Loading...
153 Redmeadow Drive Lot 31DAVIE COUNTY HEALTH DEPARTMENT '. Environmental Health Section ` P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 yJ 3 ✓ (336)751-8760 70 rb O IMPROVEMENT/OPERATION PERMIT Account #: 990003128 Tax PIN/EH #: 5861-38-2199.31VB Billed To: Venable Builders,lnc. Subdivision Info: Redland Place Lot # 31 Reference Name: Location/Address: Redland Road -27006 Proposed Facility: Residence Property Size: see map **Noir-* 4ff{ roi(Bt%t/Operation Permit DOES NOT authorize the construction 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms #Baths Dishwasher: V Garbage Disposal: ❑ Washing Machine: 0?"— Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply L Design Wastewater Flow (GPD) Site: New epair ❑ ���r System Specifications: Tank Size O—OGAL. Pump Tank GAL. Trench Width �� Rock Depth '12-11 Linear Ft.— Other: Required Site Modifications/Conditions: W�RLL ('�� 1�,QrJQ �=�i " D�F�`� ���=1 �l7' fl� ���•U�� IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** C *eeVN1lZ, Olu- at-;Q1)1QC- ill C k u N �t rj��vt Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990003128 Billed To: Venable Builders,lnc. Reference Name: ATC Number: 3729 Tax PIN/EH #: 5861-38-2199.31VB Subdivision Info: Redland Place Lot # 31 Location/Address: Redland Road -27006 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION F/1-1 **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONST IS YALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: 2-, a dgq CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. �o T Septic System Installed By: ZS (M Environmental Health Specialist's Signature : , A /� Date: d DCHD 05/99 (Revised) �. 23 p U ro .(0 N 1 _ n 0 32, 76 S I N Cn 0.752 Acres -f 1.+ --• I M I rTt 10' Public Utilityl 11 _ 95.47' 22 32,520 S 0.747 Ac SCI. � Eose 70 - Sigh t rnent vsement ---�� — 144.68''x, S 79-35'46 to w QRedmeadow Drive AVA N 79'35' 46' E 7 T77710' 80.06' -117.00' - Public Utility EasementJ�� 117.0O' - (50' 00.1 3 z 32 z ,3 z N O O Q, Ute', 30► 38 7 S N 30, 359 N 30,,3;7,3 w N 1.30, 0� w 0.6g q• Ft. • 0.6 Sq. Ft. �' i 0.6 Sq pt Cr) A 0 8 97 .� I 97 41 Ln • � Acres Acre-. Acre �. p. p f s f (� p s � � � 62.48' 46.93' 1. P S. �--- 2()' 44"W V2'00tol) 117.00' 111.0(}' 619 f0i APPLICATION FOR SITE L'VALUATION/IhIP110MIENT V00-11-1- ., ATC 7 Davie County Health Department V Envi�o�ti»enta/Heap/1 Section P.O. Box 848/210 Hospital Strect 11A 2 6 2004 Nocksvillc, NC 27028 (336)751-8760 fa* * Is P i. li=c to be Dilled S APPLICATION CANNOT BL7 BROCESSED UNLESS ALL TILL 1:EQUI1:Lll IDED. Refer to the INFORMATION BULLETIN for insL•ructioii_j. Mailing Address /Q 7 7 x9d , City/State/ZIP Cly lifY,C,,,rC ' v2'7U/ L 2. Ramo on Pcrmit/ATC if Different than Above ConLacL Person .Jyr/U,4 Home Phone�- Duainean Pliouc Mailing Address City/Stale/Zip—__.^_._•.._._, , . ,_ _, _ ,. , 3. Application For: ❑ Site EvaluationImprovement• Pexmit/ATC Ll 1soLli 4. System to Service. ❑ House ❑ Mobile Home ❑ Dusinctn ❑ Industry ❑ Other ti S. Type system requested: Conventional ❑ conventional modified ❑ innovative G. If Residence: I1 People I) Bedrooms II bathroi,in:; 2 Dishwasher ❑Garbage Disposal Washing Machine f Business/Industry /Other: verify type 7. # Commodes # Showers IF FOODSERVICE: 11: Seats ❑BasemenL/Plwnbing ❑Da::cmcnL/llo Plumbing Il People 11 Sinlcn _._. -- # # Urinals # Water Coolers Estimated Water Usage (gallon:, per day) 8. Type of water supply. -• County/City ❑ Well ❑ Conuuuni Ly 9. Do you anticipate additions or expaIlsions of Clic facility this S)'Slclll is 111(elldetl to Serve? ❑ Yes )6o If yes, what type? ***IAIPOR X1Y '*** CLIENTS dIUST COMPLETE•"f11L: nEQUIRED PROPERTY INFORNIATION 1tIsQllliS l'l:l) BELOW. I:itlicra PLAT orSITE PLAN r�ItUoSTBE, SUBMITTED by the elicit with '1'1IIS AIII'LICATION. l Property Dillic11siolls: — ' — —/ �WRITL DIMM IONS (fruni t1•lucksvi to l'ItUI't;lt'1'1': •I•:ia orae PIN: r! s�� /-3 � - �.1 �)..