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HomeMy WebLinkAboutIMPV-01-2023-187070.tif ( ) catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 12/7/2023 Owner(s): Chris Sauerbier Mailing Address: 116 Palos Verde Mooresville, NC 28117 Property location/site legal description: 4980 Kiser Island Rd, Terrell PIN: 461604637083 Improvement Permit(IP) IMPV-01-2023.187070 Date Issued 1/4/2023 Authorization to Construct(AC) AUTH-02-2023-189401 Date Issued 2/14/2023 1, Croeir fo '?d,Efi , voluntarily relinquish my rights to pursue a formal a (print full name) ppeal through the North Carolina Office of Administrative Hearings pursuant to NC General Statute 130A-24 and 150E-23 and all other applicable provisions of Chapter 1508 for the above referenced permit(s) (which includes the I Ps 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 IVa -50% Reduction Vertical (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 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 rights but that this is an option available to me so I do not have to wait 30 days for the revocation of hermit tak effect. Signature of Property Owner: ald/1 Date Signed: - NCDHHS/DPH/EHS/OSWP Revised May 2015 catawbacountync.gov Environmental Health Ccrowbo County Government Center 25 Government Drive I PO Box 389 ; Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. catawba county public health 12/7/2023 Chris Sauerbier 116 Palos Verde Mooresville, NC 28117 Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to Construct for 4980 Kiser Island Rd,Terrell PIN 461604637083 Catawba County Permits IMPV-01-2023-187070, AUTH-02-2023-189401 Dear Sir: 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 150B. 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 Catawbc County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 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 12/7/2023. 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 1S0B-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, AvIAA- fk-1)(1,/,7 Robert Phelps, REHS Environmental Health Supervisor Catawba County Public Health County: Catawba This Section for Local Health Deportment Use Only Initial submittal received: 12/19/22 by RP Date Initials Permit Number: IMPV-01-2023-187070 G.S. 130A-335(a4) states the following: VP local health department fails to act on an application for an improvement permit submitted pursuant to subsection(a3)of the section within 10 business days of receipt of a complete application, the local health department shall issue the improvement permit.' In accordance with G.S. 130A-335(a3)the improvement permit application is: O Incomplete(If box is checked, information in this section is required.) The following items are missing: Copies of this were sent to the LSS and the Owner on Date State Authorized Agent: Date: _ ❑ Denied (See attached report.) Copies of this were sent to the LSS and the Owner on Date State Authorized Agent: Date: © Complete State Authorized Agent: Date of Issuance: 1/4/23 This Improvement Permit is issued pursuant to G.S.130A-335(a2),(a3),and (a4)using the signed and sealed LSS/LG evaluation(s) attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if the site plan,plat, or the intended use changes,or if information submitted in the application was falsified, inaccurate or misleading. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. The location and identification of all property lines,easements,water lines,and other appropriate utilities shall be the responsibility of the owner. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: 1/4/28 *See attached site sketch* County: Cccka.wbck IMPROVEMENT PERMIT FOR G.S.130A-335(a2)/SL2022-11 PIN/Lot Identifier: t 1 \(.p 01S-� Issued To: SCO kk Q 18 bk _ Property Location: 1'`60 `Istct,d { -Turco IVc Z ' g,z Subdivision: 11.., ta' Svr seA- Lot tJ: H Z.