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Home My WebLink AboutAUTH-04-2023-193784.TIF * '-.0 . +AMAW ♦ - "' .Me ' 'IMP _ W"M�7� }£r. • c MNR".!"'q •www' '114'eq _.,R.rww.,/M-.< +AN"rt"M'Mp!"R ni ,.4,.:"n l4i ..,., .zr.{n+a�" +'�b'q '" .vfM+i`i,MP!'YA �M .,y�..,.M.:q N++y M'!t"�r^}'�� , A '6{d'�N6�1"._ a ww'*.9'"�' .m."",•* w.,,.µy.r,...+..+^•r<*"•^A .,u.PlPytr`` ,R ,...p�. ..M.s z-^ ^M..t--,r+r'. w„"'. .+.."w' • A fib.. s , � catawba county =. -= -'tom public }lt'illll F'.,.'..^ ‘1)L11IN'1'AI2Y RELINQUISHMENT OF ADt<71VIh t IZA'I'I�'h: AI'I'h.;�l. ItI(,11 I ti "'"•..•�- - Dine prcp.tr.d: 1 U'1 t{'20 i (twnCitsl: I kit ton Booker . \laihng,Addrrs. 2:0 l'alttnuc lice 11 a) ,r f`n ,'hitl:rlc Vl C w Propery location site legal dcs:ia,'ion: Stitih It',t; Leg Rd,Sherrill',Fend Nt. 21673 " t FIN: le I 002 t, I MPM venom Permit(IP) 1MPV-O4-2023-193780 .--Uitte Is:...•.d 4ztl'2.Q2?.-_..._.. r . Authorization to Construct(AC) AUl'11-04-2023 143784 Date i .,ucd i 't7;2023..._-. v>. "'°`' `, ..4. .,,. _.` I, ft-CL'I'_'I) ., (►1,il"�,�a);)J Y4untarily relinquish my rights to pursue a formal appeal through the\orth =_ (print full name) ;,:..,—.-• " Carolina Office of Administrative Hearings pursuant to NC General Statute 130A-24 and 150B-23 and all other applicable ~� „" provisions of Chapter 150E for the above referenced permits)(which includes the IPs and ACs)in order for the authorized 571- - agent/local health department to issue the applicable permit(new IP and/or AC)for the site. I understand b) completing this form that the pennit(s)for a =arse M.. ,1620 —_(System description) K will be revoked immediately by the authorized agent/local health department. I understand that the local health department's revocation of a permit can he 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 11'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 deci ion, I understand that by signing this form and relinquishing my right to .be." i appeal the permit revocation at the Office of Administrative I iearings that the local health department's permit revocation will become effective immediately. 1 understated and agree that the revocation of a permit that takes effect immediately is in my best interest. I ., understand that by signing this forin that I agree that I do not want to appeal the permit revocation. .,; I understand that I am not required to re 'i wish my appeal rights but that this is an option available to me so I do not have to wait 30 "I days for the revocation of the permit t t .c effect. Signature of Property Ow 7 � /Y)u' (., � �1�1t+G2' Date Si�tned;_______ .- L,C'�l.,L'('r /(� 2 ',''.5 • t4CD1114S/DPH/ENS/OSWP hcvixd play 2015 ? `- catawbacountync.gov Environmental Health (OtOw$9 County Governinrli (t:riter 25 Government Drive i'0 Boa 3$9 ( Newlcn NC ?$b58 828 455 8270 �= AAAVING 111/111t^ DETTED �. •1" raa4 At'ls.44.er.. ".sY .- . --- .,-- -tx :ar......ww ,. ".." .Ww �re»w+ ,...."" `r - mo,,;..:,a4w,.FK.uw�� a.w..kdnx"•.^'"'"-- •..... ,. ... catawba county public health October 18th, 2023 Hettion Booker 226 Palmetto Tree Way Knightdale, NC 27545 Subject: Notice of Intent to REVOKE the Improvement Permit and Authorization to Construct for 8666 Dog Leg Rd, Sherrills Ford NC 28673; PIN 461902652526 Catawba County Permits IMPV-04-2023-193780 and AUTH-04-2023-193784 Dear Hettion: 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 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 Catowbo 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 10/18/2023. 