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Home My WebLink AboutIMPV-09-2022-181101.TIF ((:" 1 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 150E-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 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 General Statute 150B-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 150E-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 111A 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-09-2022-1 8 1 101 Date Issued: 9/26/2022 Authorization to Construct(AC) AUTH-09-2022-181103 Date Issued: 9/26/2022 1, Michael Dnub ,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 IIIG /5%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 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 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 get' clot b 6 9 3 Old . (Mi Igv .,n 04/27/2022 0R.02 � y& CATAWBA COUNTY • t '7j, Public Ilealth Department Subdivision (..... �� * Environmental Health Division I'IN# 377003106249 � • PO Box 399 25 Government Drive,Newton,NC 2R65R :�� LOT# C 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. Owner/Authorized Representative Acknowledgement of Permit Receipt X _[certify that I am the owncr or authorized agent(owner's authorization required)representing the owner of the property described above. 1( 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 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:09/26/2022 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) ___clf,_ Signature Date/Time_ /014)) Method: Fax N 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 youPlease ttake a few momentts tto compiette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService rnAQI sob 63 ot la . C ;1,i„•.,fir 09/27/2022 OR:02 4+ CATAWBA COUNTY Case# 1MPV-09-2022-1 8 1 1 0 1 • ._( Public Health Department Subdivision 1 .� Environmental Health Division PINK 377003106249 PO Box 389,25 Government Drive,Newton,NC 28658 LOTf C Site Address: 1789 BALLS CREEK RD, CLAREMONT NC 28610 Name on Permit: MICHAEL DOUR 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. Improvement Permit AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS TI IIS PERMIT IS NOT FOR SEPTIC INSTALLATION 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 INITIAL SYSTEM SPECIFICATIONS Proposed Wastewater System: 25% REDUCTION System Classification: I IIG-OTHER NON-CONY TRENCH SYSTEMS REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25%REDUCTION System Classification: IIIG-OTHER NON-CONV TRENCH SYSTEMS Permit Conditions: *DO NOT CUT OR FILL OVER SYSTEM AREA *DESIGNED FRO CRAWL SPACE FOUNDATION 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. 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 Improvement Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement 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'Lass and Rules for Sewage Treatment and Disposal Systems' (I5A NCAC I8A.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to Junction 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 I Iealth of this change prior to system installation. / 'Deg") 5.41+s 09/26/2022 Authorized State Agent I'ennit Issuance Date 9/26/2027 Permit Expiration Dale No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chperntit 10/03/2022 09:5t Catawba County Environmental Health RFoq2o . 0 IvoR . ao - J1\ O \ __..______---- AuTO ° ! II °3 in in lV ry GA L o 0 ep11` I Rs - ® , �ro _cts c ,'- , l as' %7_0' H cc. o t rn _o to I L. a 1 a o m /S0' I c n O�� •1789 /30' _yy o 7d v J 293.09 128.10 Parcel: 377003106249, 1789 BALLS CREEK RD 1 in=60ft CLAREMONT, 28610 This map/report product was prepared from the Catawba County,NC Ooospatlal Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling Information contained on this map or data on this report.Catawba County promotes and recommends the Independent verification of any data contained on this map/report product by the user.The County of Catawba.Its employees,agents,and personnel,diedalm,and shall not be held liable for any and all damages,loss or liability,whether direct,Indirect or consequential which arises or may grille from this map/report product or the use thereof by any r>�or e Copyright Catawba County NC 09/26/2022 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet I of( DIVISION OF ENVIRONMENTAL HEALTH 1'- PROPERTY ID it: ,ON-SITE WASTEWATER SECTION CAUNTY: CC,.k,-47i SOIL/SITE EVALUATION OWNER mnhG�� DQ�1 .r or ON-SITE WASTEWATER SYSTEM y_�g-aa MPLICATION DATE ADDRESS: DATE EVALUATED 4-/I PROPOSED FACILITY: S FC) PR(SPOS DESIG'II FLOW(.1949): ?CO • PROPERTY SILK /O�31.1� LOCATION OF SITE: p B 1 �t CC..t i 141..,/ (ic,•c ,4- PROPERTY RECORDED: WATER SUPPLY: 0 Private 4B5Publle 0 Well U Spring 0 Other EVALUATION METHOD: 0 Auger Baring Pit 0 Cut TYPE OF WASTEWATER -�cwagc 0 Tndustdal?mess Miix D ed ,Fri acrrai_...-,....._. ,_::: --S.Or M0RkrfOLOt;' '= ::::__:::::::•:::::: :� jJj�4 ............... �� . ..... : :::._.-4...3..:.:..:.::. . ....:.:... "`' .::.................. .� ur:��:4fl = mi.".F c• t,i► HOR ::: .Y94Z ,,.... .—.. = : : ...ZON« ::::::::::::::::19d1_::::::::::::::,-: :: :igd1:::-::�::::_.:: ::::::SOIL::« . X9 155 : -..1941 :PQf1L0:� n k05�ONf DEPTfiE :iiiMKP� . L0�151S1ETCFlf`'; 1VE?Nf R ...CL2:::: G _ [ i «r. . ..... i... ... ... . ..• ,9 o g 5 L 4. 8.38 silt_ GI- . • (5-- /1 do / ./ S . IDi, : 1g .' /ic <s�� Fr - _ �� • • G ft,� a • ). 7.26 €k C L fs 2 f0� LS ac-.? & 4Zk •sci. Pi-- / (g14 eCi 5 -C' bk ScL r-v r- /L 4 0_6 (...._ ,2Y s bf. Ge- �r P S 3 i�� ik- a ci c,,sbk cc_ / / 7 F O `c7 ' i 6 $3 silk GA r--,- • / Lig, r �S 4 lbl 13 aeyer Pik c,- 13 �3 • Disown" D+'IIIAL SYSTEM REP AIIt SY FACTORS(.194b): `~ Amiable Spy(1P4S) �� SITE CLASSIFICATION((1948}:�-- G S y�,�Tsa) f� 2s-� EVALUATED BY: t" v`'KS OVALUA)PRESENT: S'ife LIAR . -3s a • COMMENTS: 1 SOIL/SITE EVALUATION Sher a (Continuation Shea-Comp/gm oilfield In full) PROPERTY ID N: DATE OF EVALUATION: COUNTY: , S P R 0 SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 .1940 E LANDSCAPE IIORIZ .1942 POSI7TON/ ON .1941 .I941 SOIL .1943 .1956 .1944 PROFILE y SLOPE% DEPTH STRUCTURE/ CONSISTENCE/ WETNF--CS/ SOIL SAPRO RESTR CLASS TEXTURE MINERALOGY COLOR DEPT71 CLASS HORIZ &LTAR 4 o -(o gr L ‘- ak_ sck ram-- PS Of Pc- Qs ii w1bk Su. r,- / Li(-3 / / , 3 .� ee COMMENTS: Updated Felxuary 2014 '' Catawba County Environmental Health \.\\\.N, s\mNDs \ O� ,.O . \--\\1110 p / L • 1 0 0 C .- / O .4( / O� ta IN co / 1 is \ \.:3 •31 bOozi oo utt toTb o rl, 440 o K. alk / / 10 f-- e 789 / // 7 a Q' � o a � o r Oooi \ 0 o� 293.I' \j0� �o 1T �� \ \\ 1 19— \ ti?Parcel: 377003106249, 1789 BALLS CREEK RD 1in=60ft CLAREMONT, 28610 This map/report product was prepared from the Catawba County,NC Leospotial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the Independent verification of any data contained on this me report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,end shall not be held liable 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 person or entity. Copyright 2021 Catawba County NC 06/17/2022