A24 1' ' Aocltcatlon Date: ') d -`�-d0
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Paresi #: �
Person Countv Heaith Deaartme�rt
Emrironmental Heaitlt Section
� 11PPLlCAT10N FOR SERVICES �
IF THE INFORAAATION IN THE APPIlCATION FOR AN IMPROVEMEi�IT PE�iMIT 13 FALSiFiED. CHANGED. OR THE SRE IS
ALTE�tED. THEN THE IMPROVEMFSIT PERMIT AND AUTNORIZATION TO CDNSTRUCT SHALL BECOME INYALID
1) Aemdt requested by: (own��rospa�ive ownerj: '� r� � M� x
t�lome Pfion� Address• o� titi�
Business Phone: ,So 3� s? o�' � 6L�c.� �2 ��� 3
Zj Name and addr+e� of carrent owner: �,FL. � �� A 1.,.1� c.� � Ar+ s
- � � �r i;s 02 .
� �r�o�(d� .C. 27343
3) Property DesCriptlon: Lotaize: Z,o2 PTa�nsh�pc • Lu����Nn.�
Dire�ons to the propecly (Induding road names and numbeis):
4) Proposed Use and Structiue
� a) PraQoaer� E�ds�9 �
�./�s r �f0 ..+ r�co fo ^a � �+f� i /`'1� � �
'f7� G.2�SS �A�L/laa0 AiCrdG� . e,� <Na�cf OL, f�n Z,sf,��.CS »� ar� ,/��
AC.�(S �/��. GoT J e,.++.—.�.-.`�'=„=+= 1�3(c,i w�E� /►W'aY^cAKc�yQo ,q.+A AC��J�E OGC-.
Description: answer ea� of the following questians;
b) Stldt B❑. Modular'� Single Wide Q Dauble Wide ❑
c) Number of 8edrnoms: .�, - - � Number of oa�parrts or peopte to be served: 3
e) 8asement Yes Q No�lf yes, # of basernetrt fodurex
� Garbage Dispoaal: Yea Q No W ,
� Dtmenaions af Proposed Strudure: Width: .S6 pepih; Z$ �
3i �S�' �PPh► Type: Pdvate gQ(new 15�or e�dst6�9 �. Pub�c q Cammun�y 0, Spdng ❑
� � Are arry we0s on a�oining property? Yea ❑ No O lf yea, locatlon
Pleaae IndicaEe D�ined 3ystam Type: (ayaEems can be raniced in or� of your prefenence)
t Conventlonal �o�#ied Conventiona! �IEermtive Innovative
_Dther (spodty):
CLEARLY STAKE ALL CORNERS AMD LINES OF THE PROPERTY.
3TAKE THE CORNERS OF ALL PROPOSED STRUCTURES.
PLFA�,SE ATTAC�I SURVEY PLAT OR S1TE Pl.AN TO TH18 APPLICATION
I hereby make appiica�on to the Person County Heaith Departrnerrt for a site evaluatlon for the on-sfite sawage disposai system for
the above-described property. l agree that the conteMs of this appaca�on are true and repre.sent the maxinuun faciGtlea to be
piaced on tt�e property. I understand if the site is altered or the i�ed use changes� the pertnit shail become imiaUd. l understai�d
that as a�p8carrt, i am ��sibie fo� identliying and marlcin9 P�'oP�Y �, comers and maldng the �te acce.ssibie fior the
personnel of the Person Courrty Heaith DepartmeM to candud their evaluatio�s. I underst�d that I am responsibie for noti�ling the
Hea�h Department if my pro ta' arry we8ands as designated by the Army Corps of Es�ginee�s,
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. Owner or Leg rese�at[ve . p� .
PCtiD. rev.10l12199 J
, . . QWo-�oa�por+rrco��iy�.
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PERSONCOUNTY . ycPEQS�NCOUN�S��`�
November 29, 2000
Cecilia Williams
1056 Shore Acres Drive
Semora, N. C. 27343
PERSON COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH PROGRAM
20-B Court Street
Roxboro, North Carolina 27573
(336) 597-1790
Re: Appiication for improvement permit for Wastewater system for property at Shore
Acres lot 1 B.
Person County Health Department File: Tax Map #A24, Parcel #1.
Dear Ms. Cecilia Williatns,
The Person County Health Deparrinent, Environmental Health Division on Novemver 28, 2000 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 serve a three bedroom residence with a design wastewater
flo�v of 360 to 480 gallons per day. The, evaluation was done in accordance with the laws and rules governing
�vaste�vater systems in North Carolina General Statute 130A-333 and related statutes and Tide 15A, Subchapter
18A, of North Cazolina AdmiiustraUve Code, Rule .1900 and related rules.
Based on the criteria set out in Title 15A, Subcl�apter 18A, of the North Carolina Administrative Code, Rules .1940
tluough .1948, the evaluation indicated that the site is UNSUITABLE for a ground absorption sewage system.
Therefore, your request for an improvement pernut is DENIED. The site is unsuitable based on flie following:
1. Soil depths to saprolite unsuitable (Rule .1943).
2. Unsuitable soil characteristics (Morphology) (Rule.1941)
3. Soil «�etness conditions indicated by chroma colorization (Rule .1942)
4. Topography and Landscape Position (Rule.1940)
5. 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 into ground water or inside your structure.
T'he 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 die 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 flie reasons set out above, the property is currently class�ed UNSUITABLE, and an improvement pernut shall
not be issued for this site in accordance wiUi Rule .19480.
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 tlus rule is enclosed. You may
lure a consultant to assisst you if you wish to try to develop a plan under �vhich 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
enviromnental liealth 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 �vriting to die local health department.
You also have a right to a formal appeal of this decision To pursue a forn�al appeal, you must file a petition from a
contested case hearing �vith the Office of Administrative Hearings, 6714 Mail Center, Raleigh, N.C. 27699-6714.
To get a copy of a petition form, you may �vrite 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 �vish to pursue a formal appeal, you must file the petiUon 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 rigl�t to a formal appeal. Beginning a formal appeal �vitlun 30 days will not interfere with any informal review
• fliat you might request. Do not wait for the outcome of any informal revie�v 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 aze required by
la�v (N.C. General Statute 150B-23) to send a copy of your pefition 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 fliat 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 informa6on
or assistance.
Sincerely,
�
/�,��
suzanne Knoa
Environmental Health Specialist
Environmental Health Division
Person County Health Department
PERSON COUNTY � �N�
PERSON COUNTY HEALTH DEPARTMENT
ENVIItONMENTAL HEALTH PROGRAM
20-B Court Street
Roxboro, North Carolina 27573 :
(336) 597-1790 -
February 7, 2001
Nathan and Mary Piess
34 Lake View Estate
Semora, NC 27343
Re: Tax Map A24, Parcei 1
Dear Mr. & Mrs. Pless:
After reviewing the application, evaluation, and denial letter for property owner Cecilia ,.
Williams concerning Shore Acres Lot 1 B, I have determined that the construction of a
building for storage and/or workshop will be permissible providing the following
conditions are met. � _
1. The building shall not be served by water or have plumbing fixtures due to the
unsuitable characteristics of the soils for a waste treatment system.
2. Person County Zoning permit be acquired. �
3. The proper building permits are secured through the Person County Building
Inspections Department.
• If I may be of further assistance, please contact me at 336-597-1790.
Sincerely,
� � �.
����
Janet O. Clayton, . .
Environmental Health Supervisor
Person County Health Department