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, eL)/7, Robbie Phelps, REHS Environmental Health Supervisor Catawba County Public Health (e:4 ) catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 10/18/2023 Owner(s): Hettion Booker Mailing Address: 226 Palmetto Tree Way Knightdale NC 27545 Property location/site legal description: 8666 Dog Leg Rd, Sherrills Ford NC 28673 PIN: 461902652562 Improvement Permit(IP) IMPV-04-2023-193780 Date Issued:4/17/2023 Authorization to Construct(AC) AUTH-04-2023-193784 Date Issued: 12/17/2023 I, ,voluntarily 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 150B-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 1IIE-50%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 1 do not have to wait 30 days for the revocation of the permit to take effect. Signature of Property Owner: Date Signed:_ NCDHHS/DPH/EHS/OSWP Revised May 2015 catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. 4.4`t (Am cot IN II. Cute fit 41 a Public Itealth Department Subdivision SHERWOOD SHORES �� . _ }s Environmental Ilealth Di. swn I'INU 461902652582 +\/f Pt)liuA 389,25 Gusemment Drnc Noaton,NC 28658 I t)lU 15 tilt Sits Address: 8666 DOG LEG RD, SHERRILLS FORD NC 28873 Name on Pon* HETTION BOOKER Property Size: Acres 0.47 Directions: NC16, Left onto Balls Creek Rd,right W Bandys Cross Rd, Left Buffalo Shoals Rd, Right E Bandys, Right Sherrills Ford Rd, Left Mollys Backbone, Right Azalea,Left Dog Leg Rd, Property on Left Owner/Authorized Representative Acknowledgement of Permit Receipt lali[ 1tfA I certiti that I am the owner or authorized agent(owner's uuthoriiation required)representing the owner of the property described atxn e. 0,A As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service RBPR-01-2023-43175,by the following method(s): • __ Received in Person } Facsimile Transmittal(Return form with signature required) I Electronic Image Transmittal!E-mail (Return receipt required) As the property owner or authorized representative I have reviewed and understand the specific conditions )C— 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(15A 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:04/17/2023 /r Owner Authorized Representative Signature(\ 1 'Y� ILL/2.). Date- 4"',21 0 " Q Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by hrunre of'person ( l sending permit) Signature €.. Date/Time 1 I II i 1` 3 i j Method: Fax 4 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 yorPlease ttake a few momentts tto complette our custtomer service survey att , http://www.surveymonkey.com/s/EHCusttomerService 1-) ,S. 1.(1.1 t )306hhtrltt':i, cO" a:;,, ,, II I a 2u?1 15.11 p,a CATAWBA COUNTYCase# nU l'H 0 3 2023 193781 (II l '� Public Health Department Subdivision SHERWOOD SHORES � Environmental Health Division PINPIN/1461902652562 'L PO Box 389.25 Government Drive.Newton.NC 28658 LOT# 15 84 � Site Address: 8666 DOG LEG RD, SHERRILLS FORD NC 28673 Name on Permit: HETTION BOOKER Property Size: Acres 0.47 Directions: NC16, Left onto Balls Creek Rd, right W Bandys Cross Rd, Left Buffalo Shoals Rd, Right E Bandys, Right Sherrills Ford Rd, Left Mollys Backbone, Right Azalea, Left Dog Leg Rd, Property on Left Authorization to Construct Permit Permit Category: New Septic Wastewater Flow: 240 g.p.d. Type of Facility: Primary Residence-New House Basement? No Basement Plumbing? No Bedrooms: 2 Water Supply: Private Well Maximum Occupants: 4 Soil LTAR: 0.275 g.p.d.1ft2 WASTEWATER SYSTEM REQUIREMENTS Proposed Wastewater System: 50%REDUCTION HORIZONTAL System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM 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: 465 sq ft Total Trench Length: 155 ft Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 20 in Minimum Soil Cover: 6 in Minimum Trench Separation: 8 ft on center Number of Drain Lines: 4 Trench Width: 3 ft Distribution: Serial Pre Treatment: NONE Additional Specifications: *Place a temporary protective fence up and around the septic drainfield area before beginning the construction of the house. 