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109 South High Field Road Lot 30DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ' P. O. Bog 848/210 Hospital Street 3 Y -7/ Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001412 Tax PIN/EH #: 5870-69-0403.30 Billed To: Tim Huff Builders Subdivision Info: Windemere Fams Sec 2 Lot # 30 Reference Name: Location/Address: Beauchamp Road -27006 Proposed Facility: Residence Property Size: see map ** OTTE( N,=b9r: 2578 N E isimprovement/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 N 005--C #People 2 #Bedrooms 3 #Baths Dishwasher: 9]�Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: 0'- Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size G •9 ('\ Type Water SupplyCCLX)W Design Wastewater Flow (GPD) Site: New M ----Repair ❑ System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width-;�e �' Rock Depth 148" Linear Ft. 0-80-1 Other: ST e . 1r-\--SV-&.U- L-t.3es TZ> -e.. Required Site Modifications/Conditions: l t-�ALA- &3 Co.J (Z -�4 to, ap f e0p L -t ai: • t Jh 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.**** ti Environmental Health Specialist's Signature: DCHD 05/99 (Revised) /1$`00 Lig--5�5. tnkvsT 1% 1a V4 s -t 9A1- so��i tzo FlI.L. G c- - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001412 Tax PIN/EH #: 5870-69-0403.30 Billed To: Tim Huff Builders Subdivision Info: Windemere Fams Sec 2 Lot # 30 Reference Name: Location/Address: Beauchamp Road -27006 Proposed Facility: Residence Property Size: see map ATC Number: 2578 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **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 WASTEWA ON IS V D FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: 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. (A4- 5�, I ah -A zs O JSP FR.�o�T Septic System Installed By: nFJ 1&&j Environmental Health Specialist's Signature: 7::�ate: DCHD 05/99 (Revised) • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT 990001412 5870-69-0403.30 Tim Huff Builders Windemere Fams Sec 2 Lot # 30 Beauchamp Road -27006 Proposed Facilitv: Residence Property Siz see map tjr; �11mb-r: 2578 **NOTE** This rmprovement/Operation Permit DOES NOT authorize the construction of aseptic 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 l 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. r Residential Specification: Building Type#People #Bedrooms #Baths 0 .�.� Dishwasher: Z/ Garbage Disposal: ❑ Washing Machine: V Basement w/Plumbing: Basement/No Plumbing: ❑ Commercial Specification: Facility Type#People #People/Shift #Seats Industrial Waste: " ❑ Lot Size 0. %ype Water Suppl}l.D // t7Aw Design Wastewater Flow (GPD) Site: New M/ Repair ❑ System Specifications: Tank Size ICCO GAL. Pump Tank I OCCGAL. Trench Width a.*' Rock Depth hs Linear Ft. 250- Other: 4 Required Site Modifications/Conditions: "-XST t STe,.3yn-o ��x�s, --r4u, u, o-, 9 0.e , Ni►S. DA- - tNi cly-iTAt K, tx—�t" rx or. L't-4:�. r— I o c M V --A6 LLQaAf, k 4 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 psf 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.**** —a r P�, RIGA FIGS Qo4� Environmental Health Specialist's DCHD 05/99 (Revised) %►�T2M.