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120 Haywood Dr 1,20 wkgVJ00b DAVIE COUNTY HEALTH DEPARTMENT I ()U IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION#,V, 3 ti *NOTE:issued in Compliance With Article Il of G.S.Chapter 130a Sanitary Sewage Systems — Permit Number Name L. F•ti\ �. �� ?_ Date t� jN2 5944 Location 0 1. �� './ �_ �\_I«'ti �� ��_ ��` G��1. ~\�•. < Wil:"s r c� \\, _i ;e�r... n.. ��� ��i,, _. ., Subdivision Name \� �` V \, « F ��-^ Lot No. Sec. or Block No. Lot Size r._s_ c.r House Mobile Home _ Business Speculation No. Bedrooms No. Baths 2- No. in Family _ Garbage Disposal YES p•/ NO ❑ Specifications for stem: Auto Dish Washer YES pV NO ❑ Auto Wash-Machine YES p.,'NO ❑ o Type Wai a Supply *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. -3b �U J a ovements permit by' �� *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 day of completion. Telephope Number: 704-634-5985. Final Installation Diagram: System installed by �a/rs1a0/(/ by A%lQ�T/� -a -= Certificate of Completion }->w `� Date ` *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. i APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section Ap� 1p 1990P. O. Box 665 RECEIVE Mockaville, NC 27028 1 . Application/Permit Requested By e Mailing Address ._c '7 A-a)0 e �• ZOD,( Home Phone QqA -177)61-e) Business Phone 2. Name on Permit if Different than Above 3. Property Owner if Different than Above 4. Application/Permit For: 0 General Evaluation S/Tank Installation 5. System to Serve: House u Mobile Home 0 Business Industry u Other 0 Unknown 6.. If house, mobile home: Subdivision Sec. Lot# � No. of People Dwelling Dimensions :�Z �AD ae$ No. of Bedrooms 4Basement/Plumbing No. of Bathrooms Basement/No Plumbing Washing Machine Dishwasher X Garbage D:isposai 7. If business, industry, other: Specify type el No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers 8. Type of water supply: X Public 0 Private 0 Community 9. Property Dimensions 10. Sewage Disposal Contractor 11 . Do you anticipate additions/expansions of the facility this system is intended to serve? 0 Yes No If yea, what type? *NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plane or the intended use . change. Effective October 1, 1989. This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this appl ation. t Date Signature b erections to P operty : DCHD (10-89) DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation NAME s.�u-c �� 9A DATE EVALUATED ADDRESS 2, 1 �� �y�ac� PROPERTY SIZE_ PROPOSED FACIILTY LOCATION OF SITE __ Hs�+•� �`F. �1��G�`� v�9 Water Supply: On-Site Well Community Public Evaluation By:C.�t_1_AugerBoring Pit Cut FACTORS 1 1 2 3 4 'Landscape position Sloe Z HORIZON I DEPTH Texture group Consistence Fe Structure 6 '� Mineralogy + ' 1 HORIZON II DEPTH y0 '� ` ' �� 2 Texture group C C C Consistence IPT Structure G ' C C Ce- Mineralogy /y d 1 ► 4 1 1 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS S5 5S SS RESTRICTIVE HORIZON ' AA SAPROLITE CLASSIFICATION S S LONG-TERM ACCEPTANCE RAT '1777 1 SITE CLASSIFICATION: EVALUATED BY: c ' LONG-TERM ACCEPTANCE RATE: 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(01-901 ■■■■■■■■■■■■■■■■■.■■■■■.■■..■■■.■■■NOON■■■e.■■■■e■■■■■■■■■■■■■■■■■ .........■........................................................ ■■■■....■..............s...■■■■.■■_...■■t.■■Ont.■.■.■t...■..t..t■ ■■■■■■■H■■■■.■■■O■■Ne.■■■■■■■■■�■NOON■O.■■■■.