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A29 218-rr-------..-. ........ �'r I '-'Q � i ax lvtap: Amount Paid: 00 . DO Parcel #: • Recei�t#: 8�3 7 Z r• ��`� �.�" �. ��.�� # �� '' *""``� � � � _�� '7(" Y` � C a � � � U %1 (� IE.±�:ca. vnn: ,r:n.ua_a-x-n..c,a.n.-n.a:,u...11 IF.-:J��:_�.�n.11.it.11a. � a M � �1 Application for Services Mee� � � � _ _ (Septic Systems and Wells) Services _ Improvement Permit (Site Evaluation) $200.00/$300.00 (if> 600 �pd) ❑ Mobile Home Replacement or Building Addition $150.00 (if site visit re uired) ell Permit cement) p �,c $2?5.0 /$12�.00 � R2p�0.CsL h ��d� ( equested ❑ Construction Autliorization _(Fee is dependent on the type of sy: ❑ Permit Revision $75.00 ❑ Repair of Existing Septic System No Charee Important: If tlie i�r.formation in t1:e application for an Improveme�tt Permit is incorrect, falsified, or tlte site is altered, tlie�z 1he I�nproven:enf Permit and the,9utl:orization to Construct sl:all becon:e invalid 1) Services Requested by: Name: ��4vL� �,1�u L L oG/� Address: � O/ Gl>�S ,G �y'v�.N Ro�i R o,z��3 0 � o , .v �, � �-� � � Phone # (home): 336-5'99-3'�-�> (work/cell): y,t� ,�'�`1.--/� � 7- 2)Name and address of current owner (if different than applicant): Natne: Address: � � 3) I'roperty Description: Lot Size; G��"tS Subdivision: Lot #: Address and/or directions to Properiy: y/Z,! Q�.^�<ti4�vti. /�o�.cQ. �/la�,(j�,� o��Jc�/�7�� O L/.t/.tj- � j ! s�� +C SC�t� �i C� /7�i luU.+a- a- J'uL .Sf�'7F'ic� m-c./ f- !� �e E '— � i� C-- /S�e '%. w c. � 9 .p ea f� �s t� 2 O a N d 4) Proposed Use and Type of Structure: Residential �_ Business/Type: Other Number of bedrooms �-• / Number of people served (seats/employees): Basement: Yes No �(with plumbing: Yes�fto � Garbage disposal: Yes No Approximate size of building foundation: Length� � Widtll �� S} Water Supply: Private Well � (Proposed Existing �) � Community Well: Public Water System: Are there welts on the adjoining properties7 No Yes �_ (please show location on site plan) U-J �GL S C�' /�? ��y 1'ti'7 �� c..w crG�. y o p-- �c3 ;�-�G. ecp�' Note: A comnleied apnlication rrzzust also include• ➢ A p[at/site plan of tl:e property that shows prope�•fy dimensiorzs and the size and locatiota of all proposed structures. ➢ A signed copy of tlae `Lot Preparation' form ver�ing that tlie property is ready to be evaluated. I am submitting this application to request services from the Person County Health Department. The information provided is accurate. I understand that if any site is altered or the intended use changes, all permits shall become invalid. Signature (Owner/Legal Representative): � • �7 ..-�—r��-�ate; �fi(�..�v��Zod � v , 11/07 Person County Environmental Health, 325 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-1790) , , .°,- _..,..._ ... _ \� � �� I�,��na ��-n ��.�c��.11 ��[ �.