A23 87The District Heolth Department
CASWELL - CHAT«'iAM .; L�E - PERSON COUNTIES
Water Supply and Sewage Disposal
IMPROVEMENTS PERMIT No.
Da �
i ..
Owner• �
Location:
1�2�
Contractor: ...(?,1��
Sewage Disposal Facilities: No. bedrooms
washing mac
Size of tank:
other automatic appliances
Other disposal facility:
Dishwasher, Disposal,
NitriScation line:
�
Water supply and sewage disposal facilities location, installation and
protection must meet state and local regulations.
5eptic tank should be pumped out every 3 to 5 years an3 shall be main-
tained by owner in such a manner as not to create a public health hazard.
Septic tank and nitrification line MUST BE INSPECTED AND AP-
PROVED BY A MEMBER OF THE DISTRICT HEALTH DEPARTMENT
STAFF BEFORE ANY PORTION OF THE INSTALLATION IS COV-
ERED AND PUT INTO USE. �/) _ /� /)
Date approved: —
Well:
Sewage Disposal:
By:
Certificale of Compleli n
/ J
Date Approved:
or
i
BY.
Sanitarian
(OVER)
Location of well and sewage disposal facilities sketched on back.
Application Date: ��� � �� �' �}�°���� Tax Map: „�
AmountPaid: o cX��� � �„• • Parcet#:
Ytecetpt #: 26"( � � � ���� �
�oxnv+aa•aam�a�adaa.d,m..1L II�Eci�m,.f! -f�.
600
t or
❑ Well Permit
Add[ilon
the tvae of
lin� Septtc System
No Charga/ CA $I50.00 or 5300.00
/OS' l�t�av 1�2�� Ci �< <'e ; � � 11 � �g }�d�'S S'
1) Applicant Informa ' n: N C 7 S i z J
Nama: C , �r � Phona (home): C��i 2(.� 13�1
Address; ' n„ {worklcell): S /q Z� � /; ��
P�c ��,, � �
2) Narae and address of current o— w�f different than applicant):
Nama: ' Phone:
Address;
3) Property DeacripHon: Lot Siza: Subdivision: ,�� %�c�+. �Q Lot #: �
Address and/ar directions to Property:
❑ yes na Does tha slte contain any Jurlsdlctlonal wetlands7
�.yes � no Uoes the stte contaitt any exiating wastawater sysiems?
� yes �0-no is any wastewater goiag to be genarated on the sita other than domesttc sewage?
0 yes �no Is tha site subject to approval by sny other public agancy?
❑ yes �,t10 Ara thera any easamants ar right of ways on this proparty7 �� �t"-�.. -�� ��
(if'yss' is checkad, plassa provide supporHng dacumentation) v ��Q �+„ �.
.�t`� `l+t- t Y`
4) �'roposed Use aud Type of Stracture:
❑ de tia �.�'e-4 �
❑ New Single �amiIy Residanca Maximmm �umbar of bedrooms:
0 Expansion of Exisdng System If axpaasion: Gtiurent number of bedraoms;
i� Repair to Melfl�ncttoning System Will there be a basement? C! yes ❑ no With plumbi�g fixtures7 ❑ yes 0 no
�Non-Residential
Type of businass: � Tota[ Square footage of Building:
Maximum number of employeas: Maximum numbarofseats;
a� Water Supply,: O Naw wal) �ExIsting Well C] Community Well ❑ Publia Wat�r fJ Spring
Ara there any existfng wells, sprfngs, ar existing waterlines on t8is property? � yes ❑ na
6) If applyiag for `Authorization to Coastruct', please tndlcate preferred syatem type(s): �
❑ Convontianal L7 Accepted C! Innovadve 0 Alternativa ❑ Other Any
I cert� tha� the lnfoYmation provfcled above ts complete and correct. I also understa�d that cf 1he ir{formatlon provided ts
inaccurate, or if th�f�e !s subse ��Iy frlt red, or the frriended use changes, allpermits and approvals shall be Jnvalic�
�����j � fl��l�r
Slgnature'(bwner/%e �al-Representative*) Date
�' Supporting dacumentation requlred. �
o Permits are valid for either 60 months or are noa-expiriag w�en accornganled by an approved piat,
• A completed `Lat Preparatton' form must accorapany any appltcation requfring a ait@ evaluation,
�,n�r,� D........., n....«�.. �.+. .:...............�..1 uw..t�l, �'fc e AA.+r..��+ e+ Ci�;+o!'� n....L..__ Lrn �'rr�l� .��. en•. ,nn�.