- Block: Section: LSS Report Provided: Yes 99 No 0 If yes,name and license number of LS5: 2Q.rvi Lie 1 /As( -Re, la rks New® Repair 0 Expansion ❑ System Relocation 0 Proposed Structure:NtAA1 S\Dtc, . -ity (2.0 t 3 4%.er Proposed Wastewater System Type:rxid ,Cony Q "J) (.dy1J. PP (Initial) �r'�Itgl Mt7d. � R ) (Repair) Fill System:❑Yes No If yes,specify:0 New ❑Existing (when adding more than 6 inches of fill to system area please provide a fill plan) Proposed Design Daily Flow: 3(so GPO Proposed LIAR 0.2•5 (Initial): Proposed LTAR(Repair): 0•2-5 Design Wastewater Strength:Igi domestic ❑high strength ❑industrial process Number of bedrooms: Number of Occupants: (g _Other: Pump Required: IN Yes 0 No 0 May be required based upon final location and elevations of facilities Artificial Drainage Required: Q Yes 0 No If yes,please specify details: . _ Co nc7 ►"I (o.r n/ .� be to - Type of Water Supply:SO Private well 0 Public well 0 Municipal Supply 0 Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes pq No 0 Drainfield location meets requirements of Rule.1950: Yes Ell No 0 Permit valid for:VI Five years(site plan submitted pursuant to GS 130A-334(13a)] 0 No expiration(plat submitted pursuant to GS 130A-334(7a)] Permit conditions: f een5 o Noose- rust be bvivr U� so r-��r �Chc covr.6c) kion , h�a her t`nw, Dro1;r\F+G1c) Licensed Soil Scientist Print Name: rv1 V e k ,C \ (AS Licensed Soil Scientist Signature: _ _ Date: The LSS evaluation is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). 'See attached site sketch• SOIL & FORESTRY SERVICES OF THE CAROLINAS, PA www.soilandforestryservices.com Project#:22-0172 Scott Oldenburg December 15`n 2022 Attn:Scott Oldenburg Email:squires8@yahoo.com RE: Soil &Site Evaluation for a 3 Bedroom Residence at 4980 Kiser Island Road, Lot 42, PIN#(461604637083),Terrell, NC 28682,Catawba County, NC. Mr. Oldenburg: At your request Soil & Forestry Services of the Carolinas(S&FS) has performed soil/site evaluation on parcel noted above.The Lot size is noted on the attached soil evaluation form. The purpose of our work was to identify soil areas with potential to support subsurface wastewater disposal systems and provide sufficient details for Session Law submittal for an Improvements Permit to Catawba County Environmental Health. Site Conditions At the time of our evaluation land cover on the property was mostly open on the front left side of the property with the remaining area wooded. Topography within the evaluated area was gentle slope near the house site with gentle percentage of slope in the proposed drainfield area. The property slopes from the middle of the lot (peak elevation) to the lake and also to the road. Property lines and corners were marked at the time of the evaluation by Dedmon Surveyors. The Surveyor provided an Autocad File of the field survey as a basemap. The proposed septic layout was located via GPS and tape measures which were used to produce the attached Site Plan.The house envelope was pinned in the field by the surveyor.The original plat for this property is attached to the submittal and is dated 1966. Methodology We evaluated soil areas through the use of auger borings.Soil morphological conditions including color, texture, structure,etc. were reviewed in the field with three auger boring locations on the property flagged and located via GPS. Two of the three auger borings are located in the proposed septic layout. Soil suitability was determined by referencing 15A NCAC 18A.1900 "Laws and Rules for Sewage Treatment and Disposal Systems".Soil&Site Evaluation Forms were utilized to record the soil morphological data for each boring. The house envelope was located via survey.An on-ground layout of system and repair was performed using a laser level. Pin flag locations of the layout were also located by GPS and tape measure. Detailed system & repair information is summarized in the following paragraph for this Lot. 4980 Kiser Island Road PIN#461604637083 (See Attached Information) The septic layout for this lot (9'centers)yielded a total of 310 linear feet of line.The primary system is proposed as 240'of Modified Conventional(PPBPS)drainfield with low pressure distribution.Trench depth(LOW SIDE)is specified at 30 inches.The lot is repair exempt(See attached