��.Il �LII,. David Bullock 4121 Burlington Rd Roxboro, NC 27574 RE: Site Evaluation Application Dated 5-1-08 located on Burlington Rd Dear Mr. Bullock: nsuring a healthy enviro�imcnt July 21, 2008 The Person County Environmental Health Department has a policy that states any application, which has not been acted upon for 3 months becomes void, and any fees paid are then forfeited. Our records indicate that an application was filed on May 1, 2008, for Lot 1 Cabin on Burlington Rd. Our Department conducted a site evaluation on May 21, 2008. We have not received a plat showing the new property lines and lengths. No other comrnunication has been received fro�n you concerning this property. If action is not taken by August 21, 2008, the application will become void and all fees forfeited. If you have any questions concerning your application, please contact Bonnie Holt of the Person County Environmental Health Department at 336-597-1790. Sincerely, . � Bonnie T. Holt, R.S. Environmental Health Specialist Person County Health Department phonc 33C.597.1790 fax 336.597.7808 325 South Morgan Street, Suite C, Roxboro, NC 27573 , �. ' �\��..�� I�nn�n��onz�rnz��.n-a1L-�:�.� �E=�I�<�.11tL�-n David Bullock 4121 Burlington Rd Roxboro, NC 27574 RE: Site Evaluation Applications Dated 5-14-081ocated on Burlington Rd Dear Mr. Bullock: nsuriug a healthy environment July 21, 2008 The Person County Environmental Health Department has a policy that states any application, which has not been acted upon for 3 inonths becomes void, and any fees paid are then forfeited. Our records indicate that three applications were filed on May14, 2008, for three lots on Burlington Rd. Our Department conducted site evaluations on June 2, 2008. We have not received a plat showing the property lines, lengths and soils area. No other communication has been received from you concerning this property. If action is not taken by September 2, 2008, the applications will become void and all fees forfeited. If you have any questions concerning your application, please contact Bonnie Holt of the Person County Environmental Health Department at 336-597-1790. Sincerely, r---� • ��-�-Q Bonnie T. Holt, R.S. Enviromnental Health Specialist Person County Health Department phone 33C.597.1790 fax 336.597.7808 32_5 South Mor�an Street, Suite C, Roxboi•o, NC 27573 -rr---___.,__ .�...,. � - j.�—�� i ax �vtap: Amount Paid: r,266 , 0� Parcel #: Rec�ipt#: . _�g �j �j ,' , �o-}�. �____�-�,� � ..�_. ��''�.� �� .___._. ;- �-- �� l�" ��.� `�I" Y!" � '/ V .11.�r.:['1.r\�]l.]L'�aK:DI�T.:IY,?IIT..�[�.�]th.'Q':�•LII..Il �F":��4'.:^.tRl�.'\L..I�Zl. � Application for Services __ _ (Septic Systems and Wells) Services Improvement Permit (Site Evaluation) $200.00/�300.00 (if> 600 Qpd) ❑ MoUile Home Replacernent or Building Addition _ $150.00 (if site visit required) ❑ Well Permit (New/Replacement) $225.00/$125.00 equested C Construction Authorization (Fee is dependent on the type of sy: ❑ Permit Revision $75.00 ❑ Repair of Existing Septic System " No Charee Important: If the i�rformation in tJ:e applicatio�: for Rn Improve�nent Permit is incorrect, falsified, or tl:e site is altered, tlien the Improvement Permit and the.Autl:orization to Construct shall becvme invall�l 1) Services Requested by: Name: �,�- � i Z� ��t �.�. �c./� Address: 1�'� ;1„/ ,�cc rL��f�.,ti Jn�<..� �' � E3 's � �, ,��.� h �' 3 Phone # (home): �� •-j �� j-5`/� / (work/cell): �//� - r � � ^r� /�, 2)Name and address of current owner (if different than applicant): Name: �� 1 t��= 5 L. G"��r.v i� o�4:'� Address; � � � �� ,v .