Loading...
118 Hagen Road Lot 49Account #: 990002780 Billed To: Blake Hope Reference Name: Residence ATC Number: 3849 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5870-59-7874.49 BH Subdivision Info: Windemere Farms two Lot #49 Location/Address: Beauchamp Rd -27006 bite: 1.4 acres 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 Sewa a Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATEIQONS) ON VAI6 FQ$&PERIOD OF FIVE Y$ARS. Environmental Health Specialist's 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. T' 41 CK,�oweq Septic System Inst ed ��' �"� 1v�CJ kz- Environmental Health Sp i a re : 5 DCHD 05/99 (Revised) r? ) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section _ P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002780 Tax PIN/EH #: 5870-59-7874.49 BH Billed To: Blake Hope Subdivision Info: Windemere Farms two Lot # 49 Reference Name: Location/Address: Beauchamp Rd -27006 Proposed Facility Residence Property Size: 1.4 acres ATC Number: 3849 **NOTE** This Improvement/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 lk>r#People #Bedrooms #Baths Dishwasher: Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial �Specification: Facility Type l_ ,�#,People #People/Shift #Seats Industrial Waste: %❑ Lot Size • I ' Type Water Supply Caw . Design Wastewater Flow (GPD) apo Site: New � Repair ❑ 11 System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width Rock Depth tt Linear Ft. 3001 Other: Required Site Modifications/Con tions: �N�%�L�- t) C -'WT@ f�7►'�' E��i� 6 �►�vJ0'v INIPROVENIENT/OPERAT ON PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. **** OTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. t 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (3 ►)751-8760.**** 4�7 r J7 Env' onmental Health Special-' is Signature:4,D�a.Lis DCHD 0199 (Revised) 96, 95 '' ��•23' S7• i E iron set 201 14 east crk. I / I 1 / to l g bC%q � �► 2 49 /C31 0 8 10401 AC. ; z I / I / iron set east crk. bank woo f0m SSS f / toWNW N 20.E N # 64.265 4 265 E �Rqi�. iron set west crk. bank l , o / o w 50 i 1.124 AC. 1 rl -0 :482,19 C22 / jffE.AD0 TOTAL= 482.19 C / 120. / / 166-24-- 75-95 i 1f l r ' V q,11, TION 1:011 SITE- L-VALUATION/INIP110VU11wr l'.0 r T VI'C Davie County Health DepartmentU� , �S P.O. �Box o848/21x0 Hon/ al Sot e Qv X00, Mocksville, NC 27028 �hF (336) 751-13760 ***IDIPORTANT*** TRIS APPLICATION CANNOT DL PROCESSED UNLLSS ALL `i'IIE REQU I INFORMATION IS PROVIDED. Refor to the INFORMATION BULLETIN for instructionD. 1. Name to be Billed )a L -Z o Contact Person Mailing AddressHome Phone 76'S_�13_3_ City/State/ZIP . ...__._. ... ,�I/un/Ce ���� Business Phone 2. Name on Permit/ATC it Different than Above Mailing Address City/State/Zip 3. Application For: f3'f ite Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: 0 Houne ❑ I4obile Home ❑ Dusinetn ❑ industry ❑ 01:11cr 5. Type system requested: 0 Convontional ❑ conventional modified ❑ innovaL•ive G. If Residence: 1t People # Bedrooms _ II I3athrooluu ODinhwasher ❑Garbage Disposal Ckla—s—hing Machine ❑BasemonL/Pliunbing ❑BasemenL-/No Plumbing 7. If Busineas/Induatsy /Other: verify type a People it Sinks # Commodes 11 Showers # Urinals 11 Water Coolaru IF FOODSERVICE: it Seats Estimated Water U3age (gallons per day) 8. Type of water supply: L7-'C'ounty/city ❑ Well ❑ Conuuunity 9. Do you anticipate additions or expansions of the facility this systca, is ii,teacicd to serve? ❑ yes 'u If ycs, What type? '1AMORTIMY' * CLIENTS MUST M11PLL•-Tds THE RL;QUIR1iD PROPERTY INFORMATION 1tI1,'Q 11J."STLll 13ELOW. Is'itller a PLAT or SITE PLAN KUST BE- SUBMITTED by the client Willi THIS APPLICATION. Properly Dilnclisions: I _ �(, Tax office PIN: 11 S9 70_547R 7� � Property Address: Road Name--!.