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PERSON COUNTY QS�NCOUM�
PERSON COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL H�ALTH PROGRAM
20-B Court Street
Roxboro, North Carolina 27573
(336) 597-1790
July 19, 2000
Kent Williams
221 Mcghee's Mill Rd.
Roxboro, NC 27573
Re: Application for improvement permit for Wastewater system for property which borders
Guy Zimmerman at 1032 Zimmerman Rd.
Person County Health Department File: Tax Map #A35
Dear Mr. & Mrs. Wlliams:
The Person County Health Department, Environmental Health Division on June 30,
2000 and July 18, 2000 evaluated the above-referenced property at the site designated on the
plat/site plan that accompanied your improvement permit application. According to your
application the site is to serve a two-bedroom residence with a design wastewater flow of 240
gallons per day. The evaluation was done in accordance with the laws and rules governing
wastewater systems in No�th Carolina General Statute 130A-333 and related statutes and Title
15A, Subchapter 18A, of North Carolina Administrative Code, Rule .1900 and related rules.
Based on the criteria set out in Title 15A, Subchapter 18A, of the North Carolina
Administrative Code, Rules .1940 through .1948, the evaluation indicated that the site is
UNSUITABLE for a ground absorption sewage system. Therefore, your request for an
improvement permit is DEyIED. A copy of ihe site evaluation is enclosed. The site is
unsuitable based on the following:
1. Unsuitable soil depth to saprolite (Rule .1943).
2. Unsuitable soil characteristics (Morphology) {Rule.1941)
3. Unsuitable available space secondary to rock outcrops (Rule 1945)
These severe soil or site limitations could cause premature system failure, leading to the
discharge of untreated sewage on the ground surface, in surface waters, directly into ground water or
inside your structure.
The site evaluation included consideration of possible site modifications, and modified,
innovative or alternative systems. However, the Health Department has determined that none of the
above options will overcome the severe conditions on this site. A possible option might be a system
designed to dispose of sewage to another area of suitable soil or off-site to additional property.
For the reasons set out above, the property is currently classified UNSUITABLE, and an
improvement permit shall not be issued for this site in accordance with Rule .1948(c).
However, the site classified as UNSUITABLE may be classified as PROVISIONALLY
SUITABLE if written documentation is provided that meets the requirements of Rule .1948(d). A copy
of this rule is enclosed. You may hire a consultant to assisst you if you wish to try to develop a plan
under which your site could be reclassified as PROVISIONALLY SUITABLE.
You have a right to an informal review of this decision. You may request an informal review by
the soil scientist or environmental health supervisor at the local health department. You may also
request an informal review by the N.C. Department of Environment and Natural Resources regional soil
specialist. A request for an informal review must be made in writing to the local health department.
You also have a right to a formal appeal of this decision. To pursue a formal appeal, you must
file a petition from a contested case hearing with the Office of Administrative Hearings, 6714 Mail
Center, Raleigh, N.C. 27699-6714. To get a copy of a petition form, you may write the Office of
Administrative Hearings or call the office at (919) 733-0926. The petition for a contested case hearing
must be filed in accordance with the provision of North Carolina General Statutes 140A-24 and 150B-
23 and all other applicable provisions of Chapter 150B. N.C. General Statue 130A-335 (g) provides
that your hearing would be held in the county where your property is located.
Please note: If you wish to pursue a formal appeal, you must file the petition form with the
Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. Meeting the 30
day deadline is cntical to your right to a formal appeal.. Beginning a formal appeal within 30 days will
not intertere with any informal review that you might request. Do not wait for the outcome of any
informal review if you wish to file a formal appeal.
If you file a petition for a contested case hearing with the Office of Administrative Hearings, you
are required by law (N.C. General Statute 150B-23) to send a copy of your petition to the North
Carolina Department of Environment and Natural Resources. Send the copy to: Office of General
Counsel, N.C. Department of Environment and Natural Resources, 1601 Mail Service Center, Raleigh,
N.C. 27699-1601. Do NOT send the copy of the petition to your local health department. Sending a
copy of your petition to the local health department will NOT satisfy the legal requirement in N.C.