� — '7 ,/�. v' �?l � �! L L, �r �.,!'� I �, it �=r'v',t' s' 3) I'roperty Description: Lot Size: ��SSubdivision: I.Ot #: � 4) Proposed Use and Type of Structurec Residential _�� . Business/Type: Other Number of bedrooms �/ Number of people served (seats/employees): Basement: Yes No _(with plunnbing: Yes _ No __) Garbage disposal: Yes No Approximate size of building foundation: I,en�th Widtlx 5) 'Water Supply: / Private Well _��Proposed V Existing _) � Comnnunity Well: Public Water System: /' Are there wells on the adjoining properties? No Yes �►/ (please show location on site plan) Note: A complefed application nt[ast also include• , � A plat/site plan of the property that sliows prope�•fy dimensions and the size afid locatioft of all proposed structures. ➢ A signed copy of tl:e `Lot Preparation' for�i verifying that tlae prope��ty is ready to be evaluated. I am submitting this applica#ion to request services from the Person County Heaith Department. The information provided is accurate. I understand that if any site is altered or the intended ase changes, all permits sliall become invalid. Signature (Owner/Legal Representative); :f� �-�T�/ �- ��,��-� �ate: U��"' i " G 1 1/07 Person County Environmental Health, 325 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-1790) • / ; X_ , _ Fpric , / � ,� �osE�l�_�_E �,��,��_ � a�a� �� ?y� �_. 0 . • � � ,',\ ��y �a�F� `� . „ — NOv �� :�,. /, � „oo �� u! �� O fy q F�, / � � � �� °j � \ A ,�q,�C` ` \ �": <<'_� � / Q \ O p � .. � / �� • • � .. � � �C n� \ � � �� ' � � � I � i5a9� � � �, ��.�� c J' j / / / i �. l / � � � � � : � � � _ � S89°27'36°E � '� , � � i , 388 j � � — i � i �\ ? �_^, i � i � ��,`�' � � , � 1 0 . 4 A C ,, \ / / .' J � � � \\ � �5�7��1 �; ��G�"� � (� � / I \ � A �-' � �,514.65 � �, \ % � � � 7 � \ , � J �\ \ NC 49 ' �� ' ,,,�J 1 � . 8 r� � \`, � I O�.J I �`/ Y� / i` I N89'31 ' 13��pd �� 1,625.74 �� i � / � � i � � / �\ � � / / �� i '� � i �' � � _ ' � � _.__— � / � "` '--� i� � j� �- � , � _____----/ , �� _ ' � v � ' � � --_ _ �,' ,r �� j ' ^I ca / / , , l � j 4 � � r;� � ,� � � , � � __ ___- � � / ' � ---- � ' \ r' -STATE I ( � i - ` � -� -- � / �,_ ---�, ll I / � �� I �- � I / � I � I � � � � I /� � � i � � � � � i � � , � , / � —----- , / � I I '�^NALD SIDNFY WFlDE � �n 9t3--= - 1 5 ; -rr-------..._ .�....,. �-14 -C� C 1 ax 1v1ap: Amount Paid: �00. DU Parcel #: ' Receipt#: • . � � � 3 �7 9 C'.�°-� `--��-•`�� S � I�'��'�.�� -��o �� - � t� � �'i��/�� .1L. � v::[7]. l'� TI. �L"'.C:P liT.:IIZT...S�.7 ,ILh.'Q'J.LR..�l .J��.L m_-+ xn. TI. ��t:.:Ia. _ Application for Services _ (Septic Systems and Wells) L9' Improvement Permit (Site Evaluation) $200.001$300.00 (if> 600 Qpd) ❑ Mobile Home Replacement or Building Addition _ $150.00 (if site visit required) ❑ Well Permit (New/Replacement) $225.00/$125.00 Services Re uested C Cnnstruction Authorization (Fee is de endent on the e of sy: L Permit Revision �75.00 � . . ❑ Repair of Existing Septic System No Charee Important: If tl:e information in the applicatioit for an Improvement Permit is incorrect, falsified, or the site is altered, tfie�t the Improventent Permit and the Autltorization to Construct sliall bec�me invali�l 1) Services Requested by: Name: 'J! ,•�v� i� .