HomeMy WebLinkAboutAUTH-06-2020-134181.tif Catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: 1/13/2023
Owner(s); Gordon and Amy Chaooel
Mailing Address: 4Rt7 Aurris Rd
Denver,NC 28037
Property location/site legal description: 4811 Burris Rd,Denver,NC
PIN: 460601055230
Improvement Permit(IP) Date Issued
Authorization to Construct(AC) AUTH-06-2020-134181 Date Issued 6/16/2020
I, Gordon&Amy Chappell voluntarily relinquish my rights to pursue a formal appeal through the North
(print full name)
Carolina Office of Administrative Hearings pursuant to NC General Statute 130A-24 and 1508-23 and all other applicable provisions of Chapter 1508
for the above referenced permit(s)(which Includes the IPs and ACs)in order for the authorized agent/local health department to issue the
applicable permit(new IP and/or AC)for the site. I understand by completing this form that the permit(s)for a
Illg.25%Reduction
(System description)
will be revoked immediately by the authorized agent/local health department.
I understand that the local health department's revocation of a permit can be appealed to the North Carolina Office of Administrative Hearings within
30 days of the revocation pursuant to the North Carolina Administrative Procedure Act. I understand that in order for the local health department to
issue another IP and AC that the current IP and AC must be revoked. I understand that the local health department's revocation of an IP or CA is not
effective until 30 days from the revocation or,if the revocation is appealed,at the time that the Office of Administrative Hearings issues a final
decision. I understand that by signing this form and relinquishing my right to appeal the permit revocation at the Office of Administrative Hearings
that the local health department's permit revocation will become effective immediately. I understand and agree that the revocation of a permit that
takes effect immediately is in my best Interest. I understand that by signing this form that I agree that I do not want to appeal the permit revocation.
I understand that lam not required to relinquish my appeal rights but that this is an option available to me so I do not have to wait 30 days for the
revocation of the permit to take effect.�ef
Signature of Property Owner: r, &tfpD d/
Date Signed:
01/20/2023
NCDHHS/DPH/EIiS/OSWP • Revised May 2015
catawbacountync.gov
Environmental Health
Ccictivhc Counly Government Centel
25 Government Drive I PO Box 389 I Newton NC 28658 828.465.8270
MAKING. LIVING. BETTER.
1110,7
catawba county
public health
01/13/2023
Gordon& Amy Chappell
4817 Burris Rd
Denver, NC 28037
Subject: Notice of Intent to REVOKE the Authorization to Construct for 4811 Burris Rd,
Denver,NC 28037; PIN 460601055230 Catawba County Permits AUTH-06-2020-
134181.
Dear Mr. and Mrs. Chappell,
The Environmental Health Division of Catawba County Public Health intends to revoke your
Authorization to Construct Permit 30 days from the date of this notice.
If the permit is revoked, you must apply for a new Authorization to Construct (AC) and meet the
requirements of the current laws and rules necessary to obtain a new AC.
You have a right to an informal review of this decision. You may request an informal review by
the environmental health supervisor at the local health department. You may also request an
informal review by the NC Department of Health and Human Services Regional Soil Scientist. 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.
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 01/13/2023. Meeting the 30-day deadline is critical to your formal appeal.
catawbacountync.gov
Environmental Health
Catawba County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
MAKING. LIVING. BETTER.
If you file a petition for a contested case hearing with the Office 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.
Respectfully,
L
ames R. Ross, REHS
Environmental Health Specialist
Catawba County Public Health