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HomeMy WebLinkAboutIMPV-03-2023-192192.tif (i) catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared. July 13,2023 OwnerIs). TablthaM il2c tan Mailing Address. 1.6fli Mn6raor Terrell,NC 28682 Property location/site legal description. 4185 Yellowbell Orjerrell _._---"— PIN 461703419180 -_..-, Improvement Permit(IP) IMVV-03_2Q23_293j92 Date Issued 3/24/23 Authorization to Construct(AC) Date Issued 4 /a to.-1 \cr c\U aoluntardy 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 1508.23 and all other applicable provisions of Chapter:SOB 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-2S%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 with,i 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 int• t. derstand 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 o rely . my ap• al ri: is 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 e ect Signature of Property Owner Date Signed. /d c9___ ' NCDHHS/OPII/EHS/OSWP Revised May 2015 catawbacountync.gov Environmental Health (c'cwbc (aunty Gosc'ii rent Centel 15 Goseind:ent Dii e I PO Box 389 I fiewlon hl 1B558 1 3/8 155 81/0 MAKING. IIVIN( . RFTTFR �? fir + rr1 ,,� __ ._. ayrrrza:arvt .v. 'WIIM ?'r:,'1�..':4:tit'y(��:nigi 1: ..l? lei, C31'S�'!r'"'�4'r.r`'t E;";� catawba county public health July 13, 2023 Tabitha Mocilan 3601 Melica Dr Terrell, NC 28682 Subject: Notice of Intent to REVOKE the Improvement Permit for 4185 Yellowbell Dr,Terrell PIN 461703419180 Catawba County Permit IMPV-03-2023-192192 Dear Ms. Mocilan: The Environmental Health Division of Catawba County Public Health intends to revoke your Improvement Permit 30 days from the date of this notice. If the permit is revoked,you must apply for a new Improvement Permit (IP) and meet the requirements of the current laws and rules necessary to obtain a new IP. 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.Rov . 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 Cctcwbc 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 July 13,2023. 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 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, f jui,(ftv yizitA Robert Phelps, REHS Environmental Health Supervisor Catawba County Public Health County: Catawba This Section for Local Health Department Use Only Initial submittal received:3/10/23 by RP Date Initials Permit Number: IMPV-03-2023-192192 G.S. 130A-335(a4)states the following: 'If a 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: ❑ 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 QQ�ff��� State Authorized Agent: .✓'�/V�1�► f Date of Issuance: 3 Z"I _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: 3-2-4 - 2y *See attached site sketch* County: Catawba IMPROVEMENT PERMIT FOR G.S.130A-335(a2)/5L2022-11 PIN/Lot Identifier: Pin # 461 703341 91 80 Issued To: Tabitha Molican Property Location: 4185 Yellowbell Drive Terrell NC Subdivision: Lot#: Block: Section: LSS Report Provided: Yes IN No❑ If yes,name and license number of LSS: Steven R. Cannon #1 291 New® Repair 0 • Expansion ❑ System Relocation ❑ Proposed Structure: House Proposed Wastewater System Type: Accepted (Initial) Vertical PPBPS (Repair) Fill System:❑Yes No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area