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447 Seaford Rd DAVIE COUNTY HEALTH DEPARTMENT ���//-�d - �� t � Environmental Health Section 2 P.O.Boa 848/210 Hospital Street 'J'� . Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT N� D�un��� �n�.�'r�e� /Ylc�m�� Account #: 990000902 Tax PIN/EH#: 5776-66-8004 Billed To: NoRnan Craver Subdivision Info: ��`��QQ�l�/�(j�- Reference Name: Norman or Ruby Craver Location/Address: Seaford Road 27006 Proposed Facility: Residence Property Size: 72 Acres ATC Nu b r. 2284 **NOTE** 'T�iis�mprovemendOperation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWAT'ER 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 PERMTT BEFORE INSTALLING SYSTEM. ,� Residential Specification: Building Type i-1�usC #People 2 #Bedrooms '-� #Baths 2 �'' d Dishwasher: � Garbage Disposal: ❑ Washing Machine: � Basement w/Plumbing: ❑ BasementlNo Plumbing: �� Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: � f ��'��� � Lot Size 72 ���-�-'I'ype Water Supply�t� Design Wastewater Flow(GPD) �oC� Site: New�Repair❑ :, , System Specifications: Tank Size�C3�AL. Pump Tank GAL. Trench Width �1 Rock Depth IZ�� Linear Ft.�� ocher: � l�� �lc.r� , I.�SC4L-t— L.�,�5 ��o.�. M��. Required Site Modifications/Conditions: ��JST�I.� C7-� C�'-}TW2 - `1J' ��w•-- ��1.� LcGP t ' - � IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative ofthe Davie County Health Department for final inspection ofthis ' system between 8:30 a.m.to 9:30 a.m.or 1:00 .m.to 1:30 .m.o the day of installation. Telephone#is(336)751-8760.**** � F'R�^�" 'Ta�1t�Kt,J . �'�'� ��� , ��DvS� --� � s T ' / . � � x��klZ'� ��. /�O. Environmental Health SpecialisYs Signature: Date: / �'�o0 DCHD OS/99(Revised) . , ' • ��— DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990000902 Tax PIN/EH#: 5776-66-8004 Billed To: Norman Craver Subdivision Info: Reference Name: Norman or Ruby Craver Location/Address: Seaford Road-27006 Proposed Facility: Residence Property Size: 72 Acres ATC Number: 2284 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 WASTE , ON IS ALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signa e: Date: ! CERTIFICATE OF COMPLETION � **NOTE** The issuance of this Certificate p etion sha indicate the system described on Improvement/Operation Permit has been installed in compli ce ' ic e 11 of .S.Chapter 130A,Section.1900"Sewage Treatment and Disposal Systems,"but shall ' NO WAY be tak a guarantee that the system will function satisfactorily for any given period of time. � N�°`�' � 1 . `=�0 �Aa�K,� ��2 �--� � L1�=s F� �� S ��/! � ��J�►v� L-t,� .��- rO�c3 �'�i Ly - �2 �� c � �,� �-���ro.J �37 � Y —���ti. L�-Tv Z�- � Septic System Installed By: 1`� L� �C _ a Environmental Health Specialist's Signature: te: L/ DCHD OS/99(Revised) -_._____..... �a•a� �- ,+� APPLICATION FOR S{TE EVALUATION/IMPROVEMEM PEAMR&ATC � � � ��2 ��- /' Q`.1! �--���p/t�> Davie County Health Depa�tment D L5 /'v � �=_ ____ -- _ Env�ivnmen�/Hes/thSection �_ , _�__ - ��-�/ ,(��o�� .o. sox 848/2l0 Hoapitsl Btrt�t DEC I 31999 G/-�= --/�---�-f l Moaksviii�, NC 27028 . � • e��,/f?eSSt�� (336)75i-8760 � . �� G ***r�c��►** sa=s ��=ra►�=oN r� a� pRocass� v�ass � �a RaQvrRan IN�OR�ATZON ZS pRCVIDED. R�tar to th� INl"OitMAT=O�I BUI.'L�T2N !or iastruatioas. l. 1�.