HomeMy WebLinkAboutAUTH-12-2021-162296.TIF (4
catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: September 14,2022
Owner(s): Davne Miller
Mailing Address: PO Box 1295
Claremont,NC 286I0
Property location/site legal description: 3060 Oak St
PIN: 376213138719
Imimprovement Permit(IP) 12-2021-162292 Date Issued 12/9/2021
Authorization�'l to Construct(AC) 12-2021-162296 Date Issued 12/9/2021
1, i�`f� 1_,/ „ 1(,",,,,L..- ,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 3 508-23 and all other applicable
provisions of Chapter 1 508 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. 1 understand by completing this form
that the permit(s)for a
251p reduction system(Illg)
(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. 1 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 1 agree that I do not want to appeal the permit revocation.
I understand that I am not required to reli • sh my appeal rights but that this is an option available to me so 1 do not have to wait 30
days for the revocation of the permit to t, ff t.
9
Signature of Property wner:
Date Signed: 4 r 7. ( 2 -2-
NCDHHS/DPH/EHS/OSWP Revised May 2015
catawbacountync.gov
Environmental Health .
Catawba County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8210
MAKING. LIVING. BETTER.
( 1
catawba county
public health
September 14, 2022
Dayne Miller
PO Box 1295
Claremont, NC 28610
Subject: Notice of Intent to REVOKE the Improvement and Authorization to Construct
Permits for a 3 Bedroom House; PIN 376213138719; Catawba County Permits IMPV-12-
2021-162292 and AUTH-12-2021-162296.
Dear Mr. Miller:
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 Authorization to Construct (AC) and meet the requirements of the current laws and rules
necessary to obtain a new IP/AC 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.
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 September 14, 2022. Meeting the 30-day deadline is critical to your formal
appeal.
catawbacountyne.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,
S- Af•-(A--\ P-Fv_c,e'
Steven Price, REHS
Environmental Health Specialist, OSWP Division
Catawba County Public Health
cc: Robbie Phelps, REHS, Environmental Health Supervisor
% dp CA'I'AWBA COUNTY Case# AUTH-12-2021-162296
•
F.e r f ll,1.y Public Health Department Subdivision
< Environmental Health Division P[N# 376213138719
PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
Site Address: . 3060 OAK ST, CLAREMONT NC 28610
Name on Permit: ROTARY DRILL SERVICE LAND COMPANY LLC
Property Size: Acres 3.83
Directions: • S Depot St, L or North on S Depot St L at top of hill, go to bottom of hill, house w/green roof on right
•
Owner/Authorized Representative Acknowledgement of Permit Receipt
X1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
1 Kis the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-08-2021-38486,by the following method(s):
JReceived in Person
Facsimile Transmittal (Return form with signature required)
jElectronic Image Transmittal/E-mail (Return receipt required) .
As the property owner or authorized representative I have reviewed and understand the specific conditions
. of the permit issued, and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 18A.1900),
. and/or Well Construction Standards(ISA NCAC 2C.0100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
•
Permit Issue Date:12/09/2021
Owner/Authorize Representative Signature
Date ZZ—
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature •
Date/Time
Method: Fax Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from youPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EtiCusttomerService
chpennil 07/152022 11:01
CATAWBA COUNTY Case# AU'l'H-12-2021-162296
cy flit , Public Health Department Subdivision
. Q "I Environmental Health Division PIN# 376213138719
PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
Site Address: 3060 OAK ST, CLAREMONT NC 28610
Name on Permit: ROTARY DRILL SERVICE LAND COMPANY LLC
Property Size: Acres 3.83
Directions: S Depot St, L or North on S Depot St, L at top of hill,go to bottom of hill, house w/green roof on right
Authorization to Construct Permit
•
Permit Category: New Septic Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-
Basement? Yes Basement Plumbing? No Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
• Soil LTAR: 0.25 g.p.d.lft2
WASTEWATER SYSTEM REOUIREMENTS
Proposed Wastewater System: 25% REDUCTION .
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Septic Tank: New Tank: 1 000 gal
Pump Tank _gal Grease Trap_gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Dralnfield: Total Area: 1,086 sq ft Total Trench Length: 362 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 26 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 5 Trench Wdth: 3 ft
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
*Do not cut,drive, fill, or grade over septic or repair areas.
'Septic system must be 10 ft from property lines, 10 ft from water lines, 15 ft from basement cuts, 5 ft from
building foundations and appurtenances, and out of right-of-ways and easements.
'Install a 1,000 gallon septic tank(risers required if top of tank is greater than 6 inches below land surface).
'Install 362 linear feet of 25%reduction system, proposed 5 lines total.
'Laid out 5 lines in the field. 1st line 78 ft, 2nd line 78 ft, 3rd line 78 ft,4th line 58 ft, and 5th line 70 ft.
*Final grade of septic area must shed surface water off and away from system.
*All gutter drains must be routed away from the septic system.
See also attached site plan.
Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent
proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved, and
may result in failure to approve the initial system installation, or the suspension/revocation of existing permits.
>>>>> Do not install system under wet conditions ««<
PROPOSED REPAIR
Repair System Required? Required Soil LIAR: 0.25 g.p.d.Ift2
Proposed System: 25%REDUCTION
System Classification: IIIG-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
el,pun tit 07/15/2022 11:01
•
CATAWBA COUNTY Case# AUTH-12-2021-162296
Public Health Department Subdivision
t"Q ^I Environmental Health Division PIN# 376213138719
yam\\ PO Box 389,25 Government Drive,Newton,NC 28658 I-p1#
!$q
Site Address: 3060 OAK ST, CLAREMONT NC 28610
Name on Permit: ROTARY DRILL SERVICE LAND COMPANY LLC
Property Size: Acres 3.83
Directions: S Depot St, L or North on S Depot St, L at top of hill,go to bottom of hill, house w/green roof on right
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to
Construct Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the
North Carolina'Lmrs and Rules/or Sewaze Treatment and Disposal Systems' (ISA NCAC 18A.1900). Neither Catawba County nor the
Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time.
Any permit issued for a conventional system may be used for an accepted system without Environmental Health authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
12/09/2021
Authorized State Agent Permit Issuance Date
12/9/2026
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
•
ehpernii 07/152022 I1:01