please provide a fill plan) Proposed Design Daily Flow: 480 GPD Proposed LIAR(Initial): .3 Proposed LIAR(Repair): ,25 Design Wastewater Strength:®domestic ❑high strength ❑industrial process Number of bedrooms: 4 Number of Occupants: Other: Pump Required: ®Yes ❑No ❑May be required based upon final location and elevations of facilities Artificial Drainage Required: ❑Yes No If yes,please specify details: Type of Water Supply:RI Private well ❑Public well ❑Municipal Supply ❑Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes® No❑ Drainfield location meets requirements of Rule.1950: Yes® No❑ Permit valid for:®Five years[site plan submitted pursuant to GS 130A-334(13a)] ❑No expiration[plat submitted pursuant to GS 130A-334(7a)] Permit conditions: Licensed Soil Scientist Print Name: Steven R. Cannon non Licensed Soil Scientist Signature: IBC �C�— /r . �Ci �t "`� Date: 3/22/23 The LSS evaluation Is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). 'See attached site sketch* 1 n. Coddle Creek Soil Consulting, LLC 5500 Deer Run Court Davidson, NC 28036 (704)706 4645 March 3,2023 Catawba County Environmental Health Attention: Robbie Phelps 349 North Center Street Newton,North Carolina 28658 Subject: Recommended Wastewater Disposal System Pin#4617033419180 4185 Yellowbell Drive Terrell,North Carolina 28682 Tabitha Mocilan,Owner Enclosed you will find a copy of the wastewater disposal system proposed for Tabitha Mocilan.The property is located at 4185 Yellowbell Drive Terrell,North Carolina 28682 described as being Pin#4617033419180.Attached are sealed soil notes as well as site 1 plans and designs for a on-site wastewater disposal system.This design is submitted under Session Law 2022-11 (S372). Please review the enclosed document presented to you. Please contact me for concerns regarding the wastewater disposal system design. "The LSS/LG eval •do s)a ,: hed to this application is to be used to issue an Improvement Pe• it in •cc,..lance with G.S. 130A-335(a2)and(a3)."fi Own- : abith Mo ' a- L Signat• e: Mr -The LSS evaluation is being submitted pursuant to and meets tell` I. SOu••e, , 130A-335(a2)."fi C ‘,a14NDAt Steve Cannon, LSS $- rt± ,' ,o r , t�a,�f'z1 Signature: G/l r/'� ` �II i. `. • , • S'eN., 1291 Design Specifications for Proposed Wastewater Systems Applicant: Tabitha Mocilan Physical Address: 4185 Babe Drive Terrell,North Carolina 28682 Pin#4617033419180 Acres: .89 Catawba County,North Carolina Source of Water Flow 4 Bedroom House Estimated Daily Flow 480 gallons/day Septic Tank 1000 gallons Source of Water Private Well Wastewater Treatment: Initial Accepted Drainfield Size 400 feet Distribution Gravity Loading Rate .3 g/d/sq.ft. Slope 6 percent Slope Correction 3 inches Trench Bottom Depth 30 inches on upslope Wastewater Treatment System: Repair Vertical PPBPS Pump Tank 1000 gallons Drainfield Size 320 feet Number of Panels 74 Panels Distribution LPP Loading Rate .25 g/d/sq.ft Slope 6 percent Slope Correction 2 inches Trench Bottom Depth 32 inches on upslope 1 Nilrilicalion Lines Elevation and Length I Applicant: Tabitha Mocilan Physical Address: 4185 Yellowbell Drive Terrell, North Carolina 28682 Pin #461703419180 Acres: 1.01 Catawba County, North Carolina Initial Line Flag Color Line Elevation Flagged Length Design Length 1 Blue 3.79' 26' 26' 2 Pink 4.47' 44' 44' 3 Green 5.35' 60' 60' 4 Yellow 6.18' 136' 136' 5 Blue 6.75' I34' 134' "rota'400' Total 400' Repair Line Flag Color Line Elevation Flagged Length Number of Panels 1 Red 3.79' 52' 12 2 Red 3.79' 52' 12 3 Orange 4.70' 53' 12 4 Orange 4.70' 53' 12 5 Pink 5.62' 55' 13 6 Pink 5.62' 55' 13 Total 320' Total 74 2 `tttt i I IINrr� I certify that this map was drawn under my supervision from an actual survey made under my �.