HomeMy WebLinkAboutIMPV-04-2023-193682.TIF catawba county
public health
July 20, 2023
Elliot Rothman
3717 Caribou Dr
Sherrills Ford, NC 28673
Subject: Notice of Intent to REVOKE the Improvement Permit for a 2 Bedroom House;
3717 Caribou Dr, Sherrills Ford, PIN 368702959342; Catawba County Permit
IMP V-04-2023-193682.
Dear Mr. Rothman:
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, which you have already done, for a new Improvement
(IP)and Authorization to Construct(AC) and meet the requirements of the current laws and rules
necessary to obtain a new IP/AC permit.
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 150B-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
Cctowbo 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 20,2023. 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 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,
Steven Price, REHS
Environmental Health Specialist, OSWP Division
Catawba County Public Health
Owe r tMtw-w•2023-t936 2
CATAw NA COI to ri' Sut'd,vt coon HtGI4*J ND GLEN
,�j^�,A� pot+lk l lcalth Ik1wtrnc u PINY 388702959342
/
1914 ! � IEnvaxxtmrntal 1icalth bivixtun 1.()10 29.30
/ PU 13ox 389.23 Government iNtvc,Newton..NC' 211r+Ss
Site Addrosa: 3717 CARIBOU OR, SHERRILLS FORD NC 28873
Name on Permit: ELLIOT ROTHMAN
Property Sire: Acres 1 5
p4k Mt Beulah Rd, right Lineberger Rd, right Caribou Dr on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
y.47.
' I certiti that I am the oxxner or authorised agent (on+ner's authoriiatiun required)representing,the twiner of
the property described above.
As the property owner or authorized representative, I have received the above referenced
` perrnit(s)as requested in the application for service EHPR-12-2022-42954. by the following methodts):
Received in Person
_ Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
s 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 (l5A NCAC I8A .1900),
and/or Well Construction Standards (ISA 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: 04/14/2023 ti /i/ )
i
Owvier:Authorized Representative Signature ' 'e't.." \,__..
Date 6- ZuL-5
Documentation of t'ermit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted b\ (n n i (J/prrAtm .velrtlilts'pt'rmil)
z Si 3
Signature - -- Date'Time. ?1
Method: Fax I Email US Mail Other
Owaer's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yoPPlease ttake a few momentts tto complette our custtomer service survey at
http://www.surveymonkey.com/s/EHCusttomerService
— ^. A . 1 /' r A
1
a{rire CATAWBA COUNTY Case# IMPV-04-2023-193682
.t- Public Health Department Subdivision HIGHLAND GLEN
s Environmental Health DivisionPIN# 368702959342
ii,,77 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 29-30
Site Address: 3717 CARIBOU DR, SHERRILLS FORD NC 28673
Name on Permit: ELLIOT ROTHMAN
Property Size: Acres 1.5
Directions: Mt Beulah Rd, right Lineberger Rd, right Caribou Dr 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 d
9•P
Type of Facility: Accessory Dwelling
Basement? No Basement Plumbing? No Bedrooms: 2
Water Supply: Private Well Maximum Occupants: 4
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 25% REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions: *Do not cut,drive,fill,or grade over septic or repair areas.
'This is an improvement permit only and is not intended for septic installation purposes.
*System will be expanded from existing 3Br to 5 Br system (adding 2Br accessory structure).
*A variance approval for the shared well to maintain less than a 100'setback to existing and
proposed new septic system and repair was approved by John Brooks on 3/20/2023.
'Maximum feasible distance over 50'to well shall be maintained for new septic system and
any future repair system.
ehpcnnn 04/26/2023 12:12
•
CATAWBA COUNTY Case IMPV-04-2023-I93682
Public Health Department Subdivision HIGHLAND GLEN
AimEnvironmental health Division PIN# 368702959342
PO Box 389,25 Government Drive,Newton.NC 2865R LOT# 29-30
tit ,r
Site Address: 3717 CARIBOU DR, SHERRILLS FORD NC 28673
Name on Permit: ELLIOT ROTHMAN
Property Size: Acres 1 5
Directions: Mt Beulah Rd, right Lineberger Rd, right Caribou Dr on right
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 aooroved,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
affected by a change in ownership of the property. This permit was issued in compliance with the provisions ot'the North Carolina lairs and
Rides for Sewage Treatment and Disposal Systems' I I5A NCAC I 8A.19001. Neither Catawba County nor the Environmental Health
Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of lime.
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.