�� d �' e,� Address: _�/ � / __ �c/r� �/ � �-T� •� /� c{� �G�i'3 c2 e' . N � ��1 Phone # (home): �j� --5 ��j ��'�'/ -r (work/cell): _y!� -.y'��. - /G /� 2)Name and address of current owner (if different than applicant): Name: ��t��J ��: ��G�< Address: �/ w�,s-�L-y�,v /.� �,� � !`ox,�o/�o, .fv� Z�-�� 1�� `/ 3) I'roperty Description: Lot Size: �� rS Subdivision: Address and/or directions/ to Properly: c/� ;� / 1� �i.--�i �� u �f7' �'N/L'r �cc�flL u� �� L1 i D./ Lot #: .Z. G�-G 7� c� � i�U� 1/ �,/ �7 4) Proposed Use and Type of Structure: Residential _,�_ Business/Type: Other Number of bedrooms 3�� / Number of people served (seats/employees): Basement: Yes No _(with plumbing: Yes , No � Garbage disposal: Yes No Approximate size of building foundation: Y,ength Widtli 5) �R'ater Supply: Private Well l�(Proposed 1� Existing _) � Community Well: Public Water System: / Are there wells on the adjoining properties? No Yes i1 (please show location on site plan) Note: A completed application rrzcrst also irtclude• ➢ A plat/site platt of the property that slioivs property dimensions and the size and locatio�t of all proposed structures. ➢ A signed copy of t1Te `Lot.l°reparation' form verifying tltat tlze property is ready to be evaluated. I am submitting this application to request services frocn the Person County Health Department. The information provided is accurate. I understand that if any site is altered or the intended use changes, all permits shall become invalid. Signature (Owner/Legal Representative): ��'�� U.-�z�� Date: �'-�✓ I' v� I I/07 Person County Environmental Health, 325 S. Morgan St., Suite C, RoxUoro, NC 27573 (336-597-1790} e I x` r- .�� ROSEVILi_E FARI��`� �� / o�, < D.B. 291 , P. � • � ��5� / �/\ � �}o �°eo�o�o �"? \ `�o \ `� s� A � � �� i / /� \ S \ � -� � A�F .o �o S� Y(,; / / �� .� \ �9 j�} \ � ,� F� � ' �e �� o 0 f;j � //-� �,� '� � ��,1 � � � '�°�o �� `� == �r , �� , , � � _ _ ,, ;� I � � � � � '� 1 1. 2 A C, i �� 75.98 � � � � / � � �� / S89°27'36°E o ACRES ,� � � __ � ,,388 �, � _ , � � , ' \'�, 2 �"—� o ' �� „�`� �[ ��,\ 1 0 . 4 A C ,� � "' � � \ �° � � ` � S87°41'S4"E i • �� \� � '��i 1,514.65 � � � � � � 3 � � � o �, , � � � _ � � N C 4 9 �' �� o. 8 A c�� N� 1 � �' R/ W / , N89' 31 ' 13"W �� \� � o � j i�� 1, 525 . 74 � � � � , � �I / � �� \ � i � � i � �, i / i `� / / �---- / � I � �� `� i � � i � �I / o � �� v, � � �. � i c o= � � r � o� -i _ o I� � r 4�. � �C �� / � �z z � �� I , /--� m i �---- � o I �=STATE � � � � o� ' � ,---- �_ � � 1 � cn ' / //�// 1�I � � _ S ' �— — / I I / � � I ' / I I / � � ' � \ �/ , I i— — — — — — I � DONALD SIDNEY WADE � ' 98-E-151 Cn - -rr---.,.-_.,._ ...,.... � —� 4 —� i Amount Paid: �00. � Re�eipt#: ��c� �� # �`-.`�, � �.�"_. �I��.� �� .____. : ��-. � � .�- _, - ,�t`` � �I�V .�l.�.v::[i. S�T.II"��C:D]tT.:]Y�tT.<S'..^�]LT.'�•?J�..Il �f �ja_-�.en.��.-�i:..:(a. Application for Services (Septic Systems and Wellsl L�?'