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Home My WebLink AboutIMPV-09-2022-181524 A°11,,,)''''\11 catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 5/31/2023 Owner(s): Jamie and Amy Laity _. Mailing Address: 4_199 Fishermans I.n Maiden,NC 28650 Property location/site legal description: 4145 Fishermans Ln,_Maiden PIN: 3677.03417267 Improvement Permit(IP) IMPV-09-2022-1 8 1 524 Date Issued: 9/30/2022 Authorization to Construct(AC) AUFI I-09-2022-181526 Date Issued: 9L3_0L2022 ___ 1, , 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 150I3-23 and all other applicable provisions of Chapter 150B 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 111I3-25%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 he 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 11'and AC that the current 11'and AC must he 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 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. 1 understand that I am not required to relinquish my appeal rights but that this is an option available to me so I do not have to wait 30 days for the revocation of the permit, take effect. ' ^"/. Signature of Property Owner: _,:7 VLC -2/ (Date Signed: 60/2_ NCDHHS/DPH/EHS/OSWP Revised May 2015 catawbacountync.gov Environmental Health (c:: :whr County Government Centel 75 Government Iltive I NO Box 389 1 Newton NC 28658 1828.465.82/0 MAKING. LIVING. BETTER. °I" , fir catawba county public health 5/31/2023 Jamie and Amy Laity 4199 Fishermans Ln, Maiden, NC 28650 Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to Construct for 4145 Fishermans Ln, Maiden PIN 367703417267 Catawba County Permits IMPV-09-2022-181524 and AUTH-09-2022-181526 To Whom It May Concern: 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 (AC) and meet the requirements of the current laws and rules necessary to obtain a new 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 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 1508. 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 Cctcwbc County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 �� Ng r w 1 n 4..11 V M �Y 1� n, n ,i r _ 0" 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 5/31/23. 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, CU Cheyanne Morgan, REHS Environmental Health Specialist Catawba County Public Health 4183: • CATAWBA COUNTY Case# IMPV-09-2022-181524 .{. Public Health Department Newton,NC 28658 Subdivision d . ��J Environmental health DivisionGovernmentDrive, L I'OT#IN# 367703417267 3 f / 18. u, Site Address: 4145 FISHERMANS LN, MAIDEN NC 28650 Name on Permit: JAMIE&AMY LAITY Property Size: Acres 3.36 Directions: 16 S, R on Buffalo Shoals, L Olivers Cross Rd, L on Burton, R on Fishermans property on Right Improvement Permit AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS THIS PERMIT IS NOT FOR SEPTIC INSTALLATION Permit Category: New Septic Wastewater Flow 240 g.p.d Type of Facility: Primary Residence-Barn Dominium Basement? No Basement Plumbing? No Bedrooms: 2 Water Supply: Private Well Maximum Occupants: 4 _ INITIAL SYSTEM SPECIFICATIONS Proposed Wastewater System: 25%REDUCTION System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP Pump Required REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25%REDUCTION System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP Pump Required Permit Conditions: -See IP 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 arc 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'Laws and Rules for Sewar;e Treatment and Disposal Systems' (15A NCAC 18A.1900). Neither Catawba County nor the Environmental I 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. alei9VL 11)1/4 09/30/2022 Authorized State Agent Permit Issuance Date 9/30/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. d Apr ru i i t 09/30/2022 13:44 Catawba County Environmental Health R8P(1-0$-1R21-ug ss) TMf7v_oevzot1- 1 55v1 /-�,, - o - z o71-l Z;, •.