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245 Oakland Avenue Lot 50-51Road Name: ! '' 1 Jr I-, L1 I `�V1Zip: **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 111-9 -1 IS VALID FOR A PERIOD OF FIVE YEARS. ENVIROt4Mtl,4TAL'HEALTH SPI!CIALIST DAT( ISSULD 1. RESIDENTIAL SPECIFICATION: BUILDING TYPE ('�k. # BEDROOMS - # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No -2iii'}'Zs- '9102xIOU -1 "I,] -I' I i+��1j %� LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) G7� NEW SITE REPAIR SITE oil, SYSTEM SPECIFICATIONS: TANK SIZE 1� GAL, PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. 'w� I' . y t �OTHER vS Y ��i�J �E F t k 7 _ _ ` 'REQUIRED SITE MODIFICATIONS/CONDITIONS: I Y 1=r.�(. 0L T1 rw-^- rA LAT t� N r 1 1 IAS I AGtZf'- t_ A t_ U C_I-I A M 6L IMPROVEMENT PERMIT LAYOUT &I OtnF (q(vD L_Qt%�y So14 (C��oJF'Izll��i� 5'r'ST�+�:` iv�JST otw 1 " K, c, ► t,. `�J r<2 V I v avT ~ Aff C, . Ger{ -1 c> (r o-• r G�C.'co�Z Nti VST'" 1�.a�iCRI •�a�►��5'�rr.-C: "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 (336)751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 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) AVT -Ki tIZATION NO: 1906 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's - e2=--- P.O. Box 848 1J i �L Name: /a`- Mocksville, NC 27028 Subdivision Name: ✓A Directions to property: � },1 1.� t .' �Tt_ Phone # 336-751-8760 Section: Lot,�: (_ r AUTHORIZATION FOR WASTEWATER Tax Office PIN:# L[7 SYSTEM CONSTRUCTION Road Name: ! '' 1 Jr I-, L1 I `�V1Zip: **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 111-9 -1 IS VALID FOR A PERIOD OF FIVE YEARS. ENVIROt4Mtl,4TAL'HEALTH SPI!CIALIST DAT( ISSULD 1. RESIDENTIAL SPECIFICATION: BUILDING TYPE ('�k. # BEDROOMS - # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No -2iii'}'Zs- '9102xIOU -1 "I,] -I' I i+��1j %� LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) G7� NEW SITE REPAIR SITE oil, SYSTEM SPECIFICATIONS: TANK SIZE 1� GAL, PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. 'w� I' . y t �OTHER vS Y ��i�J �E F t k 7 _ _ ` 'REQUIRED SITE MODIFICATIONS/CONDITIONS: I Y 1=r.�(. 0L T1 rw-^- rA LAT t� N r 1 1 IAS I AGtZf'- t_ A t_ U C_I-I A M 6L IMPROVEMENT PERMIT LAYOUT &I OtnF (q(vD L_Qt%�y So14 (C��oJF'Izll��i� 5'r'ST�+�:` iv�JST otw 1 " K, c, ► t,. `�J r<2 V I v avT ~ Aff C, . Ger{ -1 c> (r o-• r G�C.'co�Z Nti VST'" 1�.a�iCRI •�a�►��5'�rr.-C: "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 (336)751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 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) t AUTHORIZATION NO: 1906 DAVIE COUNTY HEALTH DEPARTMENT } Environmental Health Section PROPERTY INFORMATION Permittees P.O. Box 848 Name: '--- �'/ 1 � Mocksville, NC 27028 Subdivision Name: 0W4 LAA Phone # 336-751-8760 -Directions to property: Section: { { AUTHORIZATION FOR _ V_ -Y C_i>✓ __',ice Uri rJ , +� WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION _ C, L t.t�r►�� > A1C L G I t !� Lrs r Road Name: C��/� Ln tai) �I��Lip: t iU 7 5g **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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) y ---. -' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �_ ._. �i q IS VALID FOR A PERIOD OF FIVE YEARS. _ ENVIRM4&1t TAL-Ht LTH SP CIALISt DAT ISSUED 1906 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee's Name: Subdivision Name: f1?� LA DRi l ; } i 1 ► 1 Directions toproperty: _ i. t. + ' i c Section: Lot'�� 1 IMPROVEMENT PERMIT Tax Office PIN:# s Road Name: r i.'