[mprovement Permit (Site Evaluation) �200.00/$300.00 (if> 600 gpd) ❑ Mobile Home Replacement or Building Addition $150.00 (if site visit required) ❑ Well Permit (New/Replacement) $225.00/$12�.00 i ax Map: Parcel #: Services Re uested ❑ Construction Autliorization (Fee is de endent on the e of s: ❑ Permit Revision $75.00 ❑ Repair of Existing Septic System � No Char�e Important: If t1:e information in tlie applicatio�i for an Improve►ne�zt Pertnit is incorrect, falsified, or tlze site is altered, tlien the bnprovement Permit an�t theAutltorization to Construct sl:all becvme invali�i 1) Services Re uested by: Name: ' / v�� .l��t��e,� Phone # (home): ,j3�-5'94�-�y.�� Address: y/ � I �/ c��.�� 7�c+ v � (work/cell): y/,� =,S"�x•—!� �x.. �c�C t'� c�l. � , .,�t/ � j1. �-7 .�� 1 2)Name and address of current owner (if different than applicant): Name: ��1 ci' s: ,�v %/c� e/� A.ddress: L' C� i l!/�.; t-,�"�,v ��:4.' /�'��r�t2 � � .ti � � � � 3 � ��: /r $ 3) Properly Description: Lot Size: l0, � Subdivision: Address and/or directions to Prope�' �,�/� /�.:�i-��.uos�e v/. ��/ tvJ i� ,� s��v �`�t, c..�- %�u� �' �a-f�cj �f. d -� , LE' �`" �`�/s'��,�<�� v 1°�..r-r/� �._af"3 �ri-� 6�_ Lot #: � � �-,�-s; s;�� -�yy� � �i.t ;:t��- 4) Proposed Use and Type of Structure: Residential �_ Business/Type: Other Number of bedrooms `-- �� / Number of people served (seats/employees): Basement: Yes _ No �(with plumbing: Yes _ No � Garbage disposal: Yes No Approximate size of building foundatia�: lLength VVidth � 5) 'Water Supply:/ / Private Well V(Proposed V Existing _) � Comrnunity Well: Public Water System: Are there wells on the adjoining properties? No Yes �(please show location on site plan) Note: A completed application rr�ust also inclicde• ➢ A platlsite plan of the property that slzows property dimensions and the size and location of all p�oposed structures. ➢ A signed copy of tl:e `Lot Preparaiion' form verifying that tlae property is ready to be evaluated. I am submitting this apptication to request services from the Person County Health Department. The information provided is accurate. I understand that if any site is altered or the intended use changes, all perxnits sliall become invalid. Signature (Owner/Legal Representative): � �%•��-�"'�_y�ate: D� /y d v 1 I/07 Person County Environmental Healih, 325 S. Morgan St., Suite C, RoxUoro, NC 27573 (336-597-1790) • i r�� ROSEV I LLE FP.R�4=�. x� � ,' / e�, < D.�. 291, r. / TO � O �C \ � � O �J- pB� ` �/- � � �� V'�i � ry � .� � �,o�, o • � ��/ � / / � � o° �v � sA ,``F\ (,�� 1 A ,o t`�5,� A s� � ��' � < � � �,� q>°j � �9,Ft \ }u. / / �Q — � O �i/� � �-A ^�� V � `^ � O� \ \ /'.� / � 1 �� t. ._�ks' � j ' '� 1 � � � � � 'i 1 1. 2 A C, �' �� 75.98 � � � �� , � -� �� S89°27'36°E � ACRES � � � --- , � \ / 1,388 / \ _ i �� \ 2 ��1 ' �� `� ,�`� ��.� 1 0 . 4 A C ,, �\ � � � �° � �� `S87°41'S4"E � � � o � � cn i 1,514.65 \\ \ � i \ \ � o '� i • � 3 ` � � r • ` N C 4 9 �' �,� �`� o. 8 A c�� N� 1 � �' R/ W / i N89°31'13"W �� / i�� 1 , 625 . 74 � � / � � � / � � � /� .� � � \ � i / �� i � i � � / /�i �\ - _— � i � / I i � / o � --� / i � � ,`�V � C � z 1 / r 1 m -+ ` - � o � / � 43.5 AC oo I _� '� �� — — � rn � - / ' � � � ��----- � o =�TaTE � _ _ oo � � I rn � � � ��— �� n _� / � � i ' � _-- // � I i I I i ' / I I / 1 , ' � � // ' I ( � ;' r ,� ' DONA�D SIDNEY WADE � 98-E-151 Cn