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A24 6� ConnectGIS Feature Report � �� :.w:,� , . .. , . .� _ i� s Y'Yft � .. . . � •. . . . � ' � �'"� . . � . . . . _ . . . i , y� ✓rta �" :�,y ;�.:� _ .. §� . � � � �� *�-' ��°'�,�a�.��: r�, ,r � . � j � _ � , s �c�, °a . � ,-' _�* 6 ' �j � : � . 't -� 7� C -aQ �` � ��y �� ,��, t'�` . rY.i'.�.. .. . . Page 1 of 1 Person Printed April 07, 2014 See Below for Disclaimer - . .._.• _} qr�,-� ,.:.. v�� . r�- - - �, - � "�j r. y, r. - �SiR ' � '--"' � i �"� y � �� } - j�. . , _ v�'�� S � . -. .; . ` . '� �- �., �. . � " T �� z ' .� "� , . '(�,_ a i �;' . � �+. : ��-� � ":n _ '� �.` �i�, � �, � � � �_: ` �+.-,. � � 4� �- _ ; ,.,.�. ' ..� 41�y . ��..: � �bly�'� � � _ � ` "'. `� � `� � , ,�;. tY�,.t � � . ��`. � 4• �.�.- �.. 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Feet �j _�� _ A � � �«� .� �. � ;g^ or1 ,'�cres � � 't�� , ,� , . � � ,r� �,� , _-� , r 3 _ � � � � r S' a. h.� i l e� � . � � � �'ris' �,'- � . � .. .� .� . . � � �t'�L. $ t '. a�:° �� ' " iJJ Feet �� NOTICE: Recently, we have had several users report browser compatibility issuesrwhen trying to access our GIS website. Typically, the problem stems from users whc have recently upgraded to the VVindows 8 operating system or a new version of Intemet Explorer We were abte to resolve this issue by directing users to the Inteme Explorer Compatibility View tool. This link is to Microsoft's "How To" for the tool: http:/Iwindows.microsoft.com/en-US/internet-explorer/products/ie-9/features/compatibility iew If this does not solve the problem feel free to contact us at the number listed on our main page. Welcome to the Person County GIS Website. ConnectGlS has beei prepared for the inventory of real property found within Person County, and is compiled from recorded deeds, plats, and other public records. Users of GIS system arf notified that the aforementioned public information sources should be consulted for verification of the information in this system. Person County, Mobile 311, ConnectGl: ssume no legal responsibility for the information in this system. Grid is based on the NC state plane coordinate svstem, 1983 NAD. http://gis.personcounty.netlConnectGIS v6/DownloadFile.ashx?i= ags mapb9b9c9206b99... 4/7/2014 Application Date: � 7 / Amount Paid: ,�00. DO Receipt #: 8" t-F � D`� d � t � �ar �Y � �, �`�'j� ) f �� .d. � Tax Map: .� o� � � � �� Parcel#: —�- ]��cawna-aD�** � a3=a.d,rall IHCm.si..11d�la. tion for Services Services Re uested mprovement Permit (Site Evaluation) D Construction Authorization $200.00/$300.00 (if> 600 d) Fee is de endent on the e of system ermitted) ❑ Mobile Home Replacement or Building Addition ❑ Permit Revision $150.00 if site visit re uired) $75.00 0 Well Permit (New/Replacement/Repair) 0 Repair of Existing Septic System $300.00/$200.00/$75.00 Application: No Charge/ CA $ I50.00 or $300.00 1) Applicant Info`r,m ation: Name: Y�R��- �� t Phone (home): 33 b•3��- 5 2i o 0 Address: (work/cell): q1`t- Sa �I "513X 2) Name and address of current owner (if different than applicant): Name: $1�tl,tA CPb2p�.;�) � Phone: q19-S]�J 'S 13g Address: 1�01 �� o W 6 oaS � DR s�M �r� N � a�3W 3 3) Property Description: Lot Size: 1 A�'� Subdivision: NtiE►ST�-t� Lot #: Address and/or directions to Property: �1.f� OF Srl�rw �ooSt Qj� (�-tbH'f Si� :4i'�AG}t�D, ❑ yes B"no Does the site contain any jurisdictional wetlands? ❑ yes C7 no Does the site contain any existing wastewater systems? ❑ yes �-� Is any wastewater going to be generated on the site other than domestic sewage? ❑ yes 6 no Is the site subject to approval by any other public agency? ❑ yes � Are there any easements or right of ways on this property? (if `yes' is checked, please provide supporting documentation) 4) Proposed Use and Type of Structure: ❑Residential ew Single Family Residence Maximum number of bedrooms: 3-y ❑ Expansion of Existing System If expansion: Current number of bedrooms: ❑ Repair to Malfunctioning System Will there be a basement? ❑ yes ❑ no With plumbing fixtures? ❑ yes ❑ no ❑Non-Residential Type of business: Maximum number of employees: Total Square footage of Building: Maximum number of seats: 5) Water Supply.: �t'New well ❑ Existing Well ❑ Community Well ❑ Public Water ❑ Spring Are there any existing wells, springs, or existing waterlines on this property? 