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A40 170Application Date: ` � �a "� � � Amount Paid: RecEipt �: �� •�,�� "�—� ' --:- � � ZU1�T'IL�� aa.-m-aa-amaa.�-^r� �sa.��.Il. 1��C�.m.71-�7�a Tax Maa #: �� Parcai #• � \ �� `� � �PPLICATION FOR 5ERVICES � " COIVSTRUCT SHALL BECOME INVALID. �!) Perrv�ii requesi�d by: (Ownerlagent/prmspective owner): �� t �l ► �- � r )�"t^.�-�y �� 5 Home Phone: �3 (� � 2-Z� � � (�1' Address: �� f H c� � � � h / Business Phone: r��+- 2�x i3a ►�Z� fvC � � . 0�'7 S � 2) Name and addr�ss of currer�t owraer. G� )►(� � c�-,.-, �-- -S'!}r-�Y ��} i' � . i t E- FC � 2b - i�4�O x►3c� t2� G. �.-� � 7� 3) Property Descr�ption: Lot size: ��Township: r�.� Subdivision: Lot # Directions to the property (lncluding road names and numbers): 4) 6�roposed Use and $tructure Description:.answer each of the following questions: a) Proposed �C Existing _, Type of Structure: �q C�8► n� c � es�- h�,�w�dtr,: � n Depth: � � b) Number df Bedrooms: ,�,_� �. Number of occupai� or peopie to e s�erved: �� 2 _ c) Basement Ye� , No � Will there be plumbing in the basement? NO � � d) 6arbage Disposal:.Yes _, No �C " 5) 1Water �upply. Type: Private _(new X or existIng�, Public_, Community� , Spring _ � Are any weils on adjoining proper#y? Yes ,� Na _ If yes, please indicate approximate location on the 'site plan. � . ' . 6) Does your pr��eifij cantain previous9y identifiec! jur�sdlc$ional wetlands? Yes_ iVo_ , PLE�4SE Pf0'TE THE FOLLOWIIdG: 9 A PLAi O� THE PRO�Ei2TY OR S1TE PLA[d MllST BE SUBMI�TED WRH THIS �PPLiCATi�N. 9 PROPERTY L1NES AIdD CORNERS MUST BE CLE�IRLY MARKED. �, ➢ iHE PROPOSED LOCATION OF.4LL STRUCTURES MUST BE STA6CED OR FLAGGED. � THE SITE i1flUST SE READILY ACCESSIBL.� �aR AN EVALU�►T70P1 �Y T�iE HEALTH DE��►RT11iEiVT STA��: " I hereby make appEication to the Person County Heaith Department for a site evaluation for the on-siie sewage dis�osal sysiem for the above-described property. I agree that the cantenis of this appiication are true and repcesent the maximum faciiities to be plac�d on the property. I understand ifi the site is a(tered or the intended use changes, the permii shail became invalid. ' ,);�-�., �.. Owner or Legai ��/�-�� Date Pcyo, ��. os�z7roz � \ / � � . � � � _ �� , ��. � � � , � � � ; -� �,,.�.; � � � �� a�� .�� William and Sally Cates 321 Huff Road � � nsuring a healthy environment Roxboro, NC 27574 July 12, 2007 Re: Application for improvement permits for lot on Huff Rd Health Department file: cut out of Tax Map # A40 Parcel # 170 Dear Mr. & Mrs. Cates: The Person County Health Department, Environmental Health Division on July 10, 2007, evaluated the %2 acre to be cut our of 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 one bedroom residence with a design wastewater flow of 240 gallons per day. The evaluation was done in accordance with the laws and rules goveming wastewater systems in North Carolina General Statute 130A-333 including related statutes and Title 15A, Subchapter 18A, of the 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 DENIED. A copy of the site evaluation is enclosed. The site is unsuitable based on the following: _ Unsuitable soil topography and/or landscape position (Rule .1940) X Unsuitable soil characteristics (structure or clay mineralogy) (Rule .1941) X Unsuitable soil wetness condition (Rule .1942) X Unsuitable soil depth (Rule .1943) Presence of restrictive horizon (Rule .1944) X Insufficient space for septic system and repair area (Rule .1945) _ Unsuitable for meeting required setbacks (Rule .1950) _ Other (Rule .1946) These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, into surface waters, directly to 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. phone 336.597.1790 fax 336.597.7808 325 South Morgan Street, Suite C, Roxboro, NC 27573 For the reasons set out above, the property is currently classified UNSUITABLE, and no improvement permit shall be issued for this site in accordance with Rule .1948(c). However, the site classified as UNSUITABLE may be reclassified 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 assist you if yo�: 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 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 for 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 or from the OAH web site at www.oah.state.nc.us/form.htm . The petition for a contested case hearing must be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150B-23 and all other applicable provisions of Chapter 150B. N.C. General Statute 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 The date of this letter is Julv 12, 2007. Meeting the 30 day deadline is critical to your right to a formal appeal. Beginning a formal appeal within 30 days will not interfere 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. Departrrient 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 local health department if you need any additional information or assistance. Sincerely, `��-� /��" Bonnie Holt, R.S. Environmental Health Specialist Encl.: Rule .1948d