HomeMy WebLinkAboutAUTH-07-2022-175757.TIF Catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: May l6,2021
Owner(s): ___-...._Richacd.dniklitfn..5alko.wski:
Ma i ng Address __. .1836,Lntris Ln
Denver,NC?8037-7896
Property location/sae legal description. 3974 Cedarwood Tr,Terre11NC
PIN 461704734177
Improvement Permit(P) IMPV��ZL/�/�j.,__„._,_• Date Issued 7/14/2022
Authorization to Construct(AC) AINH-074922.175717 Date Issued 7/14/202:
I, ,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 150E-23 and all other applicable provisions of Chapter:SOB
for the above referenced permitts)(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 try completing this form that the permits)for a
1V Q3l.fie.ducgoa__..__---_
(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 not
effective until 30 days from the revocation or,if the revocation Is appealed,at the time that the Office of Administrative trearings 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 s gn,ng thgs form that I agree that I do not want to appeal the permit revocation
I understand that I am not required to relinquish my appeal rights but that this,s an option available tome so I do not have to wait 30 days for the
revocation of the permit to take e
Signature of Property Owner. � / j�
Dale Signed• _.
5 /`/./ 11-
NCDIIHS/DPH/EHS/OSWP Revised May 201S
catawbacountync.gov
Environmental Health
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MAKING. LIVING. CETI
111A.IN
catawba county
public health
May 16, 2023
Richard and Kristin Salkowski
1896 Lotus Ln
Denver NC, 28037-7896
Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to
Construct for 3974 Cedar Wood Tr,Terrell, NC 28682 PIN 461704734177
Catawba County Permits IMPV-07-2022-175751 and AUTH-07-2022-175757
Dear Richard and Kristin Salkowski:
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.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 1SOB. 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
(lciawbe County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1878.465.8270
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 May 16, 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 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,
gw.A,..., 4. -12•002.
James R Ross, REHS
Environmental Health Specialist
Catawba County Public Health