�. to b. sul.a (.'r3�m f}n1 L�_ U't latlF2 coa,ta►ot p.s.on /YDrvn�,•J a/z �cib �l �asu�r �►aar... �1a � ,�ald�„Cr��/� �a� aa.. �.�a6— 7��F—�7a 3 cstir�.a.a�szp C'1e m (.�.i n�sE (�C a7ol �— sa.sa... �,. -- Z. flaa� o� P�sait/11YC i! Di!l�r�at than 11bo�� 1i�ilio� �dds��• Citr/�tat.�/:ip s. Applioation rors 0 8it� =valuatioa � Zmprov�an�at II�rmit/]1SC BotU �. a�r.t.a to s•z�w� Bfons• O Mobii� Hom� O 8usia�ss � Iaduatry 0 Oth�r s. I! R��id�na�: i>P�opl� � ! Sodrooms � f &►throoms � �PJ Di�hMuf�r o oarb�q� airpo.d Q'�Naal�i�q ttaahi� 4YY�a��at/pivabiaq [I saawnt/No pltimbiaQ 6. i! suaia���/indu�tsY/Oth�st �ai!!Y tiYP� f �opl� f �in1u ' + Coo�od�� i Bhowr� t Oriaal� + 1►atar Cool�r� It r00D8�RVIC3: � S�a�s S�tiimat�d Nat�r tlsaq� f��• � �r) :' � � �. s'yp� o! wat�r �upplp: 0 Couaty/City - B'1��11 0 Commuaity e. Do yoa�nticipate�ddiNons or e�wiow o[the bcilltq t6b rystem b Intend�d to urve?,> :,. 0 Ya � If Yea,�rhxt type? . "**IMPORTANT"**CLIENT3 MUSTC�OMPLETETHE REQUIRED PROPERTY INFOIiMATION REQUESTED BELOW. `�it6er a P WT or 31TE P1.AN MIJLST88SUBMITTEb b tLe elient w�IW TH13 APPLICATION. Propecty Dimcntlons: ���Cr� R+RITE D11tECf10N8(�rom MabvtUe)to PItOPERTY: / T�:081ce PINs # �S'7 7 � - �G � �O O� ��� � � ]���it-t/.�-o-�� Property Addresa: Roid Name ��e�9�d� � L � �(dZ-d �o- � City/Zip (4A_U�4 rJ e e� �J C �E�al .�i'1� l n � . —� V in�Sabdivision provide[nform�don,aa folimve: � Name: SecHons Blockt Lot: na�e r��gts��a: /2'/3-9� Thia L to cerHfy t6�t.the tntorm�Hon pro�vided b¢orre�t to t6e bat of my knawledg�. I nnderedmd t6st any permit(�) taaned heceafter Ar�eabject to�aspenaion or revoc�idon,lf the tite pl�n�or intended ose c6aage,or If t6e infocmAtion aabmitted in t64 appllcaHon ts faVtiial or c6an�ed. J,olso,understand tbot I a�n raponslble jor al!chaiges lecurred jront tkls appUcatlon. I,6enby,afve eoasent to t6e Airthotized Repreaeohthro ot t6e Davle Coanty Ha�IW lk�artmeot to enter npon above dacribed property located in Davie Coonty and awned by CYti�'Irr,� �r-f2u � �/�fi to eoadact aU tatin�procedara�u nc�aaary to deterailne t6e dte satbi6Wty. DATE 1a-�3" � � SIGNATIJRE �iD'(it�►� p�..� ����� _ _ . THIS AREA MAY BE U3ED FOR DRAWING YOUR$1TE PLAN(Inclnde sll of the tollorriag: Ezbting and propaecd prnperty Iina and dimensione, stractnres, utbacks, and�eptie locstions). S[h Revbit Charge Date(�)s O� m� Ciieat NoH6caHon Date: EftS: Auwant Na /�� Revised DCHD(07/99) � Involce Na �f �� -_ , _ i —� � ��� ` ` � .:'r, , 559At. ) � _ . , ` \ � / � • •�� . i ,� �;--- --- , �.�� 1 T «_ 's' ,.Ccr . 2 2 0 ��{n� ��'{ � �3 15.59IC.-� . ' 't� � � �'`' ;� �'n7 � • � �"''F' . . � f �., s� -- 21_OI ' ' p'„ �2 3 0 I.IA;: '. ` e i'o�eraa 12 7iAc o S� SEE K' 8 "?V 2492� � . � .. �12AC ) rv _ 45� 3�\ ��, o � 0 � 3� . .. M � ' . . a 5 �.]�"� 25 y � , �r�y � 39301 � �30T{; / � ..' . n - .. . / • � 26 �.�BQC� Z.�7a' � u'a �_ �dr . , v+ - . 23AC. e " t�� b m � m � `��` 'r (2) " �..Y� ' 3 C .� _ T 25_02 $t's � ��6'?A� ii.� ��' 6.55Ac ,-�g p > • zs� � 1(3.83Ac)� ',i�+� � 3) m \i . 92 z r (5.87A 991 y r �6< 'a a � '.� (a� . � . "' 2� ' � � � :� � •, � �' is �snc� � � 29 ss3�� � r�,.- y�5 sei zoese '� ro � m (12Ac.