,
04/14/2023
Authorized State Agent Permit Issuance Date
4/14/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpenuit 04/27/2023 16:20
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This map/report product was prepared from the Catawba nrtttyy,�NC(3eosparial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and 1abtft infonnalion contained op 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,diacein,and steal not be held Kahle for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may
arise from this nmpIreport product or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
04/14/2023
DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet I of____1
DIVISION OF PUBLIC HEALTH,ENVIROAZEN'TAL HEALTH SECTION TY ID#:
ON-SITE WATER PROTECTION BRANCH 1 'Z gyy . r. �OUNTY:_Catawba
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all Hilda in full)
. OWNER C)to i• k k _ APPLICATION DATE
f•';i DRESS: DATE EVALUATED: Z/zt/Z3
-.A,. •' 'POSED FACILITY: 4.10, 26,, PROPOSED DESIGN FLOW(.1949): • 21ped PROPERTY SIZE:
')•`;a • ATION OF SITE: J71/ {' -.4o.. )� 6+gerr PROPERTY RECORDED:
,..AT fit SUPPLY: ❑Private 0 Public Olkell ❑Spring 0 Other lag
• a ATION METHOD: ❑.,,Huger Boring Wit it El Cut TYPE OF WASTEWATER CI Sewage ❑Industrial Process CI Mixed
aer • ' • r
,A . SOIL MORPHOLOGY OTHER
' 1 (.1941) PROFILE FACTORS
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LANDritArE HORIZON
•, Qv , DEPTH .1942 PROFILE
`s -4 A i (IF•) .1941 .1941 SOIL .1943 .1956 .1944 CLASS
..: ; 4' STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR .H LT
''' hr 5- ` '. TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ `
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Available Space(.1p45) ES e SITE CLASSIFICATION(.1948): A
ti. Type(s) \ 2 4 ��L� (� EVALUATED BY:
OTHER(S)PRESENT:
SiteLTAR `--- D_Z?S.- 0, 2
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, -.q COMMENTS:
dated February 2014
Catawba County Environmental Health ,if is-
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Parcel: 368702959342, 3715 CARIBOU DR 1 in=50ft
SHERRILLS FORD, 28673
This mapheport product was prepared from the Catawba yy.�NC Geospatlal information Services. Catawba County has made substantial efforts
to anewe the accuracy of location and labeling information uxitained on this map or data on this report Catawba County promotes and recommends
the independent verification of any data oontahwd on this map/report product by the user.The County of Catawba,its employees.agents,and
arisee personnel,
disclaim,and shall not be held liable for any and aldamages,loss or habifty,whether direct,indirect or consequential which arises or may
rnapk eport product or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
04/14/2023
''sac STAif c;
.d ,�o''., ROY COOPER • Governor
-i, li., NC DEPARTMENT OF
W t HEALTH AND KODY H. KINSLEY• Secretary
HUMAN SERVICES HELEN WOLSTENHOLME • Interim Deputy Secretary for Health
•.k ",o'_ MARK T. BENTON •Assistant Secretary for Public Health
Division of Public Health
Onsite Water Protection Branch
March 20, 2023
Megan Black and Elliot Rothman
627 S Mulberry St
Statesville, NC 28673
Re: Approval No. JMB2949
Private Well Located Less Than 100' to a Septic System [Rule 15A NCAC 2C
.0107(a)(2(C)]
Property location:
3717 Caribou Dr
Sherrills Ford, NC 28673
Dear Ms. Black and Mr. Rothman:
On March 17, 2023, the On-site Water Protection Branch received your request for a
variance from the Well Construction standards, Title 15A North Carolina Administrative
Code Subchapter 2C .0100. The request for a variance concerns a water supply well on
the referenced property currently serving one well. Another home is proposed to connect
to the well.
Specifically, the variance request grants you permission to use an existing water supply
well at a distance closer than the one-hundred-foot setback to a septic system. Achieving
the one-hundred setback would be difficult given the challenges of the property.
Based upon information provided by the Catawba County Health Department, and the
property owner, it is my finding that based upon current conditions as the site exist
today (as well as the current proposal for use of the structure) you meet the conditions
necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and (2).
On that basis and if the following conditions are met, the requested variance is
approved:
NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH
LOCATION:5605 Six Forks Road,Raleigh, NC 27609
MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642
www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
1) The well/wellhead shall meet all current 2C. 0100 standards, including but not limited
to being properly grouted, terminated at least 12" above land surface, properly
sealed, having a thread-less sample tap etc.
2) The well shall be sampled for the same parameters as required for newly constructed
well. If samples indicate contaminants, further repairs/treatment may be required.
3) No potential sources of groundwater contamination shall be stored near the well-head.
The granting of this variance is for the well location only. It in no way relieves the owner
or agent from other requirements of the North Carolina Well Construction Standards
including, but not limited to the requirements in 15A NCAC 2C .0113(b)to repair or to
abandon any well which acts as a source or channel for the migration of contamination.
This approval does not imply sufficient water quality. Further, the approval does not
relieve your responsibility to comply with any other applicable Federal, State, or local
laws or regulations.
If you have any questions regarding this variance, please contact me at (828) 713-3335.
Sincerely,
John M. Brooks R,E.1-1.S, MS
2