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143 Timber Creek Road Lot 6Dirgctions to property: - L/1' '� Section: Lot: AUTHORIZATION FOR ' `Y`. WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:# M Z Z�6 Ap ZOdZ Road Name: : **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article l I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) / ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRON HEALTH SPECIALIST DATE ISSUED L_ 0 AS Seo - ►bri AUTHORIZATION NO: 0931 DAVIE COUNTY HEALTH DEPARTMENT p Environmental Health Section PROPERTY INFORMATION Permittee's P.O. Box 848 .--;- Name: Mocksville, NC 27028 Subdivision Na qr • Phone #: 704-634-8760��" Dirgctions to property: - L/1' '� Section: Lot: AUTHORIZATION FOR ' `Y`. WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:# M Z Z�6 Ap ZOdZ Road Name: : **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article l I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) / ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRON HEALTH SPECIALIST DATE ISSUED L_ bj r, ` •f 3' r, C{ DAVIE COUNTY HEALTH DEPARTMENT Y� IMPROVEMENT AND OPERATION PERMITS ,Permittee -s Name:1'� ': 4v, Directions�to property: IMPROVEMENT PERMIT PROPERTY INFORMATION Subdivision q- r,-�r� Section: .�.f,, Lot: Tax Office PIN:#.�� Road Name• 1: l j r{ �7114' Zip; **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE 3 # BEDROOMS ? # BATHS P # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No J'I LOT SIZE TYPE WATER SUPPLY ( c:' DESIGN WASTEWATER FLOW (GPD) ? e� NEW SITE Lf REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE /DDG GAL. PUMP TANK%l9d t7 GAL. TRENCH WIDTH '� 1al ROCK DEPTH /--? LINEAR FT. " REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT l , **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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT noa reew- ) BY: D AUTHORIZATION NO.�L► 1_ OPERATION PERMIT BY: (1-C�W3�tA (\.)�N"�l DATE: / **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE T14AT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCI(D 05/96 (Revised) 1.V. LVA VTV MOckSVill6; NC 27028 (704) 634-8760 } I ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL 4 THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed 1 Contact Person %C/G Mailing AddressHome Phone }' C« c'^.e/Zip Business'Phone_��f 7oC•'%�. 2. Name c 'r.,mit/ATC if.Different than Above Mailing Ad6ress Z City/State/Zip 3. Application For: [ ite Evaluation [ ] Improvement Permit & ATC [ ] Both System to Serve: [G House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other " 5'. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] Garbage Disposal Washing Machine [ ] Basement/Plumbing [ ] Basement/N6'Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes } # Showers # Urinals # Water Coolers If Fo6dservi.e: # Seats Estimated Water Usage (gallons per day) 7. Type'of water supply: [ounty/City. . [ ] Well [ ] Community; 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes 1pro i If yes, what type? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** XT-UMOF THE PROPERTY MUST BE y SUBMITTED WITH , 6hS APPLICATION. Property Dimensions: 1WRITE DIRECTIONS (fromocksville) TO PL'OP ERTY Tax Office PIN: # Property Address: ' Road ame z�./ efA 1 City/Zip /Z /Jt/Ia�1C� .. 