``4'�*'' A R%''/,��. thatthe boundaries nrvision lon ot surveyed are indicated as drawn frocorded in DB PG or m info r oration ence nD6 PG urce ) is•2, q..° ESS'o`sti,�� or other reference source that the ratio of precision or positional accuracy it ; t — is 1:10,000+and that this map meets the requirements of The Standards of Practice for Land PRELCUINP1RY Surveying in North Carolina(21 NCAC 56.1600). _ This day of___._ 20 PR��I�IIIINAIY �0L�'ti�•SURD •`�� Professiona Lan Surveyor L- 137 \ ,,//S1r�liiiii1)N,\\\\\\ THIS MAP IS SUBJECT TO ANY EASEMENTS OR RIGHTS-OF-WAY OF RECORD PRIOR TO THE DATE OF ..,A, r. THIS MAP,WHETHER VISIBLE OR NOT. 0, ,N pa`°b')y��� / 'TITLE SEARCH NOT PROVIDED` E m 't 0 p ,: \\Z/\z \ NOTE: `ALL DISTANCES ARE HORIZONTAL FIELD \ MEASUREMENTS UNLESS OTHERWISE NOTED \ I. a<0 L\� PARCEL#4 617-0 4517-�022223'2 9A F S \ t�• �a "). , S3, CHARLES FRANKLIN HOWARD ?8 '2i• ANN R HOWARD \ te' 2 � 04' FDB2329/751 \ e \/ 1 •• \ • ',� t LL ao S • F --- ii \\ �h^ \' '600. . , m 138.26, I m N 671094.25 m» ,I 1 I E 141148.03.36", a' ,p a '3 a I ti '? I"� 1 PARCEL#4617-I N I JOSEPH P JOHt 6316 Il m CORINTHIAS C• 332T�3•, ,ry j �+ DB3720/987 1 I 1 I PARCEL#4617-0340-9923 I I BETTY H JOHNSON 1 I DB2435/497 I / V---=—v� I, DUSTIN J HILL ,certify that this map was drawn under my 1 I 1 supervision from an actual GPS survey made under my supervision and I PARCEL#4617-0451. the following information was used to perform the survey: I (1)Class of Survey: A I i BETTH H BARNETT (2)Positional accuracy: <0.10' ..,./ DB1064/63 (3)Type of GPS field procedure: RTK / (4)Dates of Survey: 17 JANUARY 2023 (5)Datum/Epoch: NAD83(2011) 20'easement per (6)Published/Fixed-control use: NC GNSS RTN DB 929/423 (7)Geoid model: GEOID18 (8)Combined grid factor(s): 0.999856885545 (9)Units: US SURVEY FEET w c m m Q - Q v GO 0 60 120 z w VICINITY MAP(no scale) 11Wi 150 0 O m ells fn �, [ intersection 0 0 aABE oa o Sill MAN 1(u: �1 BRIAN&TABITHA MOCILAN la WATFIt MFTF II RAN It10I11111 WAY :n:N1 (:IA1NIY I(IWNSHIV I1AR F'NF.0 IL1110 0 SEWER MANHf1( k1 AM • • IYIWIN POI F -�V .........OVIRHFAuu N an/F 11NE 1 'IA) I:AIAWIIA IAOUNIAIN CIRI.1.1( 10.IANI1AI4V 202:1 I 10,1,00• • lION I I)11NI1 CROHF N IV OF!:!. I'ARCLla 4 0 1 1 014 1 1110N1 0 IRON SF 1 II MONIIMFNI O WIII LN)H'.I DrrllREF IISAANNF ANAMS4 JIMMY INIMNNARA 13RIII'I'R0 I,INI 111 111 HOOK 1:1,11.11.Y A 82,04YI 1Nnuryrnl MY 01 Al MNI SI(.NA It NU J(16Y —..— —— I'Ii01'[RTY IRA et R111 V 111A 111113 MA"lb men by"'onlinelon I1l.r.I FIN 111111.AN1'SIiRv1YIN(i Inol sunVrvNll lit NEOUI I(Y ANA(''IlMAl DUSTINJ MI 101): 201101 ';1N:VI Y 1'EI1F 011MLl t 11N111-11 212 WnWry NI40n Rn IIRAF IFFI NY MAUISON N C 21025 00641020 OY 0 PAIN)WI M(INIIMFNRII MY'OWN0IS0N h1 I'RIINF WI)2'ACISYi tlI0oltavalmocom GPI Yellowbells 4 • - :' P .00 Ili . %, v Cr �S0p S It o U.) m '410JG • N�°At r O n D I /. 