�r �' r1ip: **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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE •-' 't 4 f PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPkCIA IST DAIt ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE .: INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE I-tQ'C, # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No 2e,6, y-'Zo�iu 102 x100 19 "19-7 LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) 20 NEW SITE REPAIR SITE L71 SYSTEM SPECIFICATIONS: TANK SIZE , GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR Fr. r_ OTHER 1 i�1cT {Z ►"v ► i �.J rT��C �I n„nn 5 Q "'T��n-�C.t-� S �STi+ �E�f �`t ���, 1 n - -REQUIRED SITE MODIFICATIONS/CONDITIONS: -Pt-r• (,}� b tTi u r� M yST l�t- IJ t) L>� t`t R TI-) A r�1 12 ,1 lz c--w P2��P�Q`r u14 i na14,rA r.,Jb S �4 c CLIA ►At r2 -1 v IMPROVEMENT PERMIT LAYOUT Cc'' {. q-P [OGD LOINeAY Soft-CC>�oJP I� AUL)=Ti+M MJST ► HAVC 1'5 �i L c 'J +Z.� �►=�"�=`�%2fA�. Fly v ikwst_ CvN1TI\C_T 15 -1 1LI Z.G= `moi a OAA A L)CA Ti7' Z -To y 2 u,J'i or- -CONTACT F -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 (336)751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 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) 6 DAVIE BOUNTY HEALTH DEPARTMENT IMPRO EMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee s Name: + i i t ` - Subdivision Name. t Directions to property: ' i't Section: Lot'~ a IMPROVEMENT PERMIT Tax Office PIN:# i.�. Road Name: 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) "11qV iil.l-" i 1iL7 r JuAruvii i L70VDJril.i avid' V"%-.tiiiVl\il Oiiri ' 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 # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACIILyITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY lii DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE 1 SYSTEM SPECIFICATIONS: TANK SIZE1 _!----GAL.1 PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT." " OTHER { + '! l :. t j:y i i - i ;C -1 �` "A j -i `REQUIRED SITE MODIFICATIONS/CONDITIONS: f_,) ` { ,.'-'t. S7 r; rv` !A I.T F.," rj f tZLl1 lc.. �Y 1.INf� i*,A. 1,j4r- tL At cdte,4 i�n.vr� yll rPROVEMENT PERMIT LAYOUT 1 t.r ' � t 1 I �1 (, t.�r � unrr `f �� IL l` C_. t �.!:� �� � � � { `�"� r'1 �• �.---T NJ 9 ! f .. f,. � ..5. r'��. `� _ t 1 � t rte: c-- � �• t �. •- � 'vim•, �'+r'14� 1�J !14 L;- t ->�.• � 4.�. �T. "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 (336)751-8760. / OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: "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) .,-PLICATION FOR SITE EVALUATIONAMPROVEMENT ERd 1P & A TG' Davie County Health Department D Environmental Health Section ti P.O. Box 848 NOV 1 3199 Mocksville, NC 27028 (704) 634-8760 E"VIRDAVIEECOUNT �� **IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS AL THE REQUIRED INFORMATION IS PROVIDED. �. Name to be Billed Tomo �rN /f /G Gj Contact Person TG t7 f TN -/? ;FGt Mailing Address 7lv 1 1?A RR / dllle- Ro Home Phone 2 o 3 - ?F 41 City/State/Zip !!� L .Cu F6//a0 N• C Z 7 0 /3 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: b(J Site Evaluation [ ] Improvement Permit & ATC [ ] Both 4. System to Serye: [)(( House [ 1 Mobile Home [ ] Business [ 1 Industry [ ] Other 5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] Garbage Disposal [ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes - # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: [A County/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ] No If yes, what type?. EITHER A PLAT OR SITE 13LAN 0- 1 - L-::- f YFV,9- U4� t i' ry 22 i�l-q q9 PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***yXVY, fi OF THE PROPERTY MUST BE �Ro.vT 4 • s. lye Ck R. S. SUBMITTED WITH THIS APPLICATION. Property Dimensions: /OO Y x / 80 1 ViJUTE DIRECTIONS (from Mocksville) TO PROPERTY• Tax Office PIN: # q 7 9 - - / Z O a-( ©gyp 21L_ Property Address: Road lame (3 R K GA Nib /q O F ; city/zip 1114./ ea.5y rt c i' /V. e . 