A24 50ConnectGIS Feature Report Page 1 of 1
http://gis.personcounty.net/ConnectGIS_v6/DownloadFile.ashx?i=_ags_map8f64d207491 e... 8/1 /2016
p�AR-0'5-2013 04:28PI� FR0�1-
4ppIicadon pate• ����`�
�mouat Paid: iSZ� ;`—'
l�eceipt R: �
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� lmprovemeat Permit (Site E��alaation)
' S'300.00lS.300.00 (if> 600 gpd)
��fobile Home Replacement or Buildine Addicion
5154.00 (ifsi[C visit requircd)
= V�r'tll Permit {!�ie�v/RepiscemCnUiZCpair)
� 5300.00/5240.00iS75.U0
T-675 P.001/��2 F-196
�.�� �� Jl i1e���� Tax 1VIap: ol�i
�., � � � ,�,�� � � ��,�, �. ParceH#: �J
�=7t��i3�0�^�•S='sa4'�3 Y�.CA4�1A � �1 � J��
C� I e.�►� ►�� n
lication for Services � N.'e.e_.�
Services
[7 Construcdon Auihorization
fFee is.denc�ndent an the iYnc of
�i Permit Rcvision
$75.Q0
: i itcpair of Existing Septic Sy+stem
Application: No Char�e/ CA �I50,00 ar $300.00
1} :�pplicaat Info ation: �
Vame: ''+C' /`�C /�/
address• �
�
2) Yame and address af currcnt own�r (if differcnt than applicant):
Name: S �'"
Address• 0 �,�
i' .� �Z,�__ � �___
3) Property Description: (.ot Size: t S3 Subdivision:
,�►ddress and/or dire�.tio�is to Pruheny: (�0 �
Phone {home). � `
(worWcell): ,�1 3.27 C� �n�_ Q��/
/
Phone: '
�: /9
� ycs �no Does"[hc site contain any juri�dictional wetlands? �
�yes D no Does [he sice coniain any zxiszing w�stew�aEar sysiems?
Q yes �'no Is ar.y �+astewater �oing to be gcncraccd on th� site other that: domcs�ie sewage?
� yes �no Is the site subjeet tn approval b}� ar�v oth�r public ager,cy? '
D}•es �no Are ihere any eas�menrs ar right of ways fln this praperty? ��,p�1
(if `yes' is checked, plzasz provide supporcing documeniation) l(, /��
�) Proposecl L�se aad Typc of Structure: ,
�esideatial 1� ��; 3`� � U2
� tiew Si�gle Familv Rc:sidence Maximum numher of bedroon�s: �_ �d���
`�EYpansion af Existina Sysztm tf expansion: Currcnt number of bedrooms: ��
L� � epair to v l a l f u nziionin� Sys t em V�'i ll � here be a b a s e m e n t^ ❑ y e s � o W i � h p l u m b i n g f i x t u r e s? (� y e s
ONon-Residen[ia1
T�p4 af business: _
M�vimum number of empioy«s: _
___ _ Total Syuare footage of �uilding: �,_„�.
Ma�cimum number of seaU:
5} Water SnQply: ❑ New well �Existing Wzll � Community Well C] Pablic Water ❑ 5pring
Are chere any existing wclls, sprina.a, or �xistin� waterlines on rhis property? ❑ yes � no
6) if applyiag for `Authorization to Construct', plcasc indicate preferred systEin ty�e(s):
G Conventiaoal 0 ac�ep�ed 0 inno��ative � Altar�tarive C10ther ❑ Any
�. C!`YNfu.�cU
/
�d��'S
�
�
_���
�y
❑ no
�/ r:Pr t! hII rhe inJnrmptiorrproti�ided ahnve i; cum_plate :��:r� cvrr�cr. 1 a�co una'e: stand that if the injormation pro�ided is
; ina •• , r if 1he Site is ub e rrenrlu crlrcred, ur �ha. in�ended u.�e chan.ges, a11 permi�� mld apptovals shall be imafid.
` --� � �l� �/�
i f Si�nature (Qwner/ Le�al Represenrative*) Date
� � Supporsin} dotumcntation required_
• Permits are valid for either SO moaths or are non-expiring when accompanied by an approved plat
. A c�mpleted 'Lot Prepnratinn' form must accompany any applieation requiring a site evaluation.
( t 0�11) !'ersc�n C:ou�ny EnvirQnmental H�th, 335 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-�790)
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August 12, 2016
Rodney and Tracy Pitts
833 Indian Valley Dr.
Burlington, NC 27217
RE: 60 Lakeview Estates Rd. / Ta�c Map: A24-50
Dear Mr. and Mrs. Pitts:
On August 1, 2016, you submitted an application to the Person County Health'Department
requesting a permit to expand an existing 2 bedroom septic system, to a 3 bedroom septic system.
Unfortunately, there is limited space on the property and the existing system cannot be adequately
expanded to accommodate the potential increase in wastewater flow of a third bedroom.
A representative of the property owners inquired about the possibility of installing a new system
on an adjacent lot. While an application was not submitted to evaluate this lot, several soils
borings were made across representative portions of the property. Based on the soil borings, this
property would likely be classified as `unsuitable' for the installation of a septic system. To
obtain an official evaluation, an application must be submitted to the Health Department. If the
detailed evaluation determined that that lot was `unsuitable', a letter would be provided outlining
possibie options. Two of the options would be; 1) to hire a soil scientist to independently evaluate
the property and submit a proposal to the Health Department, and 2) hire an engineer to apply for
a surface discharge permit from the North Carolina Department of Environmental Quality.
Please feel free to contact our office if you have any questions (336-597-1790).
Sincerely,
<_��
Harold Kelly, LSS, REHS
Environmental Health Supervisor
phone 336.597.1790
fax 336.597.7808
325 South Morgan Street, Suite C, Roxboro, NC 27573
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_- Person -�County �Health �Department �
` :Sewa�ge System=�improuemerats �Permit-'
Date��g� This Permit Void �After-5 Years � �t�'��
Owrier. : . . ��
;. SR#
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Location/Directions: a.
. _ �n �li •a F" . k � , _. - �S�l�-: '%�€/��.: •.-� ..� ! '.= � b_ ,�
Subdivisio �Name: �_ '. --.. _ :�, Lot#. "
Lot Size: t A n✓r ,T' of Dwelling: '�
� .
Water Supply:. � te: �J�� mmunity: '
Bedrooms: � Garbage Disposal
Basement Basement Fix �� �
INFORMA R BY C...
$�j(��: owner or entative.
REPAIR: EVAI:; ATION:
^
------- --- ' ----=---�-�� '
Size of. Septic Tank: gallons Size r Pum T �:,
Nitrif'ication I:ine: " �
Depth of Swne:. 12 inches �- '
Max Depth of Trenches: � ' ._
Altemative System: Conv. P�mp Lpp pump
Remarks:
Date Well� Approved::
BY '' �'
Date S ge m
� BY _ .
�ll should be 109�E' from any sewer system
. Sanitarian . ' '
TE OF:COMPLETION � �
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""'Sewage �System locadon, installation, and protection must meet stute -and local �
regulations. Septic'tanlc should;'be pumped out every 3 to 5`years and shali be maintained �
�;.by ownei in such manner as ,not to create�'-a pubhc:health:'hazard. Sepdc tank andFd
nitrification line must be inspected and approved by.:.a, tiiember .of the Person Counry �
, Health Deparnnent before any portion of the installation is covered: and put into use. .If
the site plans or intended use change this perriiit is subject to revocarion
(G.S.130•A 335F) �
L.ocation of sewage disposal sewage system sketched on back. ' ry
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