0 yes ❑ no 6) If ap�lying for `Authorization to Construct', please indicate preferred system type(s): �'L�onventional ❑ Accepted ❑ Innovative ❑ Alternative ❑ Other ❑ Any I certify that the infoYmation provided above is complete and correci. I also understand that if the information provided is inaccurate, r if ' e s subsequently altered, or the intended use changes, all permits and approvals shall be invadid. � L� �-ly Signature (Owner/ Legal Representative*) * Supporting documentation required. Date Permits are valid for eit6er 60 months or are non-expiring when accompanied by an approved plat. A completed `Lot Preparation' form must accompany any application requiring a site evaluation. (10/i l) Person County Environmental Health, 325 S. Morgan St., Suite C, Roxboro, NC 27573 (336-597-1790) �, �; �� ., � � � .� -� � '�� :[-�,1,-�-.�:�-• �,:,z 1_�z t-•:�,�< <11 :( �i �>>,1:1-� . � ��'est & Woodall To��n Lake & Country Properties �1ttn: Mr. Kirk West 8377 Semora Road Semora. NC 27343 � nsuring a healthy envu'onment Apri123, 2014 Re: Application for improvement permit for property at 141 Snow Goose Road (Whetstone S/D); Health Department file: Tax Map #A24, Parcel #006 Dear Mr. West: The Person County Health Department, Environmental Health Division on April 22, 201�, evaluated approximately 1.0 acre at the above-referenced property that accompanied your improvement permit application. According to your application the site is to serve an additional three to four bedroom residence with a design wastewater tlo«� of 360-480 gallons per day. The evaluation was done in accordance with the laws and rules governing wastewater systems in North Carolina General Statute 134A-333 includin� related statutes and Title 15A, Subchapter 18A, of the North Carolina :�dministrative Code. Rule. 1400 and related rules. Based on the criteria set out in Title I SA, Subchapter 18A, of the North Carolina administrati��e Code, Rules .1940 through .1948, the evaluation indicated that the site is UL�SUITABLE for a ground absorption sewage system. Therefore, your request for an impro��ement permit is DENIED. The site is unsuitable based on the following: Unsuitable soil topography and/or landscape position (Rule .1940) X Unsuitable soil characteristics (structure or clay mineralogy} {Rule .1941} �Unsuitable soil wetness condition (Rule .1942) X Unsuitable soil depth (Rule .1943) Presence of restrictive horizan (Rule .1944} X Insufficient space for septic system and repair area {Rule .1945} Unsuitable for meeting required setbacks (Rule .1950) Other {Rule .1946) These se�-ere soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, into surface waters, directly to ground �yater or inside your structure. The site evaluation included consideration of possible site modifications, and modified, innovative or alternati��e systems. The Health Department has determined that a possible option might be a system designed to dispose of sewage to another area of suitable soil off- site io additional praperty. phone 336.597.1790 fax 336.597.7808 �?i South vlor;an Street. 5uite C, RoxUoro, NC 27573 For the reasons set out abo�'e, the propert}• is currently classified UNSUITABLE, and no impro��ement permit shall be issued for this site in accordance with Rule .1948{c). H�«�e��er, the site cIassiiied as U\SUIT�BLE may be reclassified as P120VISIONALLY StiIT�BLE if �tiritten dacumentation is pro�-ided that meets the requirements of Rule .1948{d). � cop}' of this nale is enclosed. You ma�� hire a consultant to assist you if you ��ish to tn• to de��elop a plan under �i�hich your site could be reclassified as PROVISIONaLLi' SUITABLE. You ha��e a riaht to an informatian review of this decision. You may request an informal re��iew by the soil scientist or environmental health supervisor at the local health department. You may also request an information review by the N.C. Department of Health & Human Senri�es re�ional soil scientist. A request for informal review must be made in «Titina to the local health department. �'ou also have a right to a formal appeal of this decision. To pursue a formal appeal, you nlust file a petition for a contested case hearing with the Office of Administrative Hearings, 671=� Mail Sen�ice Center, Raleigh, N.C. 27699-6714. To get a copy of a petition foxrn, you ma�� w-rite the Office of Administrative Hearings or call the office at (919) 431-3000 or from the OAH web site at http•/h�.