702 If in Subdivision provide information, as follows: Name: U Ar L -4N.0 n Section: Lot #: 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 kepresentative of the Davie County Health Department to enter upon above described property located in Davie County and owned by rU0tT/I /f 145 'j- to conduct all testing // procedures as necessary to determine the site suitability. DATE l - % 3 ` SIGNATURE�j7 Revised DCHD (06-96) THIS AREA MA11 13E USED FOR L)R>tll'INC IjOUR SITE PLAN: 4"x'77 i T � 7U Jan. 26, 1999 Davie County Health Dept. To whom it may concern: We the undersign do hereby wish to exercise our option to chose the CHAMBER TRENCH SYSTEM for installation on our lot located in Davie County in the Oakland Heights Subdividion Lot #51. - � �LLI�i� ------- --- ---------- Ju ith Hope Riggs Jessie Monroe Riggs Davie County Aeal th Department Environmental Nealth Section Po Box Bas / 210 Hospital street Mocksville, NC 27028 Phone: (336)751-8760 December 11, 1998 Mrs. Judith Riggs 761 Barry Oak Road Cleveland, NC 27013 Re: Oakland Heights -Site Review(s) Lot #49 (Tax Pin 4798-96-0003) Lot #50 (Tax Pin 4798-96-0162) Lot #51 (Tax Pin 4798-96-1202) Dear Mrs. Riggs: At your request, Scott Greene, Regional Soil Scientist with the Department of Environment and Natural Resources, visited the above three sites on December 10, 1998 to review the site evaluations performed by a representative of this office on November 23, 1998. While his review supports the decision of this office regarding installation of conventional systems on each of the three lots, it was determined that an alternative, innovative on-site sewage disposal system could be installed on lot #51 to fulfill the needs of a two-bedroom residence. Therefore, the classification of lot #51 has been changed from unsuitable to provisionally suitable for the installation of an innovative on-site sewage disposal system. Lots #49 and #50 are unsuitable for the installation of on-site sewage disposal systems. Lot #50 must be grouped with lot #51 to insure that enough space is available for the residence and the septic system. Innovative system types that should meet the on-site sewage disposal needs on lot #51 include: 1) Chamber Trench System; 2) Polystyrene Aggregate Trench System. Once you are ready for an Improvement Permit, you must fill out the appropriate application. In addition, since these are alternative septic systems, we must receive a letter from you stating which type you prefer. In order to gain an Operation Permit, certain requirements must be satisfied for the approval of the installation. These include, but are not limited to: 1) The innovative system must be installed in accordance with T15A: 18A .1900; 2) The septic tank contractor must be certified to install the chosen innovative septic system; 3) Lot #50 must be grouped with lot #51; 4) Residence must be limited to two bedrooms; 5) Surface water diversion must be employed; 6) Loamy soil(Group II or III) must be brought in as cover over septic system; 7) A pumping station may be required; 8) All requirements specified on the Improvement Permit/Authorization to Construct must be met. If you have any questions, feel free to contact this office at (336)751-8760. Sincerely, i Jeff G. Beauchamp, R.S. Environmental Health Section �,. APPLICATION FOR SITE EVALUATION/IMPROVEMENT Davie County Health Department D Environmental Health Section P.O. Box 848 NOY ( 3 IM Mocksville, NC 27028 i� (704) 634-8760 FtNIRONMFWAL HEN ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS AL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed J -VO 6t /f /G 6-�j Contact Person .