■■■t■O■E■■■■■■■�■■E UNNOMME EMEMEM MEMEME MENNEN MENNENMOMMEMMENNENMENNEN MENNEN_:::::::::::C:C::C::C ■■■■eN■■.■■N■.■■■■■■■■.■■.■■■■■■�■.■■.■■■■■■■■.■■■■ NONE ■■■■■■■ ■■■■■■■■■■............■e.■■O■■■.e■■■..■.....■■.....■■■.■■.■■e NOON iiiiiiiiiiiiiiiiiiiiiiiii�iiiiiiioi�iiisiiiiiil�ii=iii■eii�iieivi�i ■■■■■.■■■.■■■■■■■■■■■■■■■.■■■■■.■■■■■■....n....■ ■■■■EMEND■■■.■■■ ■O■E■■EM■E■ ■■.■.■■■.■t■■■■■■■■■...■t■■.E...■■■■i■ ■...E..IIa■..t■■ ■..■■■■■■.■■...■■..■■■■■■■■■■■■■■t■NOON■N■■■■■■■■II■■■■■N■N■■■■■■■ ..■.............................�..■■■■.E■■■■■■Nil■............■.. ■NOON■■■■■■.e.■■■■.■■■.■■■■■■■■■ ■■■■■■■■■■■■■■e��■N■■■■■■s■.■■■.■ s Iii, v ' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT 'S�' Davie County Health Department Environmental Health Section _ pEC Z g P. O. Box 665 (C GCE \ Mocksville, N.C. 27028 is,TRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone g o 1. Permit Re nested Bye_ R x Z ,7 r r c f" 4 D (Z�Business Phone 2. Address y ' -6-12 � 1 �6 � !� d t/ � .J a .e. .✓• G _ � -?c c � 3. Property Owner if Different than Above [.J ,*el h Address 4. Permit To. In 'Alter Repair b) Privy Conventional Other Type Ground Absorption c) Sub-Division Sec. Lot NoZ_Z_7 (r1' 5. System used to serve what type facility ouse M�ome Business IndustryOther b) Number of people 6. ay If house or mobile home, state size of home and number of rooms. House Dimensions,3,g X ss Bed Rooms_Bath Rooms 3 �5- Den w/Closet e::�— b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Number and type of water-using fixtures: commodes !!k urinals garbage disposal lavatory showers -3 washing machine dishwasher sinks I 8. a) Type water supply: ubli Private Clnmmunitt b) Has the water supply system been approved?(Yes No 9. a) Property Dimensions gg - 3'., 4 X Yd o ,> 14c b) Land area designated to building site // c) Sewage Disposal Contractor r y .7 N 5 s & S-c P,f I C- \� - 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? " What type? This is to certify that the information is correct to the best of my knowledge. Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: jQ' DCHD(6-82) i DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name r^ - A- Date Address A M ^?- Lot Size 3 FACTORS AREC) AREC)2 AREA 3 AREA 4 1) Topography/Landscape Position S S S S © PS PS U 17 U U 2) Soil Texture (12-36 in.) Sandy, S S Loamy, Clayey, (note 2:1 Clay) P PS PS PS U U U 3) Soil Structure (12-36 in.) S S Clayey SoilsLPA PS PS U U U U 4) Soil Depth (inches) S S pS �PSPS PS `ITJ U U 5) Soil Drainage: Internal S S S S iF� PS PS U U External S S S PS PS PS U U U 6) Restrictive Horizons 7) Available Space S S S S PS PS PS U U U U 8) Other (Specify) S S S S PS PS PS PS U U U U 9) Site Classification S U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: Described by ` Title Date SITE DIAGRAM DCHD(6.82) Faure County .�lealt!i Dye and .� e Nealtfi yency 210 HOSPITAL STREET I P.O.BOX 885 MOCKSVILLE.N.C. 27028 PHONE:(704)634-5985 i January 4, 1989 Craig Carter Rt. 6, Box 100 Advance, NC 27006 Re: Site Evaluation Valley View Farms Corner of Yadkin Valley Road and Haywood Drive Dear Mr. Carter: On January 3, 1989, as you requested a representative from this office visited the above mentioned site. The soil was found provisionally suitable for the installation of a ground absorption sewage system. If you have any questions, please feel free to contact this office. Sincerely, Charles E. Little, R.S. Environmental Health Section CL/wd Enclosure