HomeMy WebLinkAboutAUTH-06-2022-174724.TIF catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE AI'1'FA1, RIGHTS
Date prepared: May 2._2023_.__
Owner(s): Novi&Kristinc_1V_uod ---
Mailing Address: 2401travidcncc.11ilLLDr -
Matthews,NC 28105
Property location/site legal description: 6557 Prospect 1)r,Conover
PIN: 374501488306
Improvement Permit(IP) IM1'V-01-2021-144227 Date Issued 1/252021
Authorization to Construct(AC) AU'I'I I-06-2022-174724 Date Issued 6/28/2022
s- In P -+ I t t(o\ � / .voluntarily relinquish my rights to pursue a formal appeal through the North
(print full name) \F�! C2�
Carolina Office of Administrative I Icarings pursuant to NC General Statute I30A-24 and I50B-23 and all other applicable
provisions of Chapter 15011 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
50%reduction sys1cm11llb1
(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 I Icarings 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 I Icarings 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 1 do not want to appeal the permit revocation.
I understand that 1 am not required to relinquish my appeal rights but that this is un option available to me so 1 do not have to wait 30
days for the revocation of the permit to to'e effect.
Signature of Property Owner' y t- Luce
Date Signed: 6/ y / a
NCOHHS/DPH/EHS/OSWP Revised May 2015
catawbacountync.gov
Environmental Health
(ctcwbc (ouniy Govornmcul (vole'
75 Govc'ninenl Dim I PO Bore 389 I Newton N( 78658 I 878.465 8770
MAKING. LIVING.
Catawba county
pLl:Dlic health
May 2, 2023
Kurt& Kristine Wood
2401 Providence Hills Dr
Matthews,NC 28105
Subject: Notice of Intent to REVOKE the Improvement and Authorization to Construct
Permits for 6557 Prospect Dr, Conover; PIN 374501488306;
Catawba County Permits IMPV-01-2021-144227 and AUTH-06-2022-174724.
Dear Mr. & Mrs. Wood:
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, 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 OAI-I 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 April 19, 2023. Meeting the 30-day deadline is critical to your formal appeal.
catawbacountync.gov
Environmental Health
Cntowbc 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,
5tAj-
Steven Price, REHS
Environmental Health Specialist, OSWP Division
Catawba County Public I-Iealth
I
t
01MIr• CATAWBA COUNTY Case N AU 1-1-06.2022.174724
ii,,"t irk Public Health Department Subdivision
q hr,3 f'L>jl.(,) , Environmental Health Division I'INU 374501488306
' PO Box 389.25 Government Drive,Newton,NC 28658 LOT/ 2
Site Addresa: 6557 PROSPECT DR,CONOVER NC 28613
Name on Permit: `SW ASSOCIATES,INC
Property Size: Acres 1.1
Directions: Turn onto Valwood Rd off of St Peters Church Rd.Left onto Wegowood Dr.Lot on loft on Prospect Dr,
Owner/Authorized Representative Acknowledgement of Permit Receipt
i I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
t e property described above.
941
11l:,; As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-04-2022-40688, by the following method(s):
Received in Person
_ Facsimile Transmittal(Return form with signature required)
fElectronic Image Transmittal/E-mail (Return receipt required)
.Mit•s 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:06/28/2022
Owner/Authorized Representative Signatur
`•/ Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name o/'person sending permit)
Signature ' /dJ Date/Time e�
Method: __Fax i 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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