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catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: July 17.2023
Owner(s): Deanna& James Grindstaff
Mailing Address: 2l 1 Fremont Loop
Mooresville, NC 281 15
Property location/site legal description: _ -1671 Little Mtn Rd,Catawba
PIN: 367802752372
Improvement Permit(IP) IMPV- 10-2021-158635 Date Issued 10/5/7021
James Grindstaff
1, ,voluntarily relinquish my rights to pursue a formal appeal through the North
(print full name)
Carolina Office of Administrative I Iearings pursuant to NC'General Statute I 30A-24 and 150I3-23 and all other applicable
provisions of Chapter 15013 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 II'and/or AC)for the site. I understand by completing this form
that the permit(s)for a
25%reduction system(1110
(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 II'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 I Iearings 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.
understand that by signing this form that I agree that 1 do not want to appeal the permit revocation.
I understand that 1 am 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.
Signature of Property Owner:_ r�-_• '^uj _..
Date Signed: July 18, 2023
NCDHHS/DPH/EHS/OSWP Revised May 2015
catawbacountync.gov
Environmental Health
(:;ICwhr: County Government Center
25 Government Drive PO 8cx 389 Newton NC 28658 1828.465.8210
MAKING. LIVING. BETTER .
$(4
catawba county
public health
July 17, 2023
Deanna&James Grindstaff
211 Fremont Loop
Mooresville, NC 28115
Subject: Notice of Intent to REVOKE the Improvement Permit for 4671 Little Mountain
Rd, Catawba,NC ; PIN 367802752372; Catawba County Permit
IMPV-10-2021-158635
Dear Mr. & Mrs. Grindstaff:
The Environmental Health Division of Catawba County Public Health intends to revoke your
Improvement Permit 30 days from the date of this notice.
If the permit is revoked, you must apply, which you have already done, for a new Improvement
(IP)and meet the requirements of the current laws and rules necessary to obtain a new IP permit.
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, 1711 New
Hope Rd, Raleigh, NC 27609. You may write the Office of Administrative Hearings, call the
office at(984) 236-1850 or get a copy of the petition form from the OAH web site at
http://www.oah.nc.gov. 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.
catawbacountync.gov
Environmental Health
Catawba County Government Center
25 Government Drive PO Box 389 Newton NC 28658 828.465.82/0
MAKING. LIVING. BETTER.
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 July 17, 2023. Meeting the 30-day deadline is critical to your formal appeal.
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,
Steven Price, REHS
Environmental Health Specialist, OSWP Division
Catawba County Public Health