General Statute 150B-23 that you send a copy to the Office of General Counsel, NCDENR.
You may call or write the Person County Environmental Health Department if you need any
additional information or assistance.
Sincerely,
���� � �\� ����������
s �
Ginger H. Thompson
Environmental Health Specialist
Environmental Health Division
Person County Health Department
Enclosures: 1. Copy of site evaluation
2. Copy of Rule .1948
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Tax Map #: � �
�areel #:
. APPUCATION FOR SE3tVIC�S -
IF THE INFORMATION IN THE APPIICATION FOR•AN IMPROVfiYIENf PERMIT IS FALSIR�. CHANGE�. OR THE SiTE IS _�
ALTER� THEN'THE 1MPROVEiIAENT PERMIT AND AUTHORIZATION TO CDNSTRUCT SHALL BECOME INVALID. `��
1) Permit requeated by: (Ovmerlageetlprospeclive ovme�: � Z �; Q. �'1 �,�J a\�
- Home Izho�e: .�"99-328� A�dd�es� 2 l � ; (, � ���� .
8tnu1esS Phane• " o !� �-75 7 �a�,Yr ��
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� Name and addcess of cumeat owner: o�r r
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3) Property Descrtption: t�t st� l`/a c�u,e�nworda C.0 n n i�q�a�nv
D'aedions to the
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�1 �P�d �� 0
b) Stldc Budt Moduiar � Singie Wlde Q Ooubie Wide �
� Number of Bedroo�s� 2 � Numhet af oc�pants ac peopte to be senred:
e) 8aseme� Yas �Nc � yes. cf b�sement fi�ucex .
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Ace any we0s � a�cinin9 P�'oP� Yes No 0 li yea, {or.ation -
6j Please indicaia Desii�ed Sysiem 'iYP�= I�� can be n�iaed In order of ycwr Pr�e)
� ontlonal 1Aodified Convsntionai _ Ai�e Innovative
ot� (ap�:
�i,khow� c�.� ��s �;�e,
CL�ARLY STAKE ALL CGRNERS ANO LiNES OF TIiE PROPERTY.
STAKE THE CORNERS OF ALL PROPOSED STRUCTURES.
PLEASE ATTAC�1 SURVEY P1.AT OR SiTE PUW TO TH13 APP�.tCATiON
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I hereby make a� to the Per�ot� Cau�rty l�alth De{rartrnent ioc a s�e eva�tion tor tt�e en-aite sawage dis�at sysfiem fa ,
ttu albove-descrbed propetty. l ag�ee that the �ta af tl�is �on ace true and tepc�ent tho ma�dmum � to 6�
piaced on the pnopaiy. ! und�d � the siEe is altered ar the �ded use dianges. the pe�m� sha� become inva8d.1 undecslan
that aa apQ6r.ant, i am �espons�e fo� id� and rtmrkiri9 P�'�Y i�nes, �s and matd� the sifie a�e toc th
perso�nd of the Person County Heaith Oeparhne�rt to cnr�dud ttu� e�vaiu�lona. I understand tlrat 1 am t� �' ��9 th
Health Depa�nent if mlf Pro{�% � �Y � � �� bY � �m1f �� � �e�s.
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APPlira�rt:
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subcuv�: s.a�on: �
Imarovement Permit
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New �Rapair _ Addibon _ Type of Stiudure y�.
� �lil ! V �wY l IK-�I �
. W i� (�l/1 �5 �i�d.� `�Y��VI
w� �x/� `(�'/ ��
�nt Darntit (/u r . ��C'I
# of Occupants Z # of eedrooms � othe� -- N 0 l J��
Basemant? j�8asement Fixhires? �/:�J
Projeded Daily Flow: �� g.p.d. Permit Valld For: GYt-ive ❑ o F.xpiration
Proposed Wastewater =Systerri Ty e: l�d/ �% �n% .1 ��%i�1.��+c��. �a' I � I" �t-�L
Pump Required? :' Yes �No . � ° p � .