�� Z .� � � e� r� Property Address: Road Naliic� �� • 1`J City/Zip If in a Subdivision provide inforniation, as fullows: n iAIJ Section: Block: Lot: „ � Date lionle co1•liei•s flagged: '2� lC This is to certify that (lie iuforination provided is correct to the best of illy imoilUdge. I uliderslaud that ally pCI•Iuit(s) issued liercafter are subject to suspension or revocation, if the site plans or intelided use change, or if the ilifurniatiuli subtiiitted in this application is falsified or changed. I, also, uiltlelstaud that I aln responsible for all charges hicurr,-d•li•uIII this upplicatiorl. I, liereby, give couscut to the Authorized I1cpresentalive of the Davie County Health Dcp:1i•UuL•nl to ciiter upon above described pruperty located ill Davie County aad owned by to cuuduct all testing procedures as IICccssary to detcrlllinc the site suitability. / DXIT — 0 SIGNATURE X h! TIiIS AREA MAY BE, USED FOR DRAWING YOUR SITZ; FLAN (Inclu Il of the fulloiving: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). sign given Revised DCIID (05/03 Site Revisit Charge Datc(s): Cliclit Notification Date: EIIS: Account No. V0-7 Invoice No. APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department EnvirollmentaiHealth Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 D DtE fNV�RONM oAV/ECO(�Nn�CTy ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIR�.'9` /I INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed ! e V Contact Person / n�>G1f ��d I Mailing Address D Home Phone r City/State/ZIP ��Business Phone �- %L13 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: I-Saate Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms ..i # Bathrooms 1:11 Dishwasher ❑Garbage Disposal G Washing Machine Basement/Plumbing CI Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ®-Gounty/City ❑ Well ❑ Community o. Do you anticipate additions or expansions of the facility this system is intended to serve? EHWs ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Tax Office PIN: # .3gr o2 Property Address: Road Name L i �_ City/Zip If in a Subdivision provide information, as follows: WRITE DIRECTIONS (from Mocksville) to PROPERTY: Name: Section: Block: Lot: T 3 Date Property Flagged: /�2 ^73" e!9 -�-- 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 is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 1, 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 '9�l to conduct all testing procedures as necessary to determine the site suitapility. 007000 110RIEM THIS AREA MAYBE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. Revised DCHD (07/99) Invoice No. • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900136 Tax PIN/EH #: 5861-38-2199.33 Billed To: Westview Development Co. Subdivision Info: Louise Smith Adams Lot # 33 Reference Name: Location/Address: Redland Road -2700 Proposed Facility: Residence Property Size: see map Date Evaluated: 12 V O Water Supply: On -Site Well Evaluation By: Auger Boring Pit Community Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % L4 k*7_30 HORIZON I DEPTH -Texture rouConsistenceStructure Mineralo HORIZON II DEPTH 3 Texture group Consistence ; S Structure G Mineralogy1 ' HORIZON III DEPTH 23 Texture group1 C2 Consistence rl Q Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE 'tom_SC71Ak. CLASSIFICATION LONG-TERM ACCEPTANCE RATE 5 SITE CLASSIFICATION: 1/S LONG-TERM ACCEPTANCE RATE: (--)-'T REMARKS: LEGEND Landscape Position EVALUATIONSY: S: ►?K -+Atgo OTHER(S) PRESENT: 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 Mois � 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 05/99 (Revised)