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136 Princeton Ct Lot 14 • DAVIE COUNTY HEALTH DEPARTMENT . Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001308 Tax PIN/EH#: 5860-81-7398v4 Billed To: William Joyner Builders Subdivision Info: Princeton Court Sect 1 Lot#14 Reference Name: Location/Address: Princeton Court-27006 Proposed Facility: Residence Property Size: see map ATC Number: 2893 **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 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 STTE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms L-? #Baths �5 i Dishwasher: R( Garbage Disposal: ❑ Washing Machine:e Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply�� Design Wastewater Flow(GPD) Site: New e Repair❑ i System Specifications: Tank Size I&V GAL. Pump Tank GAL. Trench Widtlr� Rock Depth -11� Linear Ft 366 Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)-W6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Departm6t for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on t e day of installation. Telephone#is(336)751-8760.**** E-::] Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) ♦ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990001308 Tax PIN/EH#: 5860-81-7398v4 Billed To: William Joyner Builders Subdivision Info: Princeton Court Sect 1 Lot#14 Reference Name: Location/Address: Princeton Court-27006 Proposed Facility: Residence Property Size: see map ATC Number: 2893 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 resented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with, 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS/. Environmental Health Specialist's Signature: Date: G CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Complebeq..shall icate the system described on Improvement/Operation Permit has been installed in compliance with AmtQe 11 G.S. apter 130A,Section.1900"Sewage Treatment and Disposal Systems,"but shall in NO WAY be en ntee that the system will function satisfactorily for any given period of time. i x N 14 � 76N5 LJ4 'Co Fi�Sr 0 lit' He Septic System Installed By: 1 S Environmental Health Specialist's Signature: DCHD 05/99(Revised) DA ON FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC 2001 Davie County Health Department JUN 2 2 EnvironmentaiHealth Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 DAME COUNTY pMRONM COUNTFAETM (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed (� /I , U Contact Person g, Mailing Address Q/+�r-/,S 0�fC,7 ✓' 0/-'W'1&- I Home Phone13-1--Z�'Z/ C!V City/state/ZIP (•YID n5,11/.C . - O) 9 _ Business Phone 336-GP-2- -�1 oL 2. Name on Permit/ATC if Different than Above Mailing Address City/State/zip 3. Application For: ❑ Site Evaluation �rovement Permit/ATC ❑ Both 4. System to Service: 9;1, Ffuse ❑ Mobile Home ❑ Business )❑ Industry ❑ Other 5. If Residence: # People # Bedrooms �S # Bathrooms z � , U Dishwasher O Garbage Disposal thing Machine �#'�ement/Plumbing 4:NBasement/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 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes 94wz 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: !l� -S WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: # 6 96(2 `l Z :Z3 gg VO Property Address: Road Name )0r.