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723 NC Hwy 801 South Lot 3 Section 2DAVIE .COQNTY HEALTH- DEPARTMENT IMPROVEMENTS PERMIT AND., CERTIFICATE -OF COMPLETION :� NG1TE; Issued in.Compl'iance with G.S. of North Carolina Chapter 130 Article 13c + Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) '' Permit, Number. Name Date Location,, . % t!`'iP Subdivision Name-?'%. �/+'%``-��r' Lot No: — Sec. or Block No. Lot Size House _ L Mobile Home — Business _ Speculation No.. Bedrooms No..Baths _ No. in Family;. — Garbage Disposal , YES ❑ NO -:F:�� ;, 'Specifications for System: � F Auto Dish Washer,. , YES U NO ❑ Auto Wash Machine-: YES ©• NO ❑� jf Type' Water Supply -!' 'a ----- =5, �a I� J 'Th'is permit Void'.if.sewage system described below.is not installed within 36 months from date of- issue. /A J r r � ...�.—.—•L--.SF rte!` - - g - w 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.or 1-:00-1 :30 P..M. on day, of. completion. Telephone Number:.704-634-5985. Final Installation Diagram: (System Installed by�Cs1j//.�°'�. Certificate of Completion.—!`!'/_/ Date {The signing of this certificate shall. indicate that the system described above las been. insfalled in compliance' with . � �`" the -standards set forth .in the above regulation, but .shall in,NO-way betaken as a "guaran'tee•tl at the system will function .1 satisfactorily for any given, period of time; A APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS "P,ERMIT Davie County Health Department Environmental Health Section P. O. Box 665 w` Mocksville, N.C. 27028;` CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. _ Home Phone l' G12 -766 :!�4-5 0 1. Permit Requested By �PnlO lel �, �� /SES _Business Phone /-212 _761 1700 W11 -If - P/7 2. Address 102-3 [,rli//�)&t) KAC•r- CLer�„���,vS,, /.1C 270/2- 3. Property Owner if Different than Above _ Address 4. Permit To: a) Install Alter Repair. b) Privy Conventional Other Type Ground Absorption c) Sub -Division (n1pe_r-4y(,looal141eg Sec. Z7 Lot No. 3 5. System used to serve what type facility: House _ Mobile Home Business Industry Other b) Number of people 2 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions Bed Rooms— Bath Rooms 2 Den w/Closet b) If Business, Industry or Other, State: Number of persons served What type business, eta Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes Z urinals garbage disposal lavatory 2 showers 2 washing machine dishwashersinks 8. a) Type water supply: Public Private Community b) Has the water supply system been approved? Yes_ZNo 9. a) Property Dimensions ! `/ 0 /X 2 0 0 X a b) Land area designated to building site i9b x foo c) Sewage Disposal Contractor 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? AID Whattype? This is to certify that the information is correct to the best of my knowledge. Date Owner Si nature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL ATE AND LOCAL LAWS Allow 5 days for processing Directions to property: DCHD (6-82) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name �%`��'-S Date Address Lot Size F GA(:T()RC ARFA 1 ARFA ? AREA 3 AREA 4 Topography/ Landscape Position S S S S PS PS PS PS U U U U !) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) PS PS PS PS U U U U 1) Soil Structure (12-36 in.) S S S S Clayey Soils PS PS PS PS U U U U Soil Depth (inches) S S S S PS PS PS PS U U U U Soil Drainage: Internal S S S S PS PS PS PS U U U U External S S S S PS PS PS PS U U U i) Restrictive Horizons ') Available Space S PS S PS S PS S PS U U U U !) Other (Specify) S PS S PS S PS S PS U U U U 1) Site Classification U—UNSUITABLE Recommendations/ Comments: S—SUITABLE PS—Provisionally Suitable Described byTitle SITE DIAGRAM Y' Y ek 4 11 �.