5sow. O • CD ; to. d3/4' „a6• i ea d `14. 1291 d c., N./ C C C If • ; 121, �o . 6� N n (1, 0 CP\ ..1 r-..i. 11 w 7 0 w w Co f q?, tic et + 1 at ao An Aga �,� 7. 4�`' ,AO w �V e0Se, °j 4; eiv ?8. co 0 x (OD O 0 sy' 33 .< N , m A. o • P��Q' 90 fT • Yellowbell Drive 4 Yellowbells , -� ili %1 r----- .13v0 S. O. .." Sc ',' ,.... 1 LT i _Cr = n(� ANDA4j0. o1 � n t 2 ,., _. : k . . `-',' .. I� I /4, 1291 $ $ 0 ■ qc • tibR7H _ .. •j� 4-J V n I•. tx1 \ to <>(, "\,\,'- '\,0,, <, \\ °\ ,, 0 83. G'' -: ' .: : . ' - ' - - < co n ss' • 4,?. C'°�crefe o• + A°O/ p(Wy o i --I Co� .4 w .'U Oe �o� ea, ck o� s '0. ° n7en1 28 • \` p�rc, /V 7 _Co O Co 33. �. co 0 o O, '�� m =0 \4°d�9� D cco a - co • Yellowbell Drive 0 0 * . , Sheet of • , ' . • ' ' ' Oit.j_, ,.19.___ PROPLR IN ID il /. . . son jstI I: I'1 kl.l TION fin ON-SITE W 1S IEW.1 RIR SYS IT:IN1 ./ i Complete all liekk ai lid') • OWNER:— ifriJ.4c._ n A , !CATION DATE ADDRESS: -0 liff; Te...-0‘....e.C,4.ec, DA IF EVALUA FED: .2.--A5723 PROPOSED FACI1.1 FY: g. 4.4A__. P& )1't/SE )ZQ., (..,:: I lily! (.I 9-4.Q): etiiri PROPER!I Sill:.: 1 OCATION OF SITI : VMS— ieifea-'(,z_.4)C-- PROPI;R.I I RI j.:0R1) il): WATER SUPPLY: !1..1‹:r ate „Public Well Spri4 i)ther- EVALl!A FION MI .ITIOD: iacr I3orirq; Pi l Cut I YPI (/I' \V\S I I \\A 1.112: '"<:.:;ace _ Induqrial Process Mixed v • -• r . R Soil MORPHOLO6Y Al, ...an sok Sco I, (.1941) P1 -. .'i Tm, 04,4. I .1940 . •) t/00, / .• 140)* ..A LANDSCAPE HORIZON iii 1. POSITION/ DEPTH ROFILE .1942 i°:iliAllt444'i-, 0 ti SLOPE% ON.) .1941 .1941 SOIL i . it (111 , ,l . ;',41111.1*4; 1'.ASS k, STR1("FERE/ CONsISTENCE/ WrINESSI S . ig, , 4 ' 7 : r LIAR TEXT( RI: %IFNI:11%10(A' (01,01I DE '1'11 .A.\&:33„0. ,, • / L L 0 -3 /( c. t4a5ife. 1/4: se70 \-1)& IIIIE codr 3,. 301. 0...... 5,,i_ ,140 k ge-e • ' • 1 ,, 3b -sD e_... .5 /(-- - 3 G °/c) .e'I._ L,..,5A. 5 104: 5.70 - 2" 414-3 0_ 5 5, P4 -C7a cc) if pc -.? 32--5 - . 3 ! 2 o -igt OZ. IL.Isqz 5, h /t 3 - / e 5 i ie-- 5/0•C 5 4•040 ST) ff f c' . / 3 3 - Co4 • ,..) I . . 2 0' Y k (2 Li)5Qt• 52A 5,0 li .. 4 s-4 •r P3 1-) 3c4--.Co 1 4 C 50- S .,--?4,15 .3 • 0 sri-Pil 011,cRiprInt.4 INI'llAl ',VS 111\4 I iZI:l'Ailt til",.1 1 N1 (>1111R 1 ,1(.1 t)Rti (.1046): . I Sill.CI .%SSIFICA LION (.1945):.:79-5 Available Space r.1945) [A:\I !!!\[1,1) 1;y: 5(.4...4-4.-- S%stem type(,) . / eC47241 V. ?PE' ()rill R(Si No S I.N I -- Site I.!rAR , 3 75'. , • commNNTs, 1,pdatekl Febritar% 21114 , _A • • • • r k , - SOIL/SITE EVALUATION Sheet _of !(.t,tvtnucitnut Shed-Complete all,field in lu/I) PROPERTY II)#: DATE OE EVALUATION: 2 — _ / COI rNTY: . , • • if 4 7A o'oc;Zi - P o SOIL MORPHOLOGY OTHER SOIL r (.1941) PROFILE FA' ' $C/ I .1940 0.34 DA j F LANDSCAPE HORIZ .1942 C' � POSITIONI ON .1941 .1941 SOH. 4 ROFILE SLOPE% I)EPTH S'TRI(:TERE/ CONSISTENCE/ WETNESS/ f't %7� t .' CLASS (IN.) TLX'1'i"RE MINERALOGY COLOR D; .,; ,pi'.+ !.. �.; ., : LIAR G ?'o „ ek_ w551_ 510 :. s .1 s, s ` 6- e S6/L s 121 • S Si° ° .3 w _ Via'" CrqR t/ 4r /° I. IN .25 C0'S �'� ws4/c S4-70 r12 S--3z O.. s S�- s � s sp ' 6.' °/ 32!'-5:` u.)sSA- y'r 4-_, 54, -?5--- ® -itA a cv5�A 5 O /i 5 / i Gr I t , SS/ 5 ( 57° qg v ?�- �f8 e. �.59C 5/4 � f . 05— COMMENTS: Updated February 2014