�n e L' 1pn 4a T �r�r`D �r n e e City/zip Alva e " If in a Subdivision provide information,as follows: Name: (�{�i v�G L TD h co 61 r Section: _� Block: Lot: � 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) 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 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 rrr Tyr 0/ :A--r to conductall testing procedures as necessary to determine the site suitability. DATE 0/ 2 2 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 Date(s): I Client Notification Date: r EHS: SO Account No. Invoice No. Revised DCHD(07/99) �� CATION-FO TE EVALUATIONAMPROVEMENT PERMIT&ATC r,,)�avie County Health Department LI Environmental Health Section jL 1999 P.O.Box 848 2 Mocksville NC 27028 _l LEWYIRtu I ffAL KaTl1 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. �aT5 '1. NametobeBilled C'1/2A�4 Mailing Address /Q 7u u4./j2 Home Phone :5,4 .w City/State/Zip A Q kl4 N� 4/, C . Z 7 U U G Business Phone :5 �L 2. Name on Permit/ATC if Different than Above Mailing Address -7Arr! &*— City/State/Zip 3. Application For: [Site Evaluation [ ]Improvement Permit&ATC [ J Both 4. System to Serve: P4 House [ ]Mobile Home [ ]Business [ ]Industry [ ]Other 5. If Residence: #People #Bedrooms #Bathrooms [ ]Dishwasher[ ]Garbage Disposal [ ]Washing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing 6. If Business/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 8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes [ ]No If yes,what type? EITHER ,l PLAT OI( SITE PLAN PROPERTY INFORMATION REQUIRED:***IMPORTANT**CA'FL\AT OF THE PROPERTY MUST BE L SUBMITTED WITH THIS APPLICATION. Property Dimensions: �WRITE DIRECTIONS(from Mocksville)TO PROPERTY: Tax Office PIN: #s Sb b - _- _5� [ -11. $ /S S3 S T -7-o Property Address: Road If tame R A L Cit !Zi A .4 arc c N. �'• 7700 ' 1t/v,r� d % C 4 7 City0p .21/ s� L?T� If in Subdivision provide information,as f ll ws: /��c ,� �a n/ �,i �P S ? S .� L; Name: = ' Section: Lot#: /� C(-O�T- - 14 &J AJ t,J m4P 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 to conduct all testing procedures as necessary to determine the site suitability. DATE 7- / Z SIGNATURE Revised DCHD(06-96) THIS AI,'EA AIAIJ 13E USED FOP, L)RAIVINC 110111,' SITE 1'LAN: /f�f4 r F i I a d for regls iry root rhe subdivision plat shorn hereon has C"I'�ftcato of Appt'ova! by the Planningoard B Imply with the County subdivision Regulations, DEPARTMENT OF TRANSPORTATION -- r I on of such variances. It any, os noted In the The Davie Court Planning Bo°rd 1 ann Ino Board and that It has been approved for hereby approved the final plat for the DIVISION OF HIGHWAYS ne otfIce of the Register of Deeds. It Is hereby WoPlawoodSubdaNelon. In PI ar ticok e approval Tor recordation does not Include PROPOSED SUBDIVISIOIN ROAD r.loll and utlllze sanitary facilities nor does It coNSmUcnONSTANDARDS CERTIFICATION fqI for the construction or occupancy of buildings _ Date Choimer. County Plomi^ Board 9 F. i inp Fee PO10 APPROVED -- __ _ DISTRICT ENGINEER- --- y._ o Director, Oovr• County Planning Deportment DATE Parcel 65 .lames Mayhew D.B. 071-392 S 83051'35"E 1548.89' 150.08' 150.08' 150.08' 150.08' "control comers 150.08' I i 150.08' 1 12.18' i 5.04' point P 1 w ILL o n _in aD � � 1 � � I % in . o o - � � o ( 18) poi � �. point Z Z Z 1 O cv Z ?l Q\ 40 ^ Z point 148.69 151100' 150.00' �p 1 point 150.00' 150.00'\ Providence C O Ll r t � 048.69' --- .a 150.00' 85°44'i 5"E 1 ,050.4,' 60 ' public S 85°44'15"E 1050.00' --. f 150.00' t 50.00' F � 15.7.00' C y� 150.00' 15,.0 '= Lo _ / CO in IC� ` I I o IQ I n - fJ PLICATION-FO -O TE EVALUATIONAMPROVEMENT PERMIT&ATC avie County Health Department O Environmental Health Section 2 199 P.O.Box 848 74- Mocksville, NC 27028 "V fXVlRG1J1.1E11TAl 11EALM (704) 634-8760 Ill;Vlf tX'�tf�tTY ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. / 1. Name to be Billed I 4 /Ori 7?S Contact Person L- Mailing Address /Q 7n r.4,4.1 j2/-12 gU c r i?O� Home Phone 171 City/State/Zip 4 Q k 14NST Z 7 0 0 0 Business Phone 5A �tL 2. Name on Permit/ATC if Different than Above 4A�nc� Mailing