A24 12���'nIC'�IC�a�cc��]L'��.� �c��.���
August 28, 2002
Susie Bailey
963 Allie.Clay Road
Roxboro. NC 27573
Re: Application for Improvement Permit for wastewater system for property off
Martha Royster Road
Person County Heaith Departrrient File: Tax Map #A24, Parcel #12
Dear Ms. Bailey:
The Person County Health Department, Environmental Health Division on August 13, 2002, evaluated the ahove-
referenced property at the site designated on the pl�dsite plan that accompanied your improvement permit
application. According to your application the site is to serve a three-bedroom residence with a design wastewater
flow of 360 gallons per day. The evaluation was done in accordance with the laws and rules governing wastewater
systems in North Carolina General Statute 130A-333 and related statutes and Tide 15A, Subchapter 18A, of North
Carolina Administrative Code, Rule .1900 and related rules.
Based on the criteria set ou[ in Title 15A, Subchapter 18A, of the North Carolina Administrative Code, Rules .1940
through .194R, 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. Soil depths to saprolite unsuitable (Rule .1943).
2. Expinsive Clay Mineralogy (Rule .1941 (3B)).
3. Available Space (Rule.1945)
These severe s�il 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.
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
suitahle soil or off-site to additional property.
For the reasons set out above, the property is cunently classified UNSUITABLE, and an improvement permit shall
not he issued for this site in accordance with Rule .194800 .
However. the site classified as UNSUITABLE may be classified as PROVISIONALLY SUITABLE if �vritten
d�cumentation 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 you wish to try to develop a plan under which your site could he reclassified 1s
PROVISIONALLY SUITABLE.
You have a risht to an informal review of this decision. You may request an informal review by the soil scientist or
environment�l health supervisor at the local health department. You may also request an infotmal 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.
phone 336.597.1790
fax 336.597.7808
20-B Court Street, Roxboro, NC 27573
You also have a right to a formal appeal of this decision. To pursue a formal appeal. you must file a retiti�n for a
contested case hearing with the Office of Administrative Hearin�s, 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 petitian for a contested case hearing must be filed in accordance with the provision of North Carolina
General Statutes 140A-24 and i 50B-23 and all other applicable provisi�ns of Chapter 1_50B. N.C. General Statue
130A-33S (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
HearinQs WITHIN 30 DAYS OF THE DATE OF THIS LETTER. Meeting the 30 day deadline is critical tc�
your right to a formal appeal. Beginning a farmal appeal within 30 days will not interfere with any informal review
that y�u might request. Do not wait far the outcome of any informal review if you wish ro file a formal appeal.
If you file a petition for a contested case hearing with the O�ce of Administrative Hearings, you are required by
la�v (N.C. General Statute i 50B-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 Counset, N.C. Department of
Environment �nd Natural Resources, 1601 Mail Service Center, Raleigh, N.C. 27699-1601. Do NOT send the copy
of the petition ro your local health department. Sending a copy of your petition to the loca] 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,
�t 4
Joel N. Hicks, RS
Environmental Health Specialist
Environmental Health Division
Person County Health Department
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Amount �aid: Q�- I �
Receipt #: I Parczl #:
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APPLlCATION FOR SERVIC�S
IF 1'HE INFORMATIORI IPI iHE APPl.iCATIOiV FOR AN IMPROVEMENT PERMIT IS IIdCORREC'T, FALSIFIED,
CFIANGED OR THE SITE IS ALTERED THE�t THE IMPIiOVEiNENT PERMIT AND AUTHORIZ�►TION TO
CONSTRUCT SHALL BECOME INVALlD.
1) Permit requested by: g ective owner): � w/1 �✓ ('�i0.1 � \
Home Phone: �t �i- � Address: � �
Business Phone: �
2) Name and address ofi current owner. � q�c�c.t-c� �&�-�� _ ���
..
Pirr�.,�/� � , � . G .
3) Properly Description:
Directions to the prope
Lot # �/
4) I�roposed Use and Strvcture Description: answer each of the following questions:
a) Proposed _, Existing , Type of Structure: Width:
b) Number of Bedrooms: �_ Number of occupants or peopie to be served: �0
c) Basement: Yes , IVo z/ Will there be plumbing in the basement?
d) Garbage Disposal: Yes No r�
Depth:
5) Water Supply Type: Private _(new ✓or existing�, Public_, Community_, Spring _
Are any wells on adjoining property? Yes ✓ No _ If yes, please indicate approximate location on the
site plan.
6) Does your property contain_previousty identified jurisdictional wetlands? Yes_ No �
PLEASE NOTE THE FOLLOWING:
➢ A PLAT OF THE PROPEl2'TY OR SITE PLr4iV MUST BE SUBMITTED WITH THIS �►PPLICATION.
➢ PROPERTY L1NES �►ND CORNERS MUST BE CLEARLY MARE�CED. , _
➢ THE PROPOSED LOCATION OF ALL STRUCTURES MUST BE STAKED OR FLAGGED.
9 THE SITE MUST BE RE�4DILY ACCESSIBLE FOR AiV EVALUATION BY THE HEALTH DEPARTMENT
STAFF.
1 hereby make application to the Person County Health Department for a site evaluation for the on-site sewage disposal
system for the above-described property. I agree that the contents of this application are true and represent the maximum
facilities to be placed on the properly. I understand if the site is altered or the intended use changes, the permit shall
becom�invalid.
" �' Cwner or Legal I�ep
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Date
PCHD, rev. 06/27/02