� A i pie 5#� OP./ 0d," � �ex 17A, 11 e / S DCHD (6.82) Z& -w Date 9'/ J - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name �O7" Date — Address Lot Size FAr:T(1RC ARFA i AREA 7 AREA 3 ARFA A Topography/ Landscape Position S S S S PS PS PS PS U U U U !) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) PS PS PS PS U U U U I) Soil Structure (12-36 in.) S S S S Clayey Soils PS PS PS PS U U U U Soil Depth (inches) S S S S PS PS PS PS U U U U Soil Drainage: Internal S S S S PS PS PS PS U U U U External S S S S PS PS PS PS N U U U U I) Restrfrtive Horizons Available Space S PS S PS S PS S PS U U U U 1) Other (Specify) S PS S PS S PS S PS U U U U I) Site Classification U—UNSUITABLE Recommendations/ Comments: S—SUITABLE 'PS—Provisionally Suitable Described by �� Title —� Date SITE DIAGRAM / i I 1 - -- DCHD (6-82) Lot No. 3 is bounded to the west by a 190 ft. property line that fronts on NC 801 to tt, west and 190 to the east and 200 ft. to the north and south. Examination of a soil boring at the back eastern end of the property indicates that approximately 0.2 ft. of topsoil overlies a reddish -brown, silty clay subsoil that has a moderate to weak, subangular, blocky structure and is slowly permeable. Below a depth of 3 ft., a brown,., gray, and tan silty clay was encountered with obvious drainage mottles as anticipated at the seasonal high water table would probably be at a depth of approximately 36 in. J. below the surface during the wet season. In addition, the front portion of each of s these lots - 3, 4, and'5 - is located in a depression that parallels NC 108. Examina- tion of soil borings on lots 4 and 5 indicates similar conditions of soil and site as those described for lot No. 3; that is, along the back or eastern portion of these lots, the soil is properly classified unsuitable for the installation of the conventional septic tank system. However, with modifications that allow for the shallow depth to slowly permeable soil, these systems should be placed at the back portion of the property at a depth not to exceed 2 ft. below the existing grade and at a loading rate of 0.3 gpd per square foot. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section R O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name Date . Address Lot Si e FAr:Tr1RC AREA 1 ARFA ? AREA 3 AREA 4 Topography/ Landscape Position S S S S PS PS PS PS U U U U !) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) PS PS PS PS U U U U 1) Soil Structure (12-36 in.) S S S S Clayey Soils PS PS PS PS U U U U Soil Depth (inches) S S S S PS PS PS PS U U U U Soil Drainage: Internal S S S S PS PS PS PS U U U U External S S S S • PS PS PS PS U U U U 1) "Restrictive Horizons Available Space S PS S PS S PS S PS U U U U 1) Other (Specify) S PS S PS S PS S PS U U U U 1) Site Classification U—UNSUITABLE Recommendations/ Comments: S—SUITABLE PS Provisionally Suitable _._- — Described by %y Title %'��"'� Datel SITE DIAGRAM DCHD (6-82) Pavie (goon#g Xealt4 cBeyar#men# anb 'Home PCUU � �genrg P,0, BOX 665 ,macksbille, �ar#h Carolina 271128 OFFICE OF THE DIRECTOR TELEPHONE September 10, 1986 „041 634.5985 Mr. Vernon D. Jones 102-3 Willow Trace Clemmons, NC 27102 Mr. Jones: 0n September 8, 1986 this office evaluated lots 3, 4, 5, Section 2 in Greenwood Lakes in order to determine the suitability of installing septic tank systems. All three lots are classified Provisionally Suit- able on the extreme back side if space is available. The house will be limited to 3 bedrooms with the septic system consisting of 500 linear feet of line and possibly a pump if the house is not built up high enough to insure proper ditch depth. If you have any questions, feel free to call. Sincerely, A�y 4-J. Robert B. Hall, Jr. R. S. Environmental Health RBHJR Enclosure