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341 Yadkin Valley Rd Lot 8 E CNHEALTH DEPARTMENT , �/C�YI(' DAMCOUNTY_ M U• IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION _ p *NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a Sanitary Sewage Systems / Permit Number Name �� o (t+`��\e _ Date - y N2 7 4 2 2 Location .� RD Subdivision Name Lot No. Sec. or Bloc Lot Size 3 CSW House Mobile Home —T Business -- Industry No. Bedrooms -.No. Baths No. in Family _ Public Assembly Other Garbage Disposal YES a NO ❑ Specifications for System: Auto Dish Washer YES Ee NO ❑ d O 0 Auto Wash Ma^hive YES p� NO ❑ X t X I► +s Z Type Water Supply Cg 'v tJ� --- *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. u , So ;J Ll ' Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985. Final Installation Diagram: System Installed by � '� 140 v sw ell .._..�— ry `4 Certificate o Completion { Date 5 11-94 'The signing of this certificate shall indicate that the system described above has been installed in 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. t ti APPLICATION FOR SITE EVALUATIONAMPROVEMENTS PERMIT + Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 2 1 1994 n ) [JAN ------------- 1. Application/Permit Requested By 1" `�, Mailing Address �a I b V' Home Phone —99'13- CA40' AS IJL 270 ►'i. Business Phone 1�1 2. Name on Permit if Different than Above 3. Application for: ❑General Evaluation 2rSeptic Tank Installation Permit 4. System to Serve: 2 House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home:Subdivision Nit,,vA �e0 Section Lot # g ❑ Basement/Plumbing No. of People S' ❑ Basement/No Plumbing No. of Bedrooms a Washing Machine No. of Bathrooms 3 11ti p'Dishwasher Dwelling Dimensions -7Q 1 Z X j 0 Q Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No.of People Served No. of Sinks No. of Commodes No.of Urinals No.of Lavatories No.of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: U(Public ❑ Private ❑ Community 8. Property Dimensions 2" X �� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes C"No If yes,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 plans or the intended use change. Effective October 1, 1989. Directions to Property: \ /fid (c�,, J ,�� '� �� , L�f ;S � �•ti;p�/ OL, 1A cli 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 application. la f✓ /'y- 9 y DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BED NE QN ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. EM I DO NOT OWN the property. If you checked Box#2,the rest of this form MUST be completed by the owner or a person authorized by the owner: 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 .3�},. 4 V/ �A;�. � F//i Ile to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD'(1/93) # DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section \ ` ` Soil/Site Evaluation q U NAME �DATE EVALUATED S 1 1 ADDRESS S P � PROPERTY SIZE PROPOSED FACIILTY oy s Q LOCATION OF SITE Water Supply: On-Site Well Community Public Evaluation By:C4�,L Auger Boring ✓ Pit f/ Cut FACTORS 1 2 3 4 Landscape position S s -S Slope z HORIZON I DEPTH h t 6 (o Texture group Q_ L CE L Consistence L IF T Structure �� R Mineralogy HORIZON II DEPTH 7 ' 111 Texture group Consistence S=C Structure 131 Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE -- — CLASSIFICATION S S S LONG-TERM ACCEPTANCE RATE + � SITE CLASSIFICATION: •�• EVALUATED BY: _ a Va+�' LONG-TERM ACCEPTANCE RATE: ` OT R(S) PRESENT: �9 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-Finn 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 Mineralofty 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■e■■e■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■/■■■iii■■■■■!