HomeMy WebLinkAboutWELL-10-2021-158937.TIF catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: 5/11/2022
Owner(s): Milligan Investments LLC
Mailing Address: �33 �'arriage Rd
Statesville,NC 28677
Property location/site legal description: 1870 Carl Dean Dr,Newton,NC
PIN: 37111121300
Well Permit WELL-10-2021-I58937 Date Issued: 10/8/2021
1, f)( 1l( iG� --- ,voluntarily relinquish my rights to pursue a formal appeal through the North
(print full name)
g
Carolina Office of Administrative Hearings pursuant to NC General Statute 130A-24 and 150B-23 and all other applicable
provisions of Chapter 150B for the above referenced permit(s)in order for the authorized agent/local health department to issue the
applicable permit(New Well permit)for the site. I understand by completing this form that the permit(s)for a
New Well
(Well Permit Type)
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 Well Permit that the current Well Permit must be revoked. I understand that the local
health department's revocation of the Well Permit 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 a that I do not want to appeal the permit revocation.
I understand that I am not required to relinquis ny 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 to
Signature of Property Owner:
Date Signed: C 'L '2,02 2_
NCDHHS/DPH/EHS/OSWP Revised May 2015
catawbacountync.gov
Environmental Health
Cotowhc County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
MAINEM IIVIU Z R€TTIP
catawba county
public health
May 11, 2022
Milligan Investments LLC
233 Carriage Rd
Statesville, NC 28677
Subject: Notice of Intent to REVOKE the New Well Permit for 1870 Carl Dean Dr, Newton
PIN 371117213660 Catawba County Permit: We11-10-2021-158937
Dear Sir:
The Environmental Health Division of Catawba County Public Health intends to revoke your
New Well Permit 30 days from the date of this notice.
If the permit is revoked, you must apply for a New Well Permit and meet the requirements of the
current laws and rules necessary to obtain a New Well 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 Specialist. 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.
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 5/11/2022. 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.
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,
4/(/,14- f iiii, v
Robert Phelps, REHS
Environmental Health Supervisor
Catawba County Public Health