�o-sem Date: qkVol) ••E,•LrN 0E'A,m[Er[• C�1.401 AC. z [ , < e 1.187 AC. T - 40 C1 CJ w •l0• f. N 47.36'43' Y C E _ 46 s+ C .3 _1 e• -9 0.947 AC. t 0.739 AC. 37.73 m `J4 N 2)•J3. N 207.41 v o r! ea W3 �_ - 37 Z I T 94.16'04* y tOTAI. 234.57 �• 14464'263' E Z _ : v N '30'37• V 67.00 167.577 C� s •� �` r 1 0.89AC. - ti __.r�:, 45_ _ to s" . 50.. - 26 8- W -• = 86.31.01• C g Z . ' ' r - - ?(� 21c oo E o` - "�° 4 % 8 n �: 0.892 AC. .�• "L m 1.124 AC. ryr ;.. 1.282 AC. _ c N 0.889 AC. = f 6a _ R/ /S - e! 8 cU" u `o• al's ° r r r, 1C c2 � 8 3 6 210.00 = b•' X536 9 7i. � � - _ . _ _ _ _ _ 8 M 1q. ' _ W N 66'30'37• Y Z $: 'O : -/ _ _ C4 _ - 340.70' C5 0.689 AC. Y S n -- 116.44 T07 •L. x6219 S 66'22.36' V 8 .. ,.. ;.,,. ca Z 2 8 42 44 ' �p2 HIGH' MEADOWS ROAD ------------- cce7 S 96• •0 • E c� a e ,06 a 43 W 0.672 AC. C�� TOTAL' 462.19 N 86'22'39• E - - co 0.689 AC. b _ _ 124. oa_ _ c10 21 a DO R H z _ 0.735 AC. _ — 1 J -120.00-- Ctt „"'.�a 5[+ e:ors - f�i 8 121 '1 Z•' C1 - - .. 166.24- C12 35---- — _ - z•' ar [:_^ 8 , TOTAL. 337.26 cf7 _ - 0.689 AC. = a N 96 ]p37• v c1• nLy ZT• ;•JE•• a cc;: IS 20' PAVED-PUSUC ` r 24 23 tt kI 22 c20 _ - T 21000 _ ��•192.26- - __ ._ S �• 37• E - _ V / N ^ 0.829 AC. V $ 0.778 AC. rti Ln, C22 12400 - C2 n Q 2i � W % - . 22 Q e ^ N :. .[ 27 m34 71r a - 29 1.702 AC. ^ f • 0.691 AC. z ��� - 30 ^ 0.842 AC. 8 �J e 8 80*53'40 E ¢ •��. 0.960 AC. z s J o r r ��}y0� 121,47 A 2.3 31 `� N :--1 �➢ ��? o�, :/ A `O ` / / 21:0 00 s7 77.34' 4 , -( s 7 ? l070/ rr rr �p" �� / / GIMP — — O 31 / KE ( 10 0.3 28 AC. Es O e 2:2 / �U / 1.777 AC. :.•`/rr 3 1 = sir / �•� t1F'� / / CL 32 = e� ` o^'.. 0.706 AC. s 0.808 AC. .\ _ + rr ° / / 3fl' tF�/ z C6p ' /` C) t 33227 ss --�- __'••=[ ar_r._, 'ifdd� rr / /'��a 0� r r_^[...>.. -'•:•,� -- a 1 0.00 •. r - •ti / Gi, s ..�cc ..o.,, ' 260. ] j, ,._. ... . TOTAL' 876.79 N 97.03.09• v In 99 ' LAWRENCE L. MOCK —./ , / -- ; s — ^. !^[ ..1• ^o ��j % j� BY WILL / vy 5L•erwrwE q;a .0 REF;Og. 55 I i 1 1 1 .B. 69 P i }� 10 S.—, STREET ADDRESS L .. -.-+ .r]' ole ••7 •1 sa< Q101 A[ • .. • •_r !.)° •^[.O .• ♦r.a /I 4 �r,�, I ° .. [ C[ • ' L�..Ir A]I!r l.<[r - _�A�L°ir�l^E?r+'•i2c-_. :^ s- ..-.. ... .r[ • .. "b"'[ ^ L' �'.r.�.nn,f ,•as { --/-/Y.-W =>�-'Te: �' -!�! -fir •ca. v < r c N n,cl r c , i•fso [ n cl]nnres •-• o r [ I_ 4 ,.,... _n f••] ..:wa. Com.• `�(�••/f •a> .r. - r _ r - ,[. T s a ! o c• 'n'e•a•cv-c / ••yP,y: r[•..rAq y -/• '-'S - A> 4.0 OEr. r -F. PARCEL n > .•.r .wit"Jay w•, r :[P 'CAIE e• ._a �:.r[.S�ss•r�s .. errr....°,•. ,��,°...,°. mw �n .. .- .p ,.,4 e.e.e ••r ,.•. .....`�s�,:...��.r • w° .n„nl. ene•e m .. °;;' •e: . _... ._ ---__ -� . .. •,...,r(e[°>li[:rYM 2 r IO A .. _ .. • . NCI VE PE 01[81 y .tn<•, r• A D°,.• nr , Cep, /yn/�/4[/•//4j7/1�_�I� —• - n IM Q°••...t..;°t /!e ,. 100 0,9 —_ .. ..:t _. �_._._ -- ��_ --_ -.:•E C^'JY, J.••Ak a^. 7• ',�/. n^Ci!•".i/ _ .._ _..r.•.' u. 'r'V,. P-•nl..r -• c. wl.i- _ .t.a ^ °•^r ••l>Ir ,I ,•... V u _ 212 X" � v + 265 w 32 ZX• � 42 /46 24 E1 20 21140 74 j' , n l ' a iia tt 'E` •. / 25e 2s937- Zp 2 7 i� 5 z5 24 1981 +1 •+W 'l -W 31 210 \G, 4i 44 193 ; �a215 + a 2.10' 1 4 .� _ p . � 244 _ 16 2.16 of 0 �+ 3V + n X `' 203 2�2 210' 42 r 11N� I ( 43 111 195 196 � 79 Y 41 42 _ v 1 ) 201 2 1198 197 I. * 217 \��� 103 - + + 67 �J 09 23 2 / L18 + 0 LI �A Af1 jR . ; •�1�_ 2VR 90 5 r : a 208 0 \i 219 229 224 / 68 t %D - 8 225 07 I$ ,' �� ' 81 �v 43 .I" � � 101 + / 34 227 2 'a 32 2 � 22 3 �' 9 51 LARGE PINE 46.97 N 0103'09' W ?