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A34 85,�poilcatton Date: � 7�' ,�rnount Paid• � Rec�i— t �k V�� �� � �srson Cauntv Health Deaartment Environmentai Health Section APQLJCATION FOR SEitVICES �ax �ao �: Pgrc�! #: 1 Permit raqu :(Ownerla errt/prospe��tive owne�: ( cS r�.s (� `ShPS Home Phon 5- C� Addr�ess: �-I�33 �cd_I,e« m; �� R� Business Ph e: � �r�cr�_ ,ru,C. A?. t�� , 2) Name and addness of cament owner. ; 3) ProperLy Descrlption: I_at stze: � Diredions to the property,(Indudtng � ro,�ns�,��x C k1U u i�U� ��,� , �c� 4) Proposed Use and Strveture Description: answer each of the fallowing questicns: a) Proposed 0, Existing ❑ b) � Sticic Built �, Moduiarp� Single Wide �. Oouble Wide ❑ i c) Number of Bedrooms: �, d) Number of occupants or people to be served: 1 .. e) Basesnen� Yes �.. No 1�If yes, # af basement fixtures: - - -- - - . _ __ __:_ _ ..____. ::.�: .: -- --. .. . _ . _ f} Garbage Disposal: Yes O, No'� � g) Dimensions of Proposed Strudure: Width: � Depth: 3 Q � 5� Water Supply Type: Prlvate (new � ar�existing �, Publ(c �, Community �, Spring ❑ . Are Is on adjoining property? Yes ❑ No � If yes, locatlon �-� 6) Please lndicate Desired System , i ype: (sysrsms can be ranked in order af your preferenca) Conventtorrai ,,,_Modifled Convendonai ; _Altemative Innovative Other (sP�Y)� � CLEARLY STAKE ALL CORNERS AND UNES OF THE PROPERTY. STi4KE THE Ct3RNERS OF'ALL PROPOSED STRUCTURES. PLEt1SE ATTACH SURVEI( PLAT OR SiTE PLAN TO TH13 APPUCATION I hereby make application to the Person County Heatth Department far a site evaluatlon for the an-site sewage disposai �system for the above-descxibed property. I agree that the canteMs of this application are true and represent the maximum faa�ties to be placed on the property. I understand if the site is altered ar the irttended use changes, the permit shall become invalid. f understand that as applic:ant, 1 am responsibie for ident(fying and maricing properiy lines, comers and making the site acc�ssible for the personnel of the Person Courrty Health Departrnerrt to condud their evaluations. I understand that i am responsible for notifying the Nealth De�artment if my property corrtains any wetlands as designafed by the Amry Corps of Engineers. _ � ��oj Owner or ai Representativ� � p� PCHD, rev.1aJ12199 • �pUNiY Gp� � �~�S 4� �1�, * ' * f � . . . - . . . . � � . wp ZQ � PERS�l� C�U(ViY '�N����"� August 8, 2001 Mr. Curtis A. Hughes 4233 McGhees Mili Rd. Semora, NC 27343 PERSON COUNTY HEALTH DEPARTMENT ENVIPrONMENTAL HEALTH PROGRAM 20-B C�urt Street Roxbor.o, North Carolina 27573 (336)597-1790 Re: Application for improvement permit for Wastewater system for property described on plat PLS-2648 prepared by Ernest B. Wood, Jr., July, 2000 Dear Mr. Hughes: On August 3, 2001, the Person County Health Department, Environmental Health Division evaluated the above-referenced property at the site designated on the plaUsite plan that accompanied your improvement permit application. According to your application the site is to senre a three bedroom residence with a design wastewater flow of 360 gallons per day. The evaluation was done in accord.ance with the laws and rules governing wastewater systems in North 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 DENIED. The site is unsuitable based on the following: 1. Unsuitable soil characteristics (expansive clay minerology, unsuitable soil structure) (Rule.1941). 2. Soil wetness conditions indicated by chroma colorization (Rule .1942) 3. Available space (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 lnto 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 anothe� area of suitable soil or off-site to additional properry' . . � For the reasons set out above, the properry 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 documen#ation 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 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. 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 Michael E. Cash, R.S. Environmental Health Program Specialist Environmental Health Division Person County Health Department P�RSO� CflU�TY Dear ,,�y� `J},� , � � � . _ �.,,��0 � . r�punn �oy yo �p �` _�'�• ..t�,;',• Y ^ 4:� • G s� G`: f PJ�'" COU� 5`r PERSON COUNTY HEALTH DEPr�RTMENT ENVIRONhiEi�'TAL HEALTH PROGRAIri 325 Souch Morgan Street ' Roxboro, Norch Carolina 27573 (33G) 597-2371 D ate: I"' S' `7 9 Re:�3 �--4 — � � � �. ) The above referenced lot has been eva(uated by the Person County • Environmentai Health Deparfinent. The results of the evaluation, a copy of whici� is attached, indicate that the site is unsuitable for installation of a ground absorption �s l q�z). Due to the (imitations on your site, this Department is not aware of any modifications or altemative measures that can be implemented to upgrade the classification from °unsuitable° to "provisional{y suitable." Your application for an improvement permit must, therefore, be denied. You have the right fo an informal review of this decision by the environmental health supervisor of this health department and also by the regional staff of the Department of Environment, Health, and Natural Resources. You should contact the health department 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 the health department for technical review. A site may be rec(assified to provisionally suitable provided written documenfation, including engineering, hydrogeologic, geologic, or soil studies indicates to the loca! health department that a proposed septic tank system or a proposed altemative system can reasonably be expected to function satisfactorily. �:,�, �:��. � � Page 2 The substantiating data from these studies must indicate that: A. The effluent (wastewater) wili receive adequate treatment; 6. The effluent (wastewater) will not contaminate any ground water or surface water; and C. The effluent (Urastewater) 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 fhe Office of Administrative Hearings, P. O. Drawer 27447, Raleigh, NC 27611-7447. A copy of a petition form will be provided fo you upon request. The petition must be received by the Office of Administrative hearings within 60 days after the date of this notice. The hearing will be held in the county in which your property is located. If you file a petition for a hearing, you must send a copy of the petition to Mr. John C. Hunter, Office of General Counsel, P. 0. Box 27687, Raleigh, NC 27611-7687. Please call or write this office if you have questions or need additional assistance. Enclosure �; .-,.�=r r=:.,. erely, �� � Environmental Health Specialist Environmental Health Division Person County Health Department . '�ti<:::