HomeMy WebLinkAboutWELL-05-2022-171104.TIF G)
catawba county
public health
1-22-2024
Nazanie Amiri
23142 LA Granja Dr
Valencia, CA 91354
Subject: Notice of Intent to REVOKE the Well Permit for 4215 Cascade St,Terrell, NC 28682,
PIN 461703116639 Catawba County Permit:WELL-05-2022-171104
Dear Nazanie Amiri:
The Environmental Health Division of Catawba County Public Health intends to revoke your 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 150E-23 and all other applicable provisions of Chapter 1508. 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 1-22-2024. Meeting
the 30-day deadline is critical to your formal appeal.
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.
o=4, CATAWBA COUNTY _ __-_ . ____ -- — - —.
!! �-�` Public Health Department Subdivision THAD AND HAROLD GABRIEI
R`i.,,,J. Environmental Health Division PINK 461703116639
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 19&ADJ
Site Address: 4215 CASCADE ST,TERRELL NC 28682
Name on Permit NICK WATTS
Property Size: Acres 0.63
Directions: Right onto Sherrills Ford Rd,right onto Hob Ln.Take a left at the end and its the 4th lot on the right
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
K—
the property described above.
X_ As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-11-2021-39300, by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
41 Electronic 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(15A 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: 05/10/2022
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature C. Date/Time lit) I ))
Method: Fax I Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature --
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Parcel: 461703116639, 4215 CASCADE ST 1 in=40t
TERRELL, 28682
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Copyright 2021 Catawba County NC
05/10/2022
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