��v.ncoah.com/forms.htm{. The petition for a contested case hearin� must be filed in accordance with the provision of North Carolina General Statutes 130A-2� and 1�OB-23 and all other applicable provisions of Chapter 150B. N.C. General Statuce I30a-335 (g) pro�Tides that your hearing would be held in the county where your propert�- 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 The date of this letter is April 23. 2Q14. Meeting the 30 day deadline is critical to }�our formal appeal. If ��ou file a petition for a contested case hearing with the Office of Administrative Hearings, �-ou are required by la�v (N.C. General Statute 1 SOB-23) to serve a copy of your petition on the Officz of General Counsel, North Carolina Department of Health & Human Services, ?QO1 Niail Sen�ice Center, Raleigh, NC 27699- 2001. Do �iQT ser��e the petition on your local health department. Sending a copy of your petition to the local health department �vill NOT satisfy the legal requirement in N.C. General Statute 1 �OB-23 that }�ou send a copy to the Office of General Counsel, NCDHHS. You ma�- call or wTite the local health department if you need any additional information or assistance. Sincerely, -�,:�,...(� �- .�£., Derrick A. Smith, LSS, REHSI Environmental Health Specialist Encl.: Rule .19�8d F^,_ . .. �`}` 1e �(. � Sr',�%h. �� ✓� � �Y �' v �.r. . ` �` e� �vi � W T "� �c+� at�l@ (�f'i --4, . ' c� r on �ounty Hea�th Department `' ; ��;Sewage System-Improvements Per �t Date: : ; s Permit V id �ter 5 Years . � SR#G� 3� Ovmer: . '` I,ocation/D'irections: . , �� - , . '• . . Subdivision Name• _ Loi� Siie: �..�� Water Suppl : 'v Bedrooms: �Basement ��Type of D I�: � Gazbage Disposal _ Basement F'ixtures: D BY . # $a111i�18I1: �/�.� -: f `cYvtCer or rep�e�enuuve I � g�pp�; EVALUATION:. Size of Septic Tank:._.��_ g�� s � Nitriiication Line: � � �Q � Tr�`c� , r Depth of Stone: 12 inches Max Deprh of Trenches: Altemative System: Conv. Pump LPP Pamp l�emarks: Q I� ----�^-------------- Date Well AppFoved:%/T Well should be 100 ft» from any sewer, system `�,'1 sy rl �_ sanitar;an 7 2�_ l�'Z Date Se e s m pgroved• � gy ' Sanitarian '�. �ER C TE OF COMPLETION ; ; _�_ � :, Contractor. - � � � s' Sewage Syscem location. 'installation, and protection must meet state and local � � regulatians. Septic tank should be pumped out every 3 to 5 years and shall be maintained � by owner in such manner as not to creaie a public health. hazard. SepEic tank and � nitrif'ication line must be inspected and approved by a member of the Peison County Health Depazunent before any portion of the installation is covered at►d put into. use. If the site plans or intended use change this pernut is subject to revocadon. (G.S. 130 A-335F) L.ocation of sewage disposal sewage system sketched on back. l /(�OVER) � � , ' .�.. ., .�/ �/ ' ��/ . � V a ' .i r : �� person County Health Department � --�, Well Permit � Date: --`� / This Peimit V'd After 3 Yeazs o�.� Owner:_�'�� R. rc�v, SR# .�33 �(o , Locadon/Direcdons: Subdivision Name:�,��d��'1.�� ►� ..S-� ��o,�_�' Lot # Drilling Contracwr. �(c� Nltw W\L _1►�u. 4kx '�� WELL CONSTRUCi'ION Distance from Nearest Property Line Distance from Source of Polludon Total Depth. Ft Yeld: �S GPM Stadc Water I.evel Ft. Water Bearing Zones: De�th FG FG��Ft. Casing: Depth: From �_ to FG Diametef: ��_Inches TYPE: Steel Galvanized Steel V ff Steci. does owner approve: 1� No Weigh� Thiclmess: � Height Above Ground: Inches Drive Shce: Yes No Were Problems Enwuntered in Setting the Casing? Yes No If "yes" give reason• i GrouG Type: Neat � S erneat Concrete Annular Space Width � Inches Water in Am�ular Space: Yes No �-3 Method: Pumped�.,. Pressure Poured�� x Depth: F�m FG Materials Used: No. Bags Partland Cement Weight of 1 bag ,� lbs. If mixture (sand, grayeJ� cuttings) - Ratio: to � ID Plates: Yes � No 4 x 4 slab Yes No De th From To Formation Descri don 'Z7 I HEREBY CER'TIFY THAT THE ABOVE INFORMATION IS CORREGT AND THAT � T'HIS WELL WAS CONSTRUCTED IN CORDANCE WITH EGULATIONS SET ,� FORTH BY THE PERSON COUNTY HI��EPA�;�'MEN'T� . � � 7 �1 qZ Date Gf3°j9L �su�a Sanitarian's Signature Date Completed Sketch well location on reverse side. �