_1 1 0' 54 5 STUMP } DAME COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation /PLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brant Godfrey Proposed Facility: Residence Property Size: Water Supply: Evaluation By: PROPERTY INFORMATION Tax PIN/EH #: 5870-69-0403.32 Subdivision Info: Windemere Farms Sec.2 Lot # 32 Location/Address: Beauchamp Road -27006 See Map Date Evaluated: U l9 h9�_ On -Site Well Community Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position C L Slope % Z- HORIZON I DEPTH 6— i v Texture group CL_ Consistence - Structure G2 Mineralogyl ; HORIZON II DEPTH `! . I X - 3 Texture group Consistence ` 5 Structure SS Mineralogy' HORIZON III DEPTH Texture group C t - Consistence Structure Qj- Mineralogy ; HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: PS EVALUATION BY: 2/ • LONG-TERM ACCEPTANCE RATE: U' J� 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 - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm Wet NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky APPUCATION FOR SITE EVAUTATION/IMPROVEMEW PERMIT Davie County Health Department Environmental Health Sec on P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 /lilW✓ jZJ,'tw ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed ( %-r- <r 4W Contact Person 7,--,m 6J a- - Mailing Address oci3lJ rt S i" , �7 R Home Phone City/state/ZIP t✓i���-Tt7w/N �-�D 7" Business Phone LAW �$__ O 16 b -Pp 2. Name on Permit/ATC i! Different than Above Nailing Address City/S �tate/Zip 3. Application For: ❑ Site Evaluation Improvement Permit/ATC ❑ Both 4. system to service: dl -douse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other — 5. If Residence: N People N Bedrooms t Bathrooms "shwasher 0 Garbage Disposal l✓Nashing Machine "..t/Plumbing f] Basement/No Plumbing 6. If Business/Industry/Other: specify type # People * sinks i Commodes i showers • Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 6- o ty/City ❑ Well ❑ Community B. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 11�"O. If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: ��'e /"�' WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # 5Y-7 0 - L 9 D Yo 3.30 ' c-ks C Property Address: Road Name li-p e-�.-c.�o City/Zip 444-0 &,r%. CC- -z-7 00 If in a Subdivision proWde information, as follows: Name: w Er,.e24L ►�C�P-"-S Section: 'D% Block: Lot: 3 Date Property Flagged: 7/a o /o o 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. 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 the site suitability. . , ,n DATE "'T / 191�� _ �'L� i SIGNATURE J THIS AREA MAY BE USED FORD e OUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures,, et c , and septic locations). Revised DCHD (07/99) Site Revisit Charge , Date(s): Client Notification Date: I EHS: Account No. ' ' -)" Invoice No. 177 q1 S7 !J 233 Z�Z APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Eni6mmenba/ Hanfib Section P.O. Bos 848/210 Hospital Street Mockaville, NC 27028 (336) 751-8760 AUG 2 5 1999 E11'�lii � ***nwcRTANT*** THIS APPLICATION CEO= BZ PROCEBBBD UNLESS ALL THE REQUIRED XMMFMATIOH IS PROVIDED. Roger to the XMRM11TXCN BULLETIN for instructions. 