HomeMy WebLinkAboutAUTH-01-2023-187967.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
,g,4 . CATAWBA COUNTY Case# AUTH-01-2023-187967
!.' t Public Health Department Subdivision
Environmental Health Division PIN# 365606386118
PO Box 389.2�Government Drive.Newton.NC 28658 LOT#
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.
Authorization to Construct Permit
Permit Category: New Septic Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
Soil LTAR: 0.275 g.p.d./ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Septic Tank: New Tank: 1,000 gal
Pump Tank _gal Grease Trap_gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 984 sq ft Total Trench Length: 328 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 16 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 5 Trench Width: 3 ft
Distribution: Serial
Pre Treatment: NONE
Pump*Mav Be* Required
Additional Specifications:
*PRECONSTRUCTION MEETING REQUIRED.
*BRING IN 4 INCHES MIN OF COVER.
*RUN WATER LINE OPPOSITE SIDE OF DRIVEWAY FROM SEPTIC.
*REMOVE EXISTING BERM.
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: 0.15 g.p.dift2
Proposed System: DRIP IRRIGATION
System Classification: VA-SAND FILTER PRETREATMENT
Pump Required ***** Operator Required
e6prniui 01,2712023 11-42
CATAWBACOUNTY Case# AUTH-0I-2023-187967
I\•
Public Health Department Subdivision
Environmental Health Division PIN# 365606386118
PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
/8. r
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.
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 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.
ehpermit 01/24/2023 10:29
Catawba County Environmental Health
zz4
/f
\k, F�
•2345\ b�
\ `a ti410
AO/ ,hdv r
> f \ C 14/
V
R
• ►' —47s
Ilel
...\ /
6-7_
. ss?r,os . f 4e.?„ t)
(1/::://"NNN7 Ci3-
�� / �� /\\I \4.-.\''
'
b� ,
?,.\\ON/
N.
17 0 f•
9 , ,x1:-]
ti
7 v
-412 C)
/G_ - Ss r
"`z
/
Parcel: 365606386118, 2357 E MAIDEN RD lin=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