�) 1. A �_ ' 18.7Ac. _. �`�y � � ' Z8 0 „ _ 1901 � sie , _:j� o `sAc. t ,�o o ��� " I AC •"'L �O � ' (tiac. ����� 18 19 ,�`. ' �; � - -,� IAc. 19.4Ac. m 2p � � ( .. � - ,� �-� . o . q s ' .. ' N 534 5 . _ IA C . _ _ _ __—' j ' � o � F�' , I 53B 56 `�-'�C`� I391 �.} . �n , s / '.'`.' . �\ . • � � - i� "r �� 1; 16 ti � � V C ziac. � _ -- . �I _ iaa� 15 _" �_ ' ;' � � '� �\ - 14 3095AC... _ 39Ac. . „` �, �y, I .� � \ y \T C � � 5QC 1 !, 1Z � �' . . ' � � � 2 o '� � 1 . , .N 5;99a • ,. y . �-. ,�.i. ,�v.W Q. � o, 3 '�y 3 �B �, � , �,� `�::� 2.18 Ae. ' a,e. � ^�e m � �o o Q Q ,� �.11 . . �. � .9" �Z ' m . Jl945•l . ' 'q� . . . � � �s ) 8 ¢ T1��- . I N . . . . � �4 : . Q .. � y � 68 � � ,.r' . .3,78Ac �v .�, � . . , � ' oe ;>' - � a� � °J .�,�,�=r �� �� B (42 ac.l � , t. 69i. ..'1 . B• � �7iA � � . . � . o�. ,,.� �' 2.Ac' � � . . . s ss�ac 10.01 . , . , ' �: (2303Ac.J �a• , 1.. 10.49Ac � �•'m m . . ��"• 0 2 C/� _ ia `� g.i,, N N t ,� • � � ( 4 _ _ m - - _ _ 590 Y . . . . d , i�i .'8At - . . w � ' . � . f+ ' nz�� . Lio h� . .�, , � 8i02 729 g`�, ' ♦' �• � � F" .'.�L ` � '. M. 460m � . 1 �I) � , .�. � . 'y��+�o � �� . � � . (16 62.9<) , 1,�' � .. . •r.�� W � . . F.. �":J.. � • , ,. �. .Y^., . • � .��i"�,, � .`� � . , ���..��.,�..+,1�t'3.,'j� . ' ' ' DAVIE COUNTY HEALTH DEPART'MENT , Environmental Health�Section Soil/Site Evaluation �'�; APPLICANT INFORMATION _ ' _ ' ' PROPERTY INFORMATION Account #: 990000902 ' Tax PIN/EH#: 5776-66-8004 . Biiled To: NoRnan Craver � '�; .' Subdivision Info: Reference Name: Norman or Ruby Craver �. Location/Address: Seaford Road 270 6 Proposed Facility: Residence Property Size: 72 Acres Date Evaluated: � D � Water Supply: On-Site Well Community Public Evaluation By: Auger Boring_� Pit Cut - FACTORS 1 2 � 3 - 4 5 6 7 Landsca osition � Slo % HORIZON I DEPTH �!o D- - r Texture rou (� G G • Consistence Swcture C!L Mineralo I". '"1 � I, > HORIZON II DEPTH - 12 � (Z - L Texture rou Consistence - Structure . Mineralo ; i Z� ' HORIZON III DEPTH � - L� �� (0 Texture rou � Consistence � Structure � � Mineralo �� - ( • HORIZON IV DEPTH ♦ � Texture ou �� Consistence Structure Mineralo � SOIL WETNESS RESTRICTIVE HORIZON'� . • SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE �O O. < SITE CLASSIFICATION: � EVALUATION BY: � �c'l-I��-�P LONG-TERM ACCEPTANCE RATE: O✓ OTHER(S)PRESENT: tS�� �ff� 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 tructur SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic 1Vlineralogx 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-gaUday/ft2 DC�ID OS/99(Revised) ■����■���■�■�■�■�■■■■������■■��■■��■■�■��■■��■■��■���■■�����■��■�■ ■�����■■�■■��■��■�■■�■��■■��■�������■�■��■■���■���������■���■■�■■■ ■■BO�i■■■i���■��■O�■�■■�■■�■■������■■■■�■■�������■��■■�■■���■eO■■ ■���������■���■��■�■■■■��■■�■��■ ■�■■■■■�■��■■��■���■��■■��■■��■■ ■����■�■■■■■��s■�ss�■�e�se■�o■■��■■����■■�■■���■��eoea��o■se■���■■ ■�■��■��■■�■�■����■�■��■��■�■����■■����■■�■■�■■■��■��■■■■��■�����■ ■������■�■���■■�■�■��■a�a■■��s■���■■�■��■■■�■ssveo��■■■s��������■■ ■■�■��■■■�■���■�■��■■■■■■����■�■���■���■■■■■�■■■��■�■■■■■�������■■ ■��■������se����■��aa■■�■■■��se■■�■■■��■■�■■�■■■■�■■■o■■o■�a�ee�■■ 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