%-G'7 ! ry -R /GG Mailing Address 7 y1 / %3/a RR / 4 / 4- go Home Phone 20573- 7 City/State/Zip L L ,lv FL1Fni0 N- C, 7-70 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: M Site Evaluation [ ] Improvement Permit & ATC [ ] Both 4. System to Serve: W House [ ] Mobile Home [ ] Business [ ] Industry [ J Other 5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] Garbage Disposal [ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: r4 County/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ] No If yes, what type? EITHER A PLAT OR SITE PLAN ""1114q4r, 1 zxby 064,1 r W PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** WYWT OF THE PROPERTY MUST BE r-Ro.1r 4 • s• QeCk R s_ SUBMITTED WITH THIS APPLICATION. Property Dimensions: / 00 X X 10 ;L k / FO ; TE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # q7 9 -©oaf -�- Property Address: Road Dame 6 1 K LA NO 0 F City/Zip Af d (,k 5 y K c is /L. c. 27o4 If in Subdivision provide information, as follows: Name:G/G r Section: Lot #: 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 iwofTH X l66:'1" to conduct all testing procedures as necessary to determine the site suitability. DATE l 1- l 3 rf j� SIGNATURE--ZZ100i Revised DCHD (06-96) THIS AREA MAY $E USED FOR bRAWINC7 YOUR SITE PLAN: ( 8 9 rJ N G 7 o C, c � V � I I -P.270 W N �( N 1 40 - 45 44 43 42 r 4 m 17. 18 46 13 14 15 16 �� n 1 OU Icy 12 I x) 1 car) L' C, ur) 1 0120) 34' - 2 4 4 _ 2 2 v 53 54 49 TQ 50 r� 51 w 52 N _ a 25 v 97 i Qn o 99 8`L.y G ?.>.3t Cpr OAKLAND PB. 4, DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME V v ')I 7W PROPOSED FACILITY 656 SUBDIVISION 0 4 fel-L`py_D Q-iTl (QTS Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit SECTION LOT -<� DATE EVALUATED PROPERTY SIZE 6p Y X �d2T Ze`I ROAD NAME (9A' 14L4�j q Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L L Sloe % Zo HORIZON I DEPTH — 2L4 o —f7 - Texture group 5 el- 511-1- LConsistence Consistence 5 Structure S k Mineralogy HORIZON II DEPTH z -1(.0 Texture grou y c- S Consistence iTLz5 ` r 55 S Structure SO k Mineralogy HORIZON III DEPTH Ila_ 0.7— Texture groupS Consistence Ila s5 Structure G2 Mineralogy HORIZON IV DEPTH Texture group�( Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: V EVALUATION BY:y �-r'P LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: GIZ I7 REMARKS:�t 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 (01-90) ■ ■ ■ ■ ■ ■■■■■■■■■■■■■■■■■■■■■■Itis"�\■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■wee■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■t1■��■Ori■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MENNENMENNENNEEMEM'�iMEMNONMEMEMEiiiiiiSEMEN ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■i ■■■■■i ■■■■■i ■■■■■■■■■■■■■■■■■■M■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■KN■■■■■■ ■■■■■■■■■■ hii■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■ ■■■■■■■■ ■■M■■■■■■M MEMOM■■■ ■■■■■NOMMEM.O■■■■N■■ ■■■■■■■■■■■■■■■■■■■■ Davie County Aealth Department Environmental ) fealth Section Po sox 848 / 210 Hospital street Mocksville, NC 27028 Phone: (336)751-8760 November 25, 1998 Mrs. Judith Riggs 761 Barry Oak Road Cleveland, NC 27013 Re: Oakland Heights -4 Site Evaluations Lot #49 (Tax Pin 4798-96-0003) Lot #50 (Tax Pin 4798-96-0162) Lot #51 (Tax Pin 4798-96-1202) Lot #98 (Tax Pin 4798-96-4319) Dear Mrs. Riggs: As requested, a representative from this office visited the aforementioned site(s) on November 23, 1998. The purpose of this evaluation was to determine the soil/site suitability for the installation of an on-site sewage system. Based on the information provided on the Application for Site Evaluation and after the evaluations were completed, Oakland Heights, Lot #98 was found to be provisionally suitable for the installation of an on-site sewage disposal system and Oakland Heights, Lots #49, #50, and #51 were found to be unsuitable for the installation of on-site sewage systems for the following reason(s): Rule .1942(A) - Soil Wetness Conditions Due to the limitation(s) on these sites, this office is not aware of modifications or alternative measures