S Y�
�y.. �..
�>...h. , ,,,_a �`r
� f.:
..a — � � � q../ � � �
�n�n�n��n�nn�nc�n�n��.� �c��.J�4,J�n
6/30/2014
Ray Coppedge
105 Warley Circle
Cary NC 27512
RE: Oak Pointe Lot 7; evaluation to locate septic repair area
Tax Map: A23 Parcel# 87
Mr. Coppedge:
nsuring a healthy environment
On June 27, 2014, our office performed a site/soil evaluation to try to locate a septic
repair area for the existing residence on this lot. The only suitable soils area we could
locate was the area previously identified by S&EC. There were no other suitable soils
areas on the property except for this one area. This means that if you decide to convey
this area to Lot 6, you would have no other repair options except to apply to NCDWR for
a surface discharge permit.
If you have any questions please call me at 336-597-1790.
Sin erely, �
,�.� �L✓i/
Adam Sarver
Person County Environmental Health
phone 336.597.1790
fax 336.597.7808
325 South Morgan Street, Suite C, Roxboro, NC 27573
m
� A r
1
.... , ,. ,
`•.,.,,;..;::. '� ; ;` ;�
.... . .. � � ����
�n��n�^�nan�n.�n���m,� �c��.J���n
July 21, 2014
James E. Stovall
PO Box 1386
Roxboro NC 27573
Re: Notice of Intent to Suspend IP/CA Permit
Health Department File: Tax Map# A23 Parcel# 86 & 87
Oak Pointe S/D Lot# 6& 7
Dear Mr. Stovall:
nsuring a healthy environment
On 7/15/2014, the Person County Health Department, Environmental Health
Division, verified that the properties referenced above were not deeded and/or recorded
prior to January 1, 1983. According to North Caxolina Sewage Laws (Article 11 of
Chapter 130A of the North Carolina General Statutes), Rules (15A NCAC 18A .1900 et
seq.), both lots require septic repair areas. As a result, the Department must suspend the
recently issued Improvement Permit/Construction Authorization due to the fact that:
1. If the proposed septic area on lot #6 was conveyed to lot #7, then lot #6 would no
longer have the required repair area.
This is to notify you that based on these findings; the Department intends to suspend
your Improvement Permit/Construction Authorization effective 30 days from the date of this
notice.
You have a right to an informal review of this decision. You may request an
informal review by the soil scientist or envirorunental 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 Service Center, Raleigh, NC 27699-6714. You may write the Office of
Administrative Hearings, call the office at (919) 431-3000 or get a copy of the petition form
from the OAH web site at http://www.ncoah.com/forms.html. 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. North
Carolina General Statute 130A-335(g) provides that your hearing would be held in the
county where your property is located.
phone 336.597.1790
fax 336.597.7808
325 South Morgan Street, Suite C, Roxboro, NC 27573
Y • �
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 July 21, 2014. Meeting the 30 day deadline is critical to your formal
appeal.
If you file a petition for a contested case hearing with the O�ce of Administrative Hearings,
you are required by law (NC General Statute 150B-23) to serve a copy of your petition on
the Office of General Counsel, NC Department of Health and Human Services, 2001 Mail
Service Center, Raleigh, NC 27699-2001.
Do not serve the petition on your local health department. Sending a copy of your petition
to the local health department will not satisfy the legal requirement in NC General Statute
150B-23 that you send a copy to the Office of General Counsel, 2001 Mail Service Center,
NC Department of Health and Human Services.
You may contact our office at 336 597-1790(phone) or 336 597-7808(fax).
Sincerely,
Y"� �
S'gnature of DHHS Authorized Agent