plat).There is 70' available for repair of Modified Conventional(PPBPS)drainfield with low pressure distribution.Trench depth(LOW SIDE)is specified at 30 inches. House foundation area must be backfilled to create additional positive fall from the front of the house to the drainfield.Application submitted by client. Session Law Requirements All information needed to issue the IP must be submitted with the application.The application shall include all information described in 15A NCAC 18A.1937(d)and be accompanied by a signed and dated statement from the applicant(owner or owner's legal representative)that reads as follows: "The LSS/LG evafuation(s)attached to this application is to be used to issue an Improvement Permit in accordance with G.S. 130A-335(02)and(a3)." Owner 11 Wt,, '1 d.O`Mi,S 1k)e rt 1 UeVe1 opme,11" Date Print Name r .-G oT' O cl ell 1 j4 Signature , :p )o ,, /SZeZZ- The LSS evaluation shall include a statement bearing the LSS seal and signature that reads as follows: "The LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A- 335(a2)." Disclaimer This report reflects the findings of S&FS,PA.This LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A-335(02J_"Any site modifications that impact the proposed septic areas on the site may nullify this design for 4980 Kiser Island Road.System design requirements and site requirements shall be adhered to for installation and Operations Permits to be issued by the local Health Department.If you have questions regarding these requirements a Pre-Construction meeting should be scheduled to discuss. Please contact S&FS if you have any questions regarding this report or the attached information. S&FS also offers septic system inspection, wetland delineation and • , services. Sincerely c, ) SOIL , lu� _A..— A. Rol c�2 C'r7q t f, 4 , p • \ •1:tLY l:l. - 123A S.Ashley Rollans, LSS ` r,Q'� Attachments: Site Plan,Soil Notes, Original Plat& improvements Permit Form O R7� 'nqom 56% ��ov, z i • / Z � � o oAo; og ' ' Ai y Q m In� y ff `113.ice' ro- g o Z ZAP 00 • o / m nOA c� • Cz Az f3� m Y� A 7 / n / s iiM ' N 04 K v N J9 9 s 4� � Q1 me0 44ti \4'' e.<) o AMinmi%. VS) cl Fa.\\i/ ' '• 41. o. \\ / Y • ---_ 0. ' �; } / i(if . ,5.77. .* '.;•,..„4,- www .u. m..i . / 11:41!4001' • • l'i ri f , r 1 Si g5` ' / 111111 qa, { �� f i ? Q`�. • / j�—, �,V • A 110p,-, Z 73 t x \\ ,...A %, , 1 \\ I c:, 1 YO w oy�o• l m N'1� \�~ y tip i-1. 1-g'?iio / �� it 11 =go. ` / �j, �' 111111 „ m x \\.._ �;� lllill d - -- % / tii 2 — 11 /cn (rJ 4 V n / 1 0 1Z x vNioac'o an ►P • ret r" n PLAT BOOK 13_17 c * z A n $ 1 m �' _ qn O to rn fp 0 O ci • C j N • Sheer 1 of_I PROPERTY ID#:461604637083 SOIUSITE EVALUATION COUNTY:Catawba for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER:Michael Kiser ADDRESS;_4603 Kiser Island Rd,Terrell,NC 28682 _._ APPLICATION DATE DATE EVA2,2__ PROPOSED FACILITY: 3BR PROPOSED DESIGN FLOW(.1949):_360 GPD PROPERTY SIZE:L_0.44 act LOCATION OF SITE' 49801(i�RiTerrell 4 2868 — WATER SUPPLY: /Private ❑Public Well f 1 Spring 0 Other PROPERTY RECORDED: YES EVALUATION METHOD: ,Auter Boring 0 Pit ❑Cut TYPE OF WASTEWATER: 'Sewage �Industrial Process rl Mixed P . R o SOIL MORPHOLOGY OTHER iF (.1941) PROFILE FACTORS .1940 E LANDSCAPE HORIZON POSITION/ DEPTH M SLOPE% (IN.) .1942 PROFILE .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ [I3% 0-4 RBCLWMSBK FRSPSEXP 4-50 RBCWMSBK FRSPSEXP PS 1 50" 0.25-0.275 L4% 0-8 RBCLWMSBK FRSPSEXP 8.50 RBCWMSBK FRSPSEXP PS FEW MN "50 0.275 2 DEEP I13% 0-7 RBCLWMSBK FRSPSEXP " PS 7-50 RBCWMSBK FRSPSEXP 50 3 — 0.275 ��a sore Sc F,4A ,,, 4 / r4%..- ...° . ..„1„,. . .. ..)., — ` 7 231 d" OF lU r)n-I'1-k �'�� DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM ter OTHER FACTORS(.1946): Available Space(.1945) PS SITE CLASSIFICATION(.1948): PS PARTIAL System Type(s) PPBPS PPBPS/Pariial EVALUATED BY:_1SHLEY ROLLANS ( ) OTHER(S)PRESENT:_MASON FREEMAN Site LTAR 0.25 0.25 COMMENTS: Lot is Exempt from Repair.Please see Attached Original Plat Updated February 2014 •1. . P. 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