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Home My WebLink AboutIMPV-01-2023-187953.TIF (; ) catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 4/18/2023 Owner-is): Laney Beard Mailing Address: 1972 Campbell Rd Newton,NC 28658 Property location/site legal description: 2357 E Maiden Rd Maiden,NC PIN: 365606386118 Improvement Permit(IP) IMPV-01-2023-187953 Date Issued 1/24/2023 Authorization to Construct(AC) AUTH-01-2023-187967 Date Issued 1/24/2023 1,0110\/' Y.?(.(tre4 ,voluntarily relinquish my rights to pursue a formal appeal through the North I(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 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 Illg—75%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 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 the permit to take effect. Signature of Property Owner: Date Signed: I 1 1 NCDHHS/DPH/EHS/OSWP Revised May 2015 catawbacountync.gov Environmental Health Ccic:vb: Collnry Goverrimenl Cenlel 25 Gavernnr.ent Drive I PO Box 389 I Newio•i NC 28658 j 828.465.8270 MAKING . IIVIN(', PIFTTFR Ai" catawba county public health 04/18/2023 Laney Beard 1922 Campbell Rd Newton, NC 28658 Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to Construct for 2357 E Maiden Rd, Maiden, NC 28650; PIN 365606386118 Catawba County Permits IMPV-01-2023-187953 and AUTH-01-2023-187967 Dear Laney Beard, 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.Qov . 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 Cciewhc 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 4/18/2023. Meeting the 30-day deadline is critical to your formal appeal. If you file a petition fora contested case hearing with the Office of Administrative Hearings,you are required by law(NC General Statute 150E-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, mes R. Ross, REHS nvironmental Health Specialist CATAWBA `'�r� Public Health COUNTY ty --Int..;) Subdivision is Environmental Health Division R� •¢_r PINS 365606386118 1114.,/>� PO Box 389,25 Government Drive,Newton.NC 28658 LOTN Site Address: 2357 E MAIDEN RD, MAIDEN NC 28650 Name on Permit LANEY BEARD Property sirs: Acres 0.99 Directions: Right off of Jim Beard Rd onto E Maiden Rd. Empty tot on right. Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the(}property described above. 'J As the property owner or authorized representative, I have received the above referenced 'Jpermit(s)as requested in the application for service RBPR-I I-2022-42740,by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) d Electronic Image Transmittal/E-mail (Return receipt required) C 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(I5A 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: 01/24/2023 Owner/Authorized Representative Signature ' ' (r✓-et Date t 1 2-11 � . 3) Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by_ (name of person sending permit) Signature E Ci Date/Time )J)7/ 3 Method: Fax Y 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 yotPlease stake a few momentts tto complette our custiomer service survey att http://www.sunreymonkey.com/s/Eff CusttomerSery Ice e beof,46,iceifittcbet 1ai,► r „c .giv chpcnnn 01/24/2023 1029 f- P C • CATAWBA COUNTY Case# IMPV-01-2023-187953 Public Health Department Subdivision ir y Environmental Health Division PIN# 365606386118 PO Box 389,25 Government Drive,Newton,NC 28658 LO'r# w Site Address: 2357 E MAIDEN RD, MAIDEN NC 28650 Name on Permit: LANEY BEARD Property Size: Acres 0.99 Directions: Right off of Jim Beard Rd onto E Maiden Rd. Empty lot 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 360 d 9•P• Type of Facility: Primary Residence Basement? No Basement Plumbing? No Bedrooms: 3 Water Supply: Public Water Maximum Occupants: 6 INITIAL SYSTEM SPECIFICATIONS Proposed Wastewater System: 25% REDUCTION System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS Pump *May Be* Required REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: DRIP IRRIGATION System Classification: VA-SAND FILTER PRETREATMENT Pump Required ***** Operator Required Permit Conditions: 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 at7ected 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' (I 5A NCAC 18A.