'During the construction of the house: Do NOT allow vehicular traffic on the drainfield area; Do NOT allow the unloading and storage of building materials on the drainfild area; Do NOT place excavated dirt on the drainfield area; and Do NOT remove any soil from the drainfield area. *If the flags marking the drainlines are removed they must be restaked by the surveyor before the septic installation can begin. *Use drop boxes to obtain serial distribution. 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? Not Required Soil LTAR: g.p.d./ft2 Proposed System: System Classification: rhl awil t4'11t 2o23 15-41 44'i`• CATAWBA COUNTY Case AUTH-04-2023-193784 fi ,� Public Health Department Subdivision SHERWOOD SHORES lip"it '3 Environmental Health Division PIN# 461902652562 • PO Box 389.25 Government Drive.Newton,NC 28658 LOT# 15 1.42 Site Address: 8666 DOG LEG RD, SHERRILLS FORD NC 28673 Name on Permit: HETTION BOOKER Property Size: Acres 0.47 Directions: NC16, Left onto Balls Creek Rd, right W Bandys Cross Rd, Left Buffalo Shoals Rd, Right E Bandys, Right Sherrills Ford Rd, Left Mollys Backbone. Right Azalea, Left Dog Leg Rd, Property on Left The issuance ofthis 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 o++nership of the property. This permit was issued in compliance with the provisions of the North Carolina'Lots 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 ../- fla, ,,„ 04/17/2023 Authorized State Agent Permit Issuance Date 4/17/2028 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpennit 04/18/2023 15:41 ��, L r'7 I cr) W ,t, I /'il 'r'- 0 -2ozs— Icl3?go W U !lt037 °- S 00'12'29"E 99.90' CV CD 1— CD!'NI \',, --1 d- o . ,z fI � 1 I .-..- _ '` `l I o Imo\ �\. \. I 3 .11 b I I I •..s,CO I • \ '''' ).‘",,,‘,\sa,,, \ . . 1* 1.1: itg (.,,, i ,� ,0 py ,,,,,,,,,,,,t, 94. \ ; IO- ti� ' I I T&J Blocks per line L , nG ' I 30 —7 —`y,`� I 45.=10 I Y9' 45.=10 I l 2.6 1 i'•1 Total:155'=35 blocks total 1 ~ IJ fr Q 'f0 ^ C. a m . 9 2' 'N.` . 1 N 05'42'3a'�W 9 W \ Q Q, � R O b z DOGLEG RD zro z 601 PUBLIC R\ Robert Phelps From: Brad Johnson <brad@tjpanel.com> Sent: Wednesday, April 19, 2023 9:56 AM To: Robert Phelps Subject: Re: Serial distribution As we spoke about on the phone yesterday, this dropbox design seems to be the best design for this lot. Thank you for emailing us on this and as always please feel free to reach out. Thanks for all you do, Brad Johnson T&J Panel Inc. On Apr 17, 2023, at 2:45 PM, Robert Phelps<RPhelps@catawbacountync.gov>wrote: Brad, Are you ok with drop box serial distribution for this design?The space is very limited. Thank you, Robbie Phelps, REHS Environmental Health Supervisor, OSWP Division 25 Government Drive, Newton, NC 28658 (828)320-3077 cell https://www.catawbacountync.gov/county-services/envi ronmenta I-health/ <image001.jpg> Confidentiality Statement:The information contained in electronic transmissions is confidential and may be subject to protection under the law,including the Health Insurance Portability and Accountability Act(HIPAA).An electronic transmission is intended for the sole use of the individual or entity to whom it is addressed.If you are not the intended recipient,you are hereby notified that any use,distribution or copying of the message is strictly prohibited.If you received a message in error,please contact the sender immediately by replying to the e-mail and delete the material from any computer. <8666 Dog I,eg site plan.pdf`