HomeMy WebLinkAboutAUTH-09-2022-181103.TIF catawba county
public health
April 3, 2025
Michael Doub Jr
4420 W Bandy Cross Rd
Claremont, NC 28610
Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to Construct
for 1789 Balls Creek Rd, Claremont NC 28658; PIN: 377003106249
Catawba County Permits IMPV-09-2022-181101 and AUTH-09-2022-181103
Dear Mr. Doub:
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.
You must apply for a new Improvement Permit and Authorization to Construct and meet the
requirements of the current laws and rules necessary to obtain a new Improvement Permit and
Authorization to Construct.
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 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 General Statutes 130A-24
and 150B-23 and all other applicable provisions of Chapter 150B. General Statute 130A-335(g) provides
that your hearing will 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 3, 2025. Meeting
the 30-day deadline is critical to your formal appeal.
catawbacountync.gov
Environmental Health
Catawba County Government Center
25 Government Drive PO Box 389 Newton NC 28658 828.465.8270
MAKING. LIVING. BETTER.
If you file a petition for a contested case hearing with the Office of Administrative Hearings, you are
required by General Statute 150E-23 to serve a copy of your petition on the Registered Agent for the
Department of Health and Human Services:Julie Cronin, Office of General Counsel, Department of
Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001.
Do not serve the petition on your local health department. Sending a copy of your petition to the local
health department will not satisfy the legal requirement in General Statute 150B-23 that you send a
copy to the Office of General Counsel, 2001 Mail Service Center, Department of Health and Human
Services.
Respectfully,
Bryan Forsee, REHS
Environmental Health Specialist
Catawba County Public Health
NOW
catawba county
public health
VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS
Date prepared: April 3.2025
Owner(s): Michael Doub Jr
Mailing Address: 4420 W Bandy Cross Rd
Claremont,NC 28610
Property location/site legal description: 1789 Balls Creek Rd,Claremont,NC 28658
PIN: 377003106249
Improvement Permit(IP) IMPV-09-2022-181101 Date Issued: 9/26/2022
Authorization to Construct(AC) AUTH-09-2022-181103 Date Issued: 9/26/2022
1, Michael Doub ,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 150B-23 and all other applicable
provisions of Chapter 150B for the above referenced permits(which includes the IPs and ACs)in order for the authorized
agent/local health department to issue the applicable permits(new IP and/or AC)for the site. I understand by completing this form
that the permits for a
I11G 25%JReduction
(System description)
will be revoked immediately by the authorized agent/local health department.
1 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 AC,is not 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 I am not required to relinquish my appeal ri s b t that this is an option available to me so I do not have to wait 30
days for the revocation of the permit to take effec
Signature of Property
p rty Owner:
Date Signed: 4/3/25
NCDHHS/DPH/EHS/OSWP Revised May 2015
catawbacountync.gov
Environmental Health
Catawba County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
MAKING. LIVING. BETTER.
ATV,�� CATAWBA COUNTY
#-f.I!y Public health Department Subdivision
v." . �te` Environmental Health Division PINN 377003106249
�\/>l, PO Box 3t9,25 Government Drive,Newton,NC 25655 l.t)TN C
t:rtiSite Address: 1789 BALLS CREEK RD,CLAREMONT NC 28810
Name on Permit: MICHAEL DOUB JR
Property Size: Acres 10.31
Directions: Right off of E NC 10 Hwy onto Balls Creek Rd. Driveway can be found right after 1777 Balls Creek Rd.
Owner/Authorized Representative Acknowledgement of Permit Receipt
X,1;1-Icertify that I am the owncr or authorized agent(owner's authorisation required)representing the owner of
the property described above.
.A,% , As the property owner or authorized representative, I have received the above referenced
�
permit(s)as requested in the application for service RBPR-04-2022-40762,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
4 Electronic Image Transmittal/E-mail (Return receipt required)
�/ � )-As the property owner or authorized representative I have reviewed and understand the specific conditions
+fl 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 I8A.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 pe ' d.
Permit Issue Date:09/26l2022
Owner/Authorized Representative Signature
Date 10/4/2022
Documentation of Permits)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by_ (name of person sending permit)
4
Signature_ ________ _. __._._ Date/Time JQ q/))
Method: Fax Ni 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 yeuPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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,44$• CATAWBA COUNTY Case it AUTI I-09-2022-181103
•
.1. Public Health Department pSubdivision
'-I Environmental Health Division Mt/ 377003106249
PO Box 389,25 Government Drive.Newton,NC 28658 LOTfr C
/: 2 5.
Site Address: 1789 BALLS CREEK RD, CLAREMONT NC 28610
Name on Permit: MICHAEL DOUB JR
Property Size: Acres 10.31
Directions: Right off of E NC 10 Hwy onto Balls Creek Rd. Driveway can be found right after 1777 Balls Creek Rd.
Authorization to Construct Permit
Permit Category: New Septic Wastewater Flow: 600 g.p.d.
Type of Facility: Prim Res/Acc Dwelling-3 bedroom home and 1 bedroom garage apartment
Basement? No Basement Plumbing? No Bedrooms: 5
Water Supply: Public Water Maximum Occupants: 10
Soil LTAR: .3 g.p.d./ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 25% REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Septic Tank: New Tank: 1,500 gal
Pump Tank _gal Grease Trap_gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 1,500sq ft Total Trench Length: 500 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 30 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 4 Trench Width: 3 ft
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
*1500GAL SEPTIC TANK
*INSTALL ON CONTOUR
*SYSTEM DESIGNED FOR A CRAWL SPACE FOUNDATION
*GUTTER DRAINS SHALL BE PIPED AWAY FROM DRAINFIELD
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 LTAR: .3 g.p.d./ft2
d./ft2
Proposed System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
ipern-I 10/03/2022 09:59
�y$• • CATAWBA COUNTY Case# AUl'11-09-2022-181103
Public Health Department Subdivision
Q Environmental Health Division l'IN# 377003106249
r^� PO Box 389,25 Government Drive,Newton,NC 28658 LOT# C
� Y SM
Site Address: 1789 BALLS CREEK RD, CLAREMONT NC 28610
Name on Permit: MICHAEL DOUB JR
Property Size: Acres 10.31
Directions: Right off of E NC 10 Hwy onto Balls Creek Rd.Driveway can be found right after 1777 Balls Creek Rd,
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' (I5A 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.
09/26/2022
Authorized State Agent Permit Issuance Date
9/26/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chpermil 10/03/2022 09:59
Catawba County Environmental Health
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ThIs map/report product was prepared from the Catawba County,NC Geospatial Infor iuon Services. Catawba County has mado substantial efforts
to ensure the aavrscy of location and labeling Information contained on this map or data on this report.Catawba County promotes end recommends
the Independent verification of any data contained on this map/report product by the user.The County of Catawba,Its employees,agents,end
personnel,disclaim,and shall not be held Ilablo for any and all damages,loss or liability,whether direct,Indirect or consequential which arises or may
arise from this map/report product or the use thereof by any Copperso oyright r
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1 Co wise County NC
09/26/2022