec.....■.t..e. ■m..to.■M■■t■nmt.to.oM■■oil
CQUNTiLTiYDE � ►T1INT
Environmental Health Section
P. 0. Box 848/210 Hospital Street
Courier 09-40-06
Mocksville, NC 27028
August 30,2005
Richard W.Bell
200 Channel Lane
Mocksville,NC 27028
Re: Site Evaluations/ Potters Field Estates
Tax Office PIN: #5749-09-2174 lots 1 thru 4
Dear Client(s):
As requested, a representative from our office visited the aforementioned site on August
29,2005. Based on the information provided on the Application for Site Evaluation and
after an evaluation was completed on the site, it was found to be provisionally suitable for
the installation of an on-site sewage system.
Before and Improvement/Authorization to Construct can be issued the appropriate
application must be filled out and the house/mobile home location staked off.
If you have any questions,please feel free to contact this office.
Sincerely,
Robert B.Hall,Jr.,R.S.
Environmental Health Specialist
RBH/dlf