1. Masa to be billed WES-1VIf,4 -DC JEt,0P1M51X- COMPJWY Contact parson EW G tVAr-Y Nailing Address '4-6% 9-fV)JQ1 )A TZ0. nose phone 336.116.7.008 City/stat./s:p kd%'41T6A - 5ALtV% ' Ne -1106 Rumness phone 136-11-1- 00"18 Z. Name on perait/ATC if Different than Above Nailing Address City/stag/zip 3. Application ror: GYsite ivaluation 0 Improvement Permit/ATC 0 Both e. system to services C3 Houses 0 Mobile Boma 0 Business 0 Industry 0 Other S. if Residence: ! People ! Bedrooms ! Bathrooms O Dishwasher U Garbage Disposal O washing Machine 0 sasesent/plushLog 0 sasesent/Ho plumbing 6. if susiaess/Industry/Other: specify type ! people ! sinks ! Commodes ! showers ! IIrinale ! water coolers IT 700D8ERVICS: #3 Seats Estimated Nater Usage (gallons per day: 7. Type of water supply: 0 County/City 0 Well 0 Community e. Do you anticipate additions or expansions of the facility this system Is Intended to serve? 0 Yes ETNo If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with TIM APPLICATION. Property Dimensions: e 177 M Tax Office PIN: # �d ,7U ' �n� �D J Property Address: Road Name /J�� uG 1t ��/�'• City/Zip H in a Subdivision provide information, as follows: WRITE DIRECTIONS (from MocksAlle) to PROPERTY: 'Mocks CNMIA Ta I?Aw ' ctni &AV(JUMDA PKPP Tv oo LeFr. Name: W1Ine e fa rr1S Section: Block: Lot: Date Property Flagged: This 1s to certify that the information provided is correct to the best of my knowledge. I understand that any permit(,) Issued hereafter are subject to suspension or revocation, If the site plans or intended we change, or If the information submitted in this application Is Glsilied or changed 1, also, understand that I am responsible for all charges incurred front 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 to conduct all testing procedures as necessary to determine the site suitability. DATE B�4 9 SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the Ung: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/99) Site Revisit Charge I Date(s): Client Notification Date: IEHS: Account No. _�� Invoice No. /141 irr LAWRENCE L. MOCK BY WILL REF:D.B. 49 P9. 8 ICON PLACEQ63 37 T FENCE CORNER 34 PAP k / A ' APPLICANT INFORMATION DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SoiVSite Evaluation Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brant Godfrey Proposed Facility: Residence Property Size Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5870-69-0403.30 Subdivision Info: Windemere Farms Sec.2 Lot # 30 Location/Address: Beauchamp Road -27006 See Map Date Evaluated: Community Evaluation By: Auger Boring Pit / Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH O- U 0-9 Texture group 0 t - L– Consistence –r SS Structure G2 Mineralogy1 HORIZON II DEPTH - 2Texture rouConsistenceStructure 17, �v lMineraloHORIZON III DEPTH Texture group Consistence 17 Structure - Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE p. SITE CLASSIFICATION: PS EVALUATION BY: t—J\zfL�l��.,P LONG-TERM ACCEPTANCE RATE: 0.3� 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 - 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) IRON PUCE 663 37 T FENCE CORNER LAWRENCE L. MOCK BY WILL REF:D.B. 49 P9. 8 34 21�12 I .06/25/2003 06:05 9406947 MARQUIS BUILDING INC. GORDON WttffNF-Y P.O. BOX 2170 AvvA"=. NC 47006 336.940.6947 GORDON WHITNEY PAGE 02