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The issuence of this permit by the Heaith Departmer�t in no way guarantees the issuanca of other permits. The pemitt
hoider is responsible for cJ�ecking with appropriate go�eming bodies In meebng their requirements. This � aits is
aubJect to revocation if the sits plan� plat� or the Intended use changas. The Improvement Permit shall not be
affected by a change in ownership of the site. This permit is subJect to compliance with the provisions of the
Laws and Rules for Sewage Treatment and Disposa� Systems of tl�e North Carolina Administrative Code.
Type of Wastewater System
Fadtity
Wastewater Svstem Reauiremer�ts
Septic Tank Size: I,�� gallons
Maximum T� Depth: � ��nches Aggregate Depth:) z In.
Flaw: ��`�v a.p.d.
NewO' RepairOExpanslon0
Basement Fixtures? a Yes Gd�lo
Pump Tank Size: �� gallons
Total Trench Length: ,� feet
N�.l h t WU,�6V1
� Soii Cover. � inches
Other.
PertnP
Trench Separation: � Feet on Cerrter
Authorized State
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The type of system permitted O does O does not dlffer from the type specified on the application: I accept
the specificationa of this pertnit - •
OwneNLegal Representative Slgnature: ���/1'�n,G�L �(l--�J�� Date: �a' D�l "'��
PCHD, rev/ 10/12/99
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Parcei : � � _
Person County Health Department
Environmental Heaith Section
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SITE SK�TCH
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� Subdivision/Section/Lot#
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Date
Sys�'em componetits represent approxlmate coniour�s o�ly. The. conlractor must f 1'ag the systeire
r�rlor to bepinninP the inslaUation to lnsure tlrat proper grade is nibintainer�
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PCHD, rev. �! 0/�12J89 � �
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_. _._ . _ . . _ ..__ ...�._: -- .... . . . ... .... .. . .. . .
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_ � .
P�rs�n ��ueaty �iealth; Departenent
�" �nvironra�eni�l Healih Secaon � 1��
7ax Nfap �: �� ✓ Parcel #:
Zaning: Township: .
Subdivision: � Section: Lot:
ApPitcant � �c s , ��.
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Location: � � n►rteiN�2✓� (�- l �''1 � _ �
Operation Permit
d� �
System Type (!n Accordance With Tabie Va): �°�
THIS SYSTEM HAS BEEN INSTALLED IN COMPLIANCE WITH APPUCABLE NORTH
CAROLINA GENERAL STATUTES, RULES FOR SEWAGE TREATMEiVI` AND DISPOSAL,
AND ALL CONDITIONS OF THE IMPROVEMENT PERMIT AND CONSTRUCTION
AUTHORIZATIO
�� �T 1(— �l-'o t
� Autho ed State Agent Date
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'Tax Map �:
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Parcei #•
PCHD, rev. 10/1?199
� PERSON COUNTY ENVIRONMENTAL HEALTH
PLEASE SEE ATTACHED PLAN FOR WELL SITE LAYOUT
Tax Map #: � � Parcel !F
Zoning Township _�la[Y � v � ^
�►PPlican� �i'i,�� '� I � I I �� �/� /� �� .
� _ . _ n A ;1 d� n
LOCat10n: V �'v
�
Subdlvislon•
Sectiom Lo�
Well Permit
Type of Water Suapiv: �Individual Commun'�ty Public
Reauirements•
Site Approved by v ' �
Grouting Approved by �O�
WeU �og L� 2�-�0�
Well Tag l - -o
Air Vent � - �-a�
Hose Bib�'�.� / .- �-o�
Concrete Slab ,��f - 8 =��
Well Driller.
Well Approved By:..�� � � ��-
Date: � - �- � -�
**See Attached Site Sketch**
Welis must be 10 feet from property lines.
V.yells must be 100 feet ftom septic systems.
Wells must hP �at �east 25 feet from any building foundation.
Othercond
PCHD, rev. 11/29/99