-eL� City/Zip If ill a Subdivision provide hiforniatIon, as follows: Natllc: Section: Block: Lot;^ 1 w,m DIRCCNONS (rrom fl.ludisville) to PRON,"UTY: Date lionie corners !lagged: 5� — /7-04 This is to certify that the information provided is correct to the best of illy knowledge. I understand that ally perulit(s) issued licrcafter arc subject to suspcusion or revocation, if the site plans or hitcaded use change, or if the iniorniation submitted in this application is falsified or clizaged. I, also, understain/!that I «aI responsible for rill charges incurred f -om 111is application. I, llcreby, give consent to the Audioriccd Rcpreseutativc of dic Davie County IIca1111 Dep:u•tulcIut to cuter upon above described property located iii Davie County and omicd by to conduct all testing proccdurc5 as Necessary to determine (lie site suitability. SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing lied proposed property lines and dimensions, structures, setbacks, and septic locations). Sign given Revised DCIID (05/03 Site Revisit Charge Datc(s): Clicut Notification Date: EIIS: ` q Account No. �` 7 4 o `{,3 y 64 j Davie County, North Carolina Spatial Data Explorer OPV'r .�,migimemwn, Spatial Data £=�Floa rer North Carolina Click on the Map to: (* Zoomin r Zoomout r Recenter Map C7) Identify: Parcels 7 - Zoom Factor. Radius Search (feet) 0 NW —,297---- _297—_....a, o Angle • Q ,. �.� 7874 0856 VV < 6870597874 Y Y �. 26 07 '15 �'' 76150606 r 'TNSr3, 60 —. 4 4571 SW, Parcel Data Find Adjoining Parcels NE I RS' y 2608 Page 1 of 2 Map L. Draw L Draw select Boundary r7 Census Tra City Bound County Zor Multi Syl r E911 Fire D r Flood Pane Flood Zone �? Parcels School Dist Multi Syl F soils I Town Zonir r Townships Multi Syl Voting Prec Infrastructu r Driveways Rail Lines Street Cent USlNC Higl Multi SyI U N Aerial Phot Physical r Creeks and i E911 Addre r Fire Depart F' Schools Draw L MAP Ct This map is prep: inventory of real 1 within this jurisdic compiled from reo plats, and other r and data. Users c hereby noted th ;ft= I... 8/10/2004 • Land Unit/Type. F8020B0049 J LT • Deed Book/Page. 00205 ! 0548 • Deed Date. 1998/09/04 • County ID. F8020B0049 • Sales Price: $0.00 • Account Number.77742250 • Property Address: • PIN:5870597874 • Legal 1:LOT 49 WINDEMERE FARMS • County Zoning: R -A • Owner Name: WESTVIEW DEVELOPMENT COMPANY • Census Code. • OwnerlAddress 1: WESTVIEW DEVELOPMENT COMPANY • City Code: • OwnerlAddress 2. • Fire District. • OwnerlAddress 3.2631 REYNOLDA ROAD • Flood Zone: ZONE X • City,State Zip. WINSTON SALEM ,NC 27106 - 0000 • Flood Community. 370308 • Land Value: $25,200.00 • Flood Panel: 0045 C • Building Value: $0.00 • Flood Map Date: 12-17-1993 http://66.208.132.254/servl et/com.esri.esrimap.Esrimap?Name=Davie&Cmd=Clk&L4 Page 1 of 2 Map L. Draw L Draw select Boundary r7 Census Tra City Bound County Zor Multi Syl r E911 Fire D r Flood Pane Flood Zone �? Parcels School Dist Multi Syl F soils I Town Zonir r Townships Multi Syl Voting Prec Infrastructu r Driveways Rail Lines Street Cent USlNC Higl Multi SyI U N Aerial Phot Physical r Creeks and i E911 Addre r Fire Depart F' Schools Draw L MAP Ct This map is prep: inventory of real 1 within this jurisdic compiled from reo plats, and other r and data. Users c hereby noted th ;ft= I... 8/10/2004 APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Enviionmentol Health Secdon P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336) 751-8760 — r5 rn i, �'+n AUG 2 5 1999 ***IMPORTANT*** THIS APPLICATION CANNOT ISE PROCESSED UNLESS ALL TSE REQUIRED IMrM1►T10H i8 PROVIDED. Refer to the INrORMATION BULLZTIN for instructions. 1. name to beBlued WEsv) �J 17F�/EioPMtNT �o"'�PJVJ`/ Contact person GotvizcY Walling Address 243% R•Eyr►aLnOZO. some phone 33b-IWZoog city/statems, ,tic 2� lOb s minae phone 0018 2. name on permit/ATC it Different than Above tailing Address city/state/zip 3. Application nor: 08ite avaluation l] Improvement Permit/ATC 0 Both fV00 e. system to service: R/Houses 0 Mobile Home 13 Business 0 Industry 0 Other 5. If Residence: ; People i Bedrooms • Bathrooms D Dishwasher O Garbage Disposal O washing Machine O Basement/plumbing 0 Bassmsnt/no plumbing 6. if Business/Zndustry/Others specify type 2 people f sinks # Commodes + showers i Urinals • water Coolers Ir rO0DSZRVICE: # Seats Zstimated Nater Usage (canons per day) 7. Type of water supply: 0 County/City O well 0 Communitty a. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes ®�o If yes, what type? ***1MPOR7ANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either *PLAT or SITE PLAN MIJISTBESUBM IM by the client with THIS APPLICATION. Property Dimensions: '2e 177d)O Tax Office PIN: # �D �U — in V Q Y, Property Address: Road Name/'�--�— City/Zip WRITE DIRECTIONS (from Mocksville) to PROPERTY: Mocks 64MIX ro N&ft ccw J?fAVdfAHP /z,/,_ PAPPOL-" 01i If in a Subdivision provide information, as follows: Name: Wt mr<m � F"a%r-' Section: Block: Lot:�Lpj Date Property Flagged: This is to certify that the information provided Is correct to the best of my knowledge. I understand that any permits) Issued hereafter are subject to suspension or revocation, Ifthe site plans or intended use change, or if the information submitted in this application is falsiikd or changed 1, also, understand that I am responsible for all charges Incurredfrom 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 to conduct all testing procedures as necessary to determine the site sultabWty. THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the Mlowlegt Existing and proposed property hues and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/99) Site Revisit Charge IDS"): Client Notification Date: I ERS: Account No. Invoice No. l% 6 ns 69ti Arco 30 + ,� old + 81 021 O L5 S / p ►S IS Q�17 L6 0 - 891 691 Q / AV A OW tib0� 22 �68 rN o - 4y�j�/E21 / 2 + + 69 21 lot is OL ` 1N � 921 e t 612 09 o� OB 1 ^y ji + + �Ol .'1'� (�12 �' L61 812 12 861 66[ 2 0 2 �� 6[ 961 ,2 S61 E► 2v v6 ►►Z o LI IM 5L 9t2 5ZI > ` 0 � LSi t + Stell ►61 TIC) 611 It i n'M1 8S[ t+ 1661 E61 62 Sp I' N 1 981Vfb Bl L81 88I OV4 681 L2 BV 6-.2D Y2 EL2 I � ESI ►91 L y02 J99 + ►2 82 + 1 n A 201 02 ►2 �' U61 o, 6►22L2 SL. ;a 1 1 ssl oar OS2 69 I 9S ti US ►s2 2 4 �(J5,il tL2 - --� + + 62 92 r {, o V Y Q p p 60'919 3 •LC,E2.E8 S2 S C + 9L O 0 ONr10-d NO211 310 E F36Z + 22'2 192 3 .80.EE.SB S 292 1 Iwo � g f, I I AOO1' j • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION 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 #: 5870-69-0403.49 Subdivision Info: Windemere Farms Sec.2 Lot # 49 Location/Address: Beauchamp Road -27006 See Map Date Evaluated: (a Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope % i o7, HORIZON I DEPTH O - S Texture group CL Olt - Consistence SS 5 Structure rj Mineralogy I ; b / HORIZON II DEPTH ILO�• Texture groupG Consistence _ Structure L C Mineralogy ' HORIZON III DEPTH 1(0- 2G - Texture groupQ Consistence r r Structure 66 Mineralogy; HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: y S LONG-TERM ACCEPTANCE RATE: 0.41 REMARKS: EVALUATION BY: %7- � ' 5awt+V4 i OTHER(S) PRESENT: 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 Mineralog 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) LAWRENCE L. MOCK BY WILL '. REF:D.B. 49 Pg. 8 CARL D. Z05. E i 0�'?3'005 20 TOTAL* 982.22-----y ON Po! i D.B. 191 2969 I S 83.23'S7•.E 200.14 •:,i c nam• 47 = E 0.753 AC. �N � 48 4, w r 0.740 AC. ►!e �0� 165 = t20 2�O ' 49 _orl h ' 2-Tj - t t e 1.401 AC. r r r 25 - �' - , .. 1.187 Ac. 46 N 47.36' 45' Y 0.739 AC. 53.75 m x _ ^ 2)"ss. ,4v 207 � _ " ��� � by N '8't 6• pg. V TOTAL■ 234.37 -� N 46.41'25' E ? 28 % 1.16'04' 64.26 V Jp- t45 � 167.57 l l... t 10 50 ` O.` o- t n^ g i s 0.892 AC. 1.124 AC. 1.282 AC. leo € IL be � 36 4J '23• T- ,107 $ i — — 1 — -- 340.70-` 116.49" TDTAL� x82.19 S 86'22'38' V � t3 w 44 C22 HIGH MEAD 0WS ROAD 0.872 AC. G`�TOTALs 482.19 N 86.22'38' E Z AC. _ _ 120. oc_ _ W 8 222 T 99 ZA, J G1 - - 7S. 95 - 166.24- — — 120-00- — n �.9 1 l Z ca JBUC 23 r ' ~ 24 ' 0.829 AC. N 2 0.776 AC r22 T! ho 8 1.702 AC. �• Cv 121.43 ��. . o/ �h / AZA 100.37 S j7' 3&,< 47' V AN'l r °ro/ 1.7.28 77 AC. ..,• . ; �o��J / to 9 / w G� � p / �� C) i.'cc