that can be implemented at the present time to upgrade the classification from "unsuitable" to "provisionally suitable." Your application for Improvement Permits for Oakland Heights, Lots #49, #50 and #51 must, therefore, be denied. You have the right to an informal review of this decision by the Environmental Health Director of this office and also by the regional staff of the Department of Environment and Natural Resources. You should contact this office to arrange for this further review. You may also wish to obtain the services of a private consultant to collect site- specific data and submit such data and a system design to this office for technical review. A site may be reclassified to provisionally suitable provided written documentation, including engineering, hydrogeologic, geologic or soil studies indicates to this office that a proposed on-site sewage system or a proposed alternative system can reasonably be expected to function satisfactorily. The substantiating data from these studies must indicate that: A) The effluent(wastewater) will receive adequate treatment; B) The effluent(wastewater) will not contaminate any ground water or surface water; and C) The effluent(wastewater) will not be exposed on the ground surface or be discharged to surface waters where it could come into contact with people, animals or vectors. Finally, you have the right to a formal appeal of this decision if you file a petition for a contested case hearing with the Office of Administrative Hearings, PO Drawer 27447, Raleigh, NC 27611-7447. A copy of a petition form can be provided to you on request. The petition must be received by the Office of Administrative Hearings within thirty(30) days of the date of this notice. The hearing may be held in Davie County. If you file a petition for a hearing, you must send a copy of the petition to Mr. Richard Whisnant, DENR, Office if General Counsel, PO Box 27687, Raleigh, NC 27611- 7687. If you have any questions, feel free to contact this office at (336)751-8760. Sincerely Jeff G. Beauchamp, R.S. Environmental Health Section enc(s) M NORTH CAROLINA AGREEMENT DAVIE COUNTY THIS AGREEMENT entered into this lt�V- day of April, 2002, by and between JUDITH HOPE RIGGS and husband, JESSIE MONROE RIGGS, hereinafter referred to as Sellers, and ANA-GUADALUPE MENDEZ, hereinafter referred to as Purchaser. WHEREAS, the Sellers have agreed to sell and the Purchaser has agreed to purchase from the Sellers Lots 49, 50, and 51 of Oakland Heights, as set forth in Plat Book 4, Page 122, and 123, Davie County Registry. WHEREAS, certain terms and conditions and disclosures have been made concerning the purchase of these lots. IN CONSIDERATION OF $13,000.00 and other valuable consideration, the Sellers and Purchaser hereby agree as follows: 1. That Lot 51 has an existing septic tank plan and the Purchaser has been provided a copy of the plan by the Sellers. 2. That the Purchaser has been advised that there is not a septic tank plan for Lots 49 and 50. 3. That the Sellers or any prior owners shall not be liable or responsible for any problems related to any brush or vegetation which may have been buried on Lots 49 and 50. 4. That the Sellers shall be responsible for the payment of the preparation of the Warranty Deed conveying the property to the Purchaser and deed stamps, and the Purchaser shall be responsible for paying the recording fee for the deed. Sellers shall be responsible for payment of any fees associated with this Agreement. 5. The Sellers have shown the Purchaser the lot boundary lines and provided the Purchaser with a copy of the Protective Covenants for Oakland Heights and a copy of the recorded plat for said lots. This Agreement contains all the terms and conditions of the agreement between the parties hereto.