7do 6 21 3 ✓P t g If in S1< :ivision provide information, as follows: Name: , Section:__ Lot #: ''-7- 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 ys 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 / //Cl 0=14 el -'9 Zp/e/ Alk-- t uct all t ting ce ures as necessary to determine the site suitabi'ity. r DATE— SIGNATURE Revised ATESIGNATURERevised DCHD (06-96) ' .,THIS AREA MAY $E USEI) FOR DRAWING YOUR SITE PLAN: ,ccc� preo�o srce.1"�Z4�.1. Davie County Heafth Department and.Come Health agency 2nvironmenta( ealth Section P.O. 80X 848 / 210 HOSPITAL STREET COURIER #09-4-06 MOCKSVILLE, N.C. 27028 PHONE: (704) 634-8760 May 22, 1997 F Dick Anderson Construction 225 Wing Haven Lane Mocksville, NC 27028 Re: Timber Creek II/Lot.6 Dear Mr. Anderson: This letter is regarding Lot 6, Section II of the Timber Creek subdivision in Davie County. After further evaluation and increased lot size this office classifies this lot provisionally suitable for an oversized, modified septic tank system. If you have questions, feel free to call this office. Sincerely, Robert S. Hall, Jr., R.S. Environmental Health Section RH/xd cc: Zoning Office Davie County .health Department and dome Health Agency Environmenta(Heafth Section P.O. Box 848 / 210 HOSPITAL STREET COURIER #09-40-06 MOCKSVILLE, M.C. 27028 PHONE: (704) 634-8760 Dick Anderson Construction 225 Wing Haven Lane Mocksville, NC 27028 February 27, 1997 SCG Re: Timber Creekf/Lot 6 Dear Mr. Anderson: , I This letter is to confirm our conversation on February 27, 1997, regarding lot 6 in the proposed Timber Creek subdivision in Davie County. Upon closer review this office feels that there is insufficient soil depth to install a conventional septic tank system; however, a low pressure pipe system or sand filter system may be an alternative. I have requested our regional soil scientist to assist me in making this determination. He is scheduled to be at our office on March 17, 1997. If you have questions or I can be of further assistance, feel free to call. Sincerely, /)6'W' ?�glq k,5 - Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd cc: Jesse Boyce, Zoning Officer DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME f!✓9'�DATEEVALUATED /ct PROPOSED FACILITY 1-1 PROPERTY SIZE It, , 'v SUBDIVISION ROAD NAME e O ' e2 Water Supply: Evaluation By: On -Site Well Auger Boring Community Pit Public 6i Cut FACTORS 1 2 3 4 5 6 7 Landscape position Z__L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 119,0 Texture group Consistence - Structure /71 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: P ? EVALUATION BY: I ZZ LONG-TERM ACCEPTANCE RATE: l OTHER(S) PRESENT: REMARKS: zoYG.t/ e-yLEGEND 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 (01-90) ■ ■ ■■ ■■MBE■ ■■■■■■ ■E■■E■ ■E■■E■ ■■MB■■ ■■MB■■ ■■MB■■ ■■RVE■ ■ONFO■ ■AYINKri ■■r■■:: ■■MMM ■■M■■■ ■■■■■■ ■■■■■■ ■ ■ ■E■R■■ ■■■R■■ ■■■■■■ ■■■■■■ FARNE■■ '►AGM■■ ■ ■ ■ ■ ■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■■■EEM■■■■■ME■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■ ■ ■ AL WORIZATION NO: Q 9 31 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Permittee's 'P.O. Box 848 Name: �A�/ ,9Vet2 v9-2 ! Mocksville, NC 27028 Phone #: 704-634-8760 Duqctions to property: %�� � ; " f;, /' �'` r/- AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION PROPERTY INFORMATION Subdivision N�arr Section: Lzzr Lot: Tax Office PIN,:# �Y^ r Road Name: !' J t 1A,� Z fiy **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED f RESIDENTIAL SPECIFICATION; BUII:DING TYPE / # BEDROOMS `,sem # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or Nc COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or N, LOT SIZE TYPE WATER SUPPLY !f DESIGN WASTEWATER FLOW (GPD)': ` t NEW SITE 1'' REPAIR SITE ' SYSTEM SPECIFICATIONS: TANK SIZE °�I'r"� /GAL. PUMP TANKL10 4 GAL. TRENCH WIDTH 7 ROCK DEPTH a LINEAR FI. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT "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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT f «(+ re SYS M INSTALLED BY: D c�iw,SL, aA�M_, i iLn l `�1,� ' ��T-�1�� DATE: / no 1 ! AUTHORIZATION NO. OPERATION PERMIT BY: i "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised)