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HomeMy WebLinkAboutAUTH-05-2022-171364.tif catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 5/18/2023 Owner(s): Scott toll Mailing Address: —T 170NntmandyAd.__ —_. Mooresville,NC 28117 Property location/site legal description: 4496 Kiser Island Rd,Terrell PIN: 461602577965 improvement Permit(IP) IMPV-09-2Q2 1-157 1 60.._ Date Issued 9/3/2021 Authorization to Construct{AC) NTH-05.2022.171364 _ Date Issued 5/12/2022 r, 5cc Sty ,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 1508-23 and all other applicable provisions of Chapter 1506 for the above referenced permits)(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 IVa-50%Reduction (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. I understand that the local health department's revocation of an IP or CA is riot 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 agree that I do not want to appeal the permit revocation. I understand that tam not required to relinquish my appeal rights but that this is an option available to me so I do riot have to wait 30 days(or the revocation of the permit to take effect. Signature of Property Owner: Date Signed: S 2 2 23 - — NCOHHS/DPH/EHS/OSWP Revised May 2015 catawbacountync.gov Environmental Health �7 (i. 'tri - Ifni Onrt I 1'U Rcr. 389 • Ii;, l9- lit 1861)r I d1,; 155 4111A1 11 ,;„ ` catawba county public health May 18, 2023 Scott Stull 170 Normandy Rd Mooresville, NC 28117 Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to Construct for 4496 Kiser Island Rd, Terrell PIN 461602577965 Catawba County Permits IMPV-09-2021-157160 and AUTH-05-2022-171364 Dear Mr. Stull: 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 IP/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 Church 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 Ccicwbc 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 5/18/2023. 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 1506-23) 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, James R Ross, REHS Environmental Health Specialist Catawba County Public Health 01:1144 CATAWBA COUNTY Case# 4-111liti Public Health Department Subdivision c s Environmental Health Division PiNN 46f 602577965 1�/0 PO Box 369,25 Government Drive,Newton,NC 28ti58 LOTq 2 faIrSlteAdd►ess: 4496 KISER ISLAND RD,TERRELL NC 28682 Name on Permit: 'NEST HOMES LLC Property Size: Acres 0.54 Directions: $on NC 16,Eon Hwy 150,approx 7 miles,Right on Kiser Island Rd,Kiser Island Rd to parcel on Left d� Owner/Authorized Representative Acknowledgement of Permit Receipt 1 I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. (WAs the property owner or authorized representative,I have received the above referenced permit(s)as requested in the application for service RBPR-01-2022-39866,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) TElectronic Image Transmittal/E-mail (Return receipt required) As the property owner or authorized representative I have reviewed and understand the specific conditions of the permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(1SA NCAC 18A.1900), and/or Well Construction Standards(1SA NCAC 2C.0100), shall apply to the issuance of this permit and the construction of the wastewater system and/or water supply well permitted. Permit Issue Date: 05/12/2022 Owner/Authorized Representative SignatureAjiat,4-N...--1 Date 511(6/2o9_2, Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by 1 (name of person sending permit) Signature I _Date/Time hA V)) V Method: Fax _ ‘ Email US Mail Other Owner's request to send by the above indicated method of transmittal In lieu of signature We want tto hear from youPlease ttake a few momentts tto complette our custtomer service survey att http://www.survernonkey.com/s/EtiCusttomerService 1') posirno nest/knits. etoi lief as,IN2022 12:112 yy$• CATAWBA COUNTY Case# Al ITt 1-05-2022-17 1364 .t Public health Department Subdivision H Environmental Health Division PIN# 461602577965 PO Box 389,25 Government Drive,Newton,NC 28658 I or# 2 /842 s� Site Address: 4496 KISER ISLAND RD, TERRELL NC 28682 Name on Permit: *NEST HOMES LLC Property Size: Acres 0.54 Directions: S on NC 16, Eon Hwy 150, approx 7 miles, Right on Kiser Island Rd, Kiser Island Rd to parcel on Left Authorization to Construct Permit Permit Category: New Septic Wastewater Flow: 360 g.p.d, Type of Facility: Primary Residence- Basement? Yes Basement Plumbing? Yes Bedrooms: 3 Water Supply: Private Well Maximum Occupants: 6 Soil LTAR: 0.3 g.p.d.lft2 WASTEWATER SYSTEM REQUIREMENTS Proposed Wastewater System: 50% REDUCTION HORIZONTAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Septic Tank: New Tank: 1,000 gal Second Septic Tank- 1,000 gal Pump Tank 1.000 gal Grease Trap_gal Dosing Volume 200 gal Pump Specs: 29.14 GPM © 2.1848 TDH Pressure Head 2 ft Draw Down 9 52 in Drainfield: Total Area: 600 sq ft Total Trench Length: 200 ft Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 20 in Minimum Soil Cover: 6 in Minimum Trench Separation: 8 ft on center Number of Drain Lines: 5 Trench Width: 3 ft Distribution: LPP Pre Treatment: NONE Pump Required ***** Operator Required Additional Specifications: USE 3/16 HOLES, ONE PER PANEL ALTERNATING BETWEEN THE 2 AND 10 O'CLOCK POSITION. GRINDER PUMP TO 2 SEPTIC TANKS IN SERIES. GRINDER PUMP SUPPLY LINE MUST BE 25 FEET MIN TO ANY WELL. 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: 0.3 d.fft2 9•p• Proposed System: 50%REDUCTION HORIZONTAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ***** Operator Required 05/17/2022 08:31 qc • CATAWBA COUNTY Case# AUTH-05-2022-171364 t 111 Public Health Department Subdivision d Environmental Health Division PIN# 461602577965 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 2 Ig. Site Address: 4496 KISER ISLAND RD, TERRELL NC 28682 Name on Permit: *NEST HOMES LLC Property Size: Acres 0.54 Directions: S on NC 16, E on Hwy 150, approx 7 miles, Right on Kiser Island Rd, Kiser Island Rd to parcel on Left 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'Laws and Rules for Sewage Treatment and Disposal Systems' (I 5A NCAC I 8A.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. 05/12/2022 Authorized State Agent Permit Issuance Date 9/3/2026 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. cttpcnmit 05/16/2022 12:02