HomeMy WebLinkAboutIMPV-02-2022-166386.TIF catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: 08/022022
Owner(s): Zuaatsa Diaz
Mailing Address: _ 9960 Wnodworth Ct
Wellington,Ft.33414
Property location/site legal description: 1026 Fyc Dr
PIN: 372016738128
Improvement Permit(IP) IMPV-02-2022-166386 Dale Issued 02/24/2022
Authorization` to Construct(AC) AUTI I-02-2022-166388 Date Issued 02242022
I. G-() fQ Z ,voluntarily relinquish my rights to pursue a formal appeal through the North
(pri t full name)
Carolina Office of Administrative Hearings pursuant to NC General Statute 130A-24 and l 50fi-23 and all other applicable
provisions of Chapter 150B 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
25°%Jl DUCTION
(System description)
will be revoked immediately by thc 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 ofAdministrative
Hearings within 30 days of thc 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 thc 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 thc 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. 1
understand that by signing this form that I agree that I do not want to appeal the permit revocation.
I understand that I am not required to relinquish m •ppcal 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 to , c
Signature of Property Owner _
Date Signed: 0A/O3 faoa7
NCDHHS/DPH/EHS/OSWP 777 Revised May 2015
catawbacountync.gov
Eaviroaraenlal Health
Cctcwbc County Government (enter
25 Government Own J PO 8or 389 I Newlon N( 28658 I 828.465 8270
MAKING. LIVING. BETTER.
trey'
catawba county
public health
8/2/22
Zuyitsa Diaz
9960 Woodworth Ct
Wellington, FL 33414
Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to
Construct for 1026 Fye Dr,Newton, NC PIN 372016738128
Catawba County Permits IMPV-02-2022-166386 and AUTH-02-2022-166388
Dear Zuyitsa Diaz:
The Environmental Health Division of Catawba County Public Health intends to revoke your
Improvement Permit and Authorization to Construct 30 days from the date of this notice.
If the permits are revoked, you must apply for a new Improvement Permit and Authorization to
Construct (IP/AC) and meet the requirements of the current laws and rules necessary to obtain a new
I P/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 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.Rov . The petition
for a contested case hearing must be filed in accordance with the provision of North Carolina General
Statutes 130A-24 and 150E-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
Cotowbo County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
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 8/2/2022. 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 150E-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,
i „ E.es
Dean Evans, REHS
Environmental Health Specialist
Catawba County Public Health