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191 Carolina Avenue Lot 11-12DAVIIE COUNTY HEALTH DEPARTMENT •--; = IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'NOTE: Issued in Compliance With Article 11 of G.S. Cha ter 130a , Sanitary Sewage Systems �o�u�-O.fpoSOi f I Jam-- Permit Number Name Ns i 6 4. Location P Y .` i� C r>ioGr/Oo/1S T PA��1 K' Pm a eve SubdiviisionName bDOo Lot No. 11- IZ Sec. or Block No. Lot Size House — f� Mobile Home — Business -- Industry No. Bedrooms ..No. Baths —.2-- No. in Family_ PubllcAssembly Other Garbage Disposal YES ❑ NO Q Specifications for System:j Auto DishWasher YES NO ❑ Auto Wash Ma:hine YES (� NOD Type Water 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. r- M Improvements permit by f '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. r , Final Installation Diagram: Installed by, `41' FAv r. it F Certificate of Completion 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. n,� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 S-1.9 mer- 1. Application/Permit Requested By Z474pl J al Mailing Address 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve: ❑ Business ❑ General Evaluation 2louse ❑ Industry 5. If house, mobile home: Subdivision No. of People No. of Bedrooms No. of Bathrooms Dwelling Dimensions Home Business Phone Er-s-eeptic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures - 7. Type of water supply: �blic ❑ Private 8. Property Dimensions 'e!9C Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ BasementtNo Plumbing 0 Washing Machine bDishwasher ❑ Garbage Disposal ❑ Yes 'BNo ❑ Community 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: This is to certify that the information provided is correct to the best of my knowledge, and I underst d I am re onsible for all charges incurred from this application. j JV DATE SI ,NRF CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 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 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'(1193) �t/ los A , ►� /ID VIE COUNTY HEALTH. DEPARTMENT Environmental Health Section Soil/Site Evaluation. Si91J DATE EVALUATED, ADDRESS PROPERTY C21SIZE enc PROPOSED FACIILTYLOCATION OF SITE Water Supply: On -Site Well / Community - Public, " Evaluation By: Auger Boringy Pit Cut FACTORS 1 2 3 4 Landscape position 41 41 'A, ' Sloe Z - HORIZON I DEPTH I Texture group Consistence Structure Mineralogy HORIZON II DEPTH " Texture group 0C C Consistence i Structure �� X Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure. Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION77t)7 V3 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: EVALUATEDBY: /&,;It & 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-Vcry friable FR -Friable- - FI -Finn - VFI-Very firm EFI-Extremely firm Wet NS -Non sticky SS -Slightly sticky S -Sticky VS -Very Sticky. - NP -Nonplastic 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 Dam? County Aealtl Department and Nake Yfealllf gyency, '210 HOSPITAL STREET I P.O. BO% 665 MOCRSVILLE. N.C. 27028 - PHONEI(704)634.5985 - August 25, . 1993 Joan Cartner c/o Swioegood-Wall & Assoc. . 300 S. Main St. Mockeville, HC 27028 Res 2 Site Evaluations Carovoods/Lots 11 & 12 Dear Mrs. Cartner: On August 20 and again on August 23, this office evaluated two lots 11 and 12 in the Carawoods subdivision in Davie County. Due to the soil conditions each lot is classified unsuitable for the installation of a septic tank system. However, there is an area of provisionally suitable soil that borders the back middle portion of these lots. If the two lots are combined, a permit could be issued for one dwelling. . If you have question, feel free to call. Sincerely, l Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd J i i Enclosure i ccsJoan Cartner P' 0. Box 403 Davidson, HC 28036 l DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION___/__LOT_Z,2 Soil/Site Evaluation APPLICANT'S NAME DATEEVALUATED PROPOSED FACILITY PROPERTY SIZE y 1*4 G SUBDIVISION ROAD NAME Water Supply: On -Site Well $ Community Public ti Evaluation By: Auger Boring - Pit S i Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group e4G Consistence Structure / /G Mineralogy / HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure . Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE . SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: �(01-90) EVALUATION BY: ��4/Z OTHER(S) PRESENT: GEND 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 tructure 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) LIAR - Long -terns acceptance rate - gal/day/ft2