Address '7/Irr/ L- '- City/State/Zip 3. Application For: [Site Evaluation [ ]Improvement Permit&ATC [ ]Both 4. System to Serve: Pq House [ ]Mobile Home [ ]Business [ ]Industry [ ]Other 5. If Residence: #People #Bedrooms #Bathrooms [ ]Dishwasher[ ]Garbage Disposal [ •]Washing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing 6. If Business/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 8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes [ ]No If yes,what type? EI 111/7 it, .l PL-1I OR SITE PLAN PROPERTY INFORMATION REQUIRED:***IMPORTANT***AFL\1T OF THE PROPERTY MUST BE LL�� } SUBMITTED WITH THIS APPLICATION. Property Dimensions: C �� ��T3 ��"22;WRITE DIRECTIONS(from Mocksville)TO PROPERTY: Tax Office PIN: # 5--66o - - _5f !). S / P S-7 -7-o Property Address: Road game &A L 7�rllu,� City/zip Al• ; 7003 /1/01r4-A y % 04,64.4 7Zret_.. If in Subdivision provide information,as follows � J ,�l c.� ra / G.i S ? S/AD L;"- Ice Name: - ; Section: Lot#: 4,07- t o V.JL;,jJ /V7,4 P 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 to conduct all testing procedures as necessary to determine the site suitability. DATE 7- / Z - SIGNATURE Revised DCHD(06-96) THIS AREA HI411 13E USED FOR L)RA1VINC 110111: SITE PLAN r i '0/0 Filed for reels tv that the subdivision plat shown hereon has C-tV'"Ilte Of Approval by the PtaststiW Board amply with the County Subdivision Regulations, DEPARTMENT OF TRANSPORTATION lien of such variances, It any, as noted In the The r I ann Ino Board and that I t has been a Ma Dade G-mV alon. BoorO 1ir`� °�'D"'d *nd D�for the DIVISION OF HIGHWAYS the office of the Register of Deeds. Ifplsvbar eby Maplewood ��' In Plot ticok 'h. approval for recordation does not Include PROPOSED SUBDIVISIOINROAD stall and utlllze sanitary facilities nor does It CONSMLITIONSTANDARDS CERf1F1GTION �1 for the construction or occupancy of Dvildings Date Chd"on,County Planning Board Filing Fee Pal d APPROVED __ MSTRICT ENGINEER Davie C Director, Ounty Planning Dep Oriment DATE Dy - - L F1 Parcel 65 .lames Mayhew D.B. 071-392 ---- 1 . S 83°51'35"E 1548.89' 1 50.08• 150.08' � 150.08' 150.08' rn"control coer 150.08' i 150.08' i 12.18' • S.04' z W laJ point Li Ln {�� 01 � p) �J � 1 6� 1 i0 _ cr cn I.t ^ i to 1h °O - n a' / // It/ CJ O N O ° O in O .t \ J1j I*i Z O N O N v N p o `- _/ point Z N i S -r N ' 6 n Z - CV ' { Z Z Q nJ ^ point U � 1 148.69' 150.00' 150.00' 150 00' X . ;) t S 1 paint S 8 044'15"E 1048.69' _ 150.00'Pro` I �erCe Court ,050.4,' — 60 ' public 150.0 S 85044'1 5"E 1050.00' --f, � � ZS 0 1�'0 00' 15.0.00' t 50.00' C 150.0 Y 150.00' `G (V x LO n } cc LO 1 LO Ir V / N C..: l LO 1 ° I f1 0 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section • Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account M 989900111 Tax PIN/EH#: 5860-81-3296.14 Billed To: Gray Potts Subdivision Info: Princeton Lot#14 Reference Name: Gray or Betty Potts Location/Address: Baltimore Road-2700 Proposed Facility: Residence Property Size: 144 x 277 Date Evaluated: se,IC� 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% HORIZON I DEPTH O - Texture group `G L, C Consistence Structure L le- Mineralogy HORIZON II DEPTH Texture groupG C Consistence ; Structure k Mineralogy ;1 HORIZON III DEPTH i LP - 2 —?_4 Texture group Consistence Structure L A Mineralogy ` HORIZON IV DEPTH Texture group Consistence Structure k Mineralogy1 SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE S S CLASSIFICATION ( S LONG-TERM ACCEPTANCE RATE O. SITE CLASSIFICATION: S EVALUATION BY: LONG-TERM ACCEPTANCE RATE: 0'3.� 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 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)