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. 01/24/2023 Authorized State Agent Permit Issuance Date 01/24/2028 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpennit 01/24/2023 10:30 • Catawba County Environmental Health /4 /� cN� •2345 � O • F \\N / dvc ,C� G>tij ►' '7 w lo e. qo ,, C� fis ...7., / <-11\\\ > J1 nt ?..\\:sve <if 9 / 1x --- [2] G - 'V "7,,L i . / Parcel: 365606386118, 2357 E MAIDEN RD 1in=50ft MAIDEN, 28650 This map/report product was prepared from the Catawba County,NC Geospatial 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,disclaim,and 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 01/23/2023 . , • DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet I, of DIVISION OF OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: A -Ree.k,13 APPLICATION DATE_ ADDRESS: DATE EVALUATED: Tkp2i7(.3•C3),:e PROPOSED FACILITY: l'ROFOSErSIGN FLOW(.1949): 3(06 PROPERTY SIZE: LOCATION OF SITE: /114'eil PROPERTY RECORDED: WATER SUPPLY: 0 Private ublic n Well Li Spring ri Other ... EVALUATION METHOD: 0 Aurr Boring [4.PI( 0 Cut TYPE OF WASTEWATER: 11-Beivage 0 Industrial Process 0 Mixed . ;-, ' ..:, .,•, ';I:' 7-'t.k'e?t!i;',•ligi,,J:-.1 it .;Jib: -!!..,, ..::Ileit •i:.':3% :Ii..,,- , , e,-- -i ,;.'. . :,,-,-,' A ,,., , .11tir:,-;,...%:. '4.'..'id''''.'s.- ;,.:. ;:4';,!1'','5:4..:',11:'4'. 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IP 1 13.1 2 A/9 • in6 . - 5/11X- 16 -f.r —5:E —//6 i,161ti c ,54 1 4 --r-,- si 3 • 1 ),.-6- Prip • - DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): SITE CLASSIFICATION(.1948): Available Space(.1945) EVALUATED BY: Systcm Type(s) OTHER(S)PRESENT: Site LTAR COMMENTS: Updated February 2014 • DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheug of- DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) LOWNER. r' ye,r) _ APPLICATION DATE ADDRESS: DATE EVALUATED: WiT2.761,2 PROPOSED FACILITY:a i P SE DESIGN FLO (d 949): 3jt PROPERTY SIZE: LOCATION OF SITE: � ,��,? /� ' PROPERTY RECORDED: WATER SUPPLY: 0 Private ti.14Cblic ❑Well/ ❑Spring fl Other EVALUATION METHOD: ❑Au er Boring �rt �]Cut TYPE OF WASTE WATER: age ❑Industrial Process ❑Mixed ��,.. trS� #T a I '�.. � '�>: �l 1 `•`'�'�� - s'. �'�taaii ft' R- ;r� -r•,•y r 4. 4 f - l f P .,s �y yy t k�y } „ • , 'F f - Nr`�t ; P t.. _1'• r' j •1 37tg t+ „t}... �.., y' yh 11; t?y J 7 f•'.. w a••� y ., � _ : J 1 tr 1' �f l a.. , ``� 4 ':d: : ' .e l t} I ..; ' � . f f y a Lw , MFrj I f� ! Ci .1 tA ).�} "p p i` 1 r. L (r - f" (-5,./ , - (5-dk i i L5r- L,--- /0 -L i T �E /r j v/r � v 5 � 5 M I /Q LI-1 (1 / ,- ,i.t. „2 ,) -, c�z/ "ri-f- Liz3b ` 6 (3 ---2/0 * y / t ACx 1 (e () 4 5i ' ;f 5,B ,5'1 -fr S f 3 4 al-r-4, L . ; k-E - s �� ` it DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): /,� Available Space(.1945) SITE CLASSIFICATION(.1948 : /� l EVALUATED BY: i ��, System Type(s) cl r•t� OTHER{S)T PRESENT: Site LTAR r37 0 COMMENTS: 5 Updated February 2014 — Catawba County Environmental Health / /.....:0 0.- I(o .. kAa k %t r 6 3/U < e2 ) 356 14 `)-kci& 0-1_ vrA)4 er Li C--5, ,Ic. w� 4o oi, )46 je 4k 3 . 01 t /-i/54 149;) �� ter •D/ / -ek N. „... �} - Cl- FR S4 55 Sg� 1 ,4440, / f2 r b e4-0,` C Ff. 5 r 55 >8ic- I , f lx• / — FR s r— s5 �..s;;.<< (, ` 17 b � �3 c y gtC . FR 56-- 55 V$, \ Si ' i;L 6 0 gay s ,'7 \ ,r-_%� / (, / `'�r °1114g 6-1), 4p ,\ Ilk �D pRSSST sg1 25 C f� 5S s,� �,k /\ o'- 747 Vo,_ �� 55 5� (/' 1 3 ,� 16' - IP C Ff 5 SC Sh1L c4c7e SS3,5' - CY-.01.c.1):: SE 531c:p• • e_ i__ „4/( v 72 / r' . 2 -?.S V9 f)q S Parcel: 365606386118, MAIDEN, 28650 1in=60ft This map/report product was prepared from the Catawba County,NC Geospatial 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,aril personnel,disclaim,and shall not be held liable for any and ali damages,loss or liability,whether di►ect,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 11/10/2022