�■I!IR11a�■■■■■■■■■■■■■ is■■■/■■■■■/■■ ■■■■■■■u■■■■■■■■■■■■■er�rw.■■■■■ ■■■a � �■■C■■■■■■■■r�■■t"■■■■■■ ■■■ ■■■■■■■■■■■■■■■/■■■■■■■L�ii911■■■■■�Ciih'ai■■■ ■■■■■■I%■■■li�'tii■■■■■■e■ ONEMONE ■■■■■■■■e■■■■■■■■■■■■■■■■■■■■■�■■■eta•_ :.■■■s�i/i■Cutti:�tla>tf■■■■■s ■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■Illi■■■■■■■■■■■C■■■i■■..■■■■■■■■■■■■■■■■■ ■■■■■■�■■■■■■�■■■■■■�■■■■■■ rte,+-■■■■■■ ■s,■■■ ■■■e■ m■■■■■■ ■■■■■■ ■■■■■■ ■w■■■■ ■w■._:��:a� eti■■■■N■■■■■■ ■■■■■■ ■■■■■■■e■■■■■■■■■■■■■■■■tri■iii■e■■■i■■■■e■■■t.■■e0 om■■■■■■■■■■■■■■ ■■■■■■■■■■e■■■■■■■■■■■■■�f■■■■■■■■■■■■■■■■■■la■■e■e`i■■■■■■■■■■■■■■■ ■■■■■■■■■■/■■■■■/■■■■■■■ti■/■11.■■■■■■■■■■i ■Ita■■■■C lar■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■fal■■■�tafrl■■■■■■■■■e■�■�fa■■■■ ■�\`fi■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■tl■■■moi/C:■R,i7.7/ C■CIS ■� C��m\�CCCCCC: CCCCCCCCCCCCCC�CCCC:.:CI�:CCCiCCy':::C a■■■L�■■ 1`■■C■C\■C■■■■■■■C ■■■■■■■■■■■■■■■■■■■■■■■/fa■■■■■■■�■■■ u■■.I■ ■■ ■■■■ ■■■■■■■■■■■■■■■■■■e■■■■■■e■■■■■■_■■■■_■_■_CC■C■�i C■ Wry■v■■�■■■■■■ ■ ■■■■■■■■■■■e■■■■■■e■■■■fr;�/■■■■■■!.G■■11■■e■■■■■■ems\ ■■Ri►'i ■■■►\■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■�■e■■■eee■ ■■■e 1. ■■■.0 H■■■■■■ ..............■■■■e■■e■■■e■e■■■■e■ ■■■u . ■■■■ �►CCCCCCMENN■■■■ CCCCC■�■■CCCCCCC:■CCN■CCCCCCCC�■CCCCCCNCCCCC= ■■��!■CC C�\CCCCC Emmeline CCCC�CCC:=CCCCCCCCCCCCCCC�CCCCCCCCCC■t:\CCCCCCC:CCCCC ....................................■■■. . ■■■■■�■■i■ ■■■■■lr■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■_■■■■■■■■■■■��■■■■■■■Ci■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■�■■■■■Mea ■■■■■■■■■■■■�■■■■■■■■.■■■ ■■■■■■■■■■/e■■■■■■■■■■/■■e■■■■■■ee■■■■■w■ N■■etu■■■■■1•■■■■■■■\I■■■ C ■■■■■■■■■wi■■■■■■■■■■■■■/iu■■■■e■■■■■■■■ ■■■■ ■■■■■■elll■■ ■■■■■�■■■ ■■■■■■■■�■/e■■■■■■■■■■■■■ ■■■■■■■■■■■■/e■ ■■■■ ■■■■■■■iii■C■■■■■.■■ ■t.■■C■■■■■■■■■■■■■/■■■■■■■■■■■■■�■■w■■e■■■■■■e■■■■■■■i■■■■■■u■■■■ T DAVIE COUNTY HEALTH DEPARTMENT r 0) Environmental Health Section ' R 0. Box 665 11 A�)G /�y►+� Mocksville, N.C. 27028 V SOIL/SITE EVALUATION /! Name,�v�� :i/r-�t�.�r�:�/�- G�?i'.�ro:��- •-Cooe! .- � .ai2uu�✓-- Date Address '? "�3 ' 7 Lot Size �rs�issand /1 e 7-7Id Z FACTORS AREA 1 AREA 2 AREA 3 AREA 4 1) Topography/Landscape Position S PS PS U U U U 2) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) <I (fn PS PS U U U U 3) Soil Structure (12-36 in.) S S S S Clayey Soils em9 <::n> PS PS U U U U 4) Soil Depth (inches) „ S S S S �o cfs> ® PS PS U U U U 5) Soil Drainage: Internal S S S S PS PS U U U U External �S7 A S S PS PS U U U U 6) Restrictive Horizons �Lcu e�`�' p(i.u�z dal 7) Available Space S ` S S S PS PS U U U U 8) Other (Specify) S S _ S S PS PS PS PS U U U U 9) Site Classification U—UNSUITABLE S—SUITABLEPS—Provisionally Suitable Recommendations/Comments: Described by 0'-'CL Title �kn'6 µU'OL Date SITE DIAGRAM vR%tG.N 1233. 1021 5�3s4g• DCHD(6-82) �tti�ie (1�nun#� �ettl#� �e�ttr#men# nub pnme peul#4 '�gencg P. O. BOX 665 deuchsiiille, YvO4 Carolina 27Q28 OFFICE OF THE DIRECTOR TELEPHONE October 29, 1986 (7041 634.5985 Ms. Hazel Armstrong Box 762 Bermuda.Run Advance, NC 27006 Re: Soil/Site Evaluations - Lot #8 Valley View Farms, Davie County Ms. Armstrong: The aforementioned property was evaluated by this office on February 10, 1984. This site consist of approximately 3 acres. This site was classified as provisionally suitable, thus an improvements permit can be issued to install a septic tank system. Whomever will be building on this .site must contact this office and submit an appli- cation for an improvements permit. Please advise should this office be of further assistance concern- ing this matter. Si erely, Jo ndo, R. S. Director Env roonmental Health JM:sg cc: Craig Carter 10-19-90