� �� WPII-of- 10/- l815Z3 o co p •41 • a \\to . l Ao v• 05 F NM OW 26 c'S' 1S' I .J {fib talk VI 1 �Q ` �� brivG V. Q � � ti 'El 428,50 3` to )"ID `-k 1v /--1 21,85 1° •4159 42.29 R 0) uV 47) cV Parcel: 367703417267, 4145 FISHERMANS LN 1in=80ft MAIDEN, 28650 This map/report product was prepared from the Catawba County,NC Geospattal 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 Indepondonl verification of any data contalnod 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�damagos,lase or liability,whether direct,Indirect or consequential which arises or may arise from this map/report product or the use!hereof by any person or entity. Copyright 2021 Catawba County NC 0912 812 0 2 2 6 SYSTEM Line# Color Elevation Length Hole Size Flow/Tap qpd Trench Area Cony LTAR 25%LTAR 50%LTAR 1 110 SC1180 3/4 10.1 50.50 330 0.15 0.11 0.08 2 110 SCH 80 3/4 10.1 50.50 330 0.15 0.11 0.08 total feet = 220 gal/min= 20.2 101.00 660.00 0.15 0.11 0.08 Des.Flow 240 Pump Run= 5.00 soil LTAR 0.275 DEPARTMENT OF HEALTH AND HUMAN SERVICES Slim( r of I DIVISION OF PUBLIC HEALTH;ENVIRONMENTAL HEALTH SECTION PROPERTY ID I: ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba_ SOIL/SITE EVALUATION for ONSITE WASTEWATER SYSTEM (Can**an&Ids hs IWI) • OWNER: Tre-c, /¢ ; • ADDRESS: _ APPLICATION DATE PROPOSED FACILITY: DATE EVALUATED: Viols./ OF SITE: �AM PROPOSED DESIGN FLAW(.1949): ZgO6PD PROPERTY SIZE: Y/Yr fcfike , (. PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public ( Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring aPit 0 Cut TYPE OF WASTEWATER: 0 Sewage 0 Industrial Pruoess 0 Mixed +.ter • • R • _ O ' 4 SOIL MORPHOLOGY OTHER I r. � (.1941) t PROFILE FACTORS... L 1940 E LAN1D5cA E ]BORIZON - . ' POSmON) DEPTH : : - PROFILE ..,/ SLOPE.% - (IN.) .1942 r: . .1941 .1941 SOIL • 1943 ' 1936 .1944 CLA39 STRUCTURE/ CONSISTENCE/ WEI'rtESS! SOIL . SAPRO '. &LTAR TEXTURE MINERALOGY COLOR DEPTH . CLA83 H0 'c- '"� 4-z Y Ssk - A' 6 '��` N.¢ �S 1 j ?g-YL `rec C /g .Se- ,C A_ 2 7f` O- L{ `S.jk ScL r7 .tE 6 , • ,�_ a s� c (4. ti4 fs' / i _re- /2 2 39- y `'s.erc c ), r se- £ n Zac, o =o _ �d(. c /ter Se- "Ad_ "if/ �-�- .,v,� �r 3 LA yy -ssb c. Fr r�- • . O. z� ,r ' ;:4,. , ._r '-sue set -Cr �' 4 Ls s- u. ...rifle._ z C- ,Fr -re- &, O. a, 2 k-' r tr C- Fr 1r 4 • DESCRLIMON 1Ni11AL sys rw 1 REPAIR SYSTEMOTHER FACTORS(.1946): . SITE CLASSIFICATION(.1941): pj Masi*Space(.1945) gf Os Sys TYPOEVALUATED BY: AIL-v�. OTTER(S)PRESENT': Site LTAR OO 17c n. 175` COMMENT's: vhdos4 Psbruary 2014 J Catawba County Environmental Heafth v 0 . 9 00 - • ,e 4 ' .sassAk - a 7 # • 4 rz 3 QrDq 614 jti I I .41 Iis ......................„, Parcel:367703406958,Y f Y5 FISHERMANS LN 1 Irk OOR MAIDEN,2$650 This ri.pinapon product irsa prapa.d Morn the Columba Caux*y,NC Geoupollid inaarmodon 9alloaa. Cameo tbuaa uas awe sidlrei __o abes lo enure . osaor��of location and tabling dote contained on tee�mapr fkaerpru�rd or a map a deft on add repot c.s..t�.Oaaay iaa.nnt.s am nem rnn�o the Inclobardent panorama,didii and Volnot icat of be held liable for any and at Mimosa,loam ot product orr awl user.The r raydru t,Cawt+r as arrpoy.a�teems. mi Ybitr..Aaita dM.tt indirect v avmpuaerl aAldi arias v wr arise from this maplrport product or Ow use thereof by any potion v matey. Copyritfit=I Cognate Cosily NC OM2112021