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Home My WebLink AboutWELL-05-2023-195058.TIF ((; ) catawba county public health November 12th, 2025 Gordon Family Investment Inc. 15720 Brixham Hill Ave Ste 300 Charlotte, NC 28277-4784 Subject: Notice of Intent to REVOKE the Well Permit for 3542 Mt. Pleasant Rd,Sherrills Ford NC 28673; PIN:460701175286. Catawba County Permit WELL-05-2023-195058. Dear Property Owner: The Environmental Health Division of Catawba County Public Health intends to revoke your Well Permit 30 days from the date of this notice. You must apply for a new Well Permit and meet the requirements of the current laws and rules necessary to obtain a new Well 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 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.gov. The petition for a contested case hearing must be filed in accordance with the provision of General Statutes 130A-24 and 150B-23 and all other applicable provisions of Chapter 150B. General Statute 130A-335(g) provides that your hearing will be held in the county where your property is located. 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 November 12th, 2025. 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 General Statute 150E-23 to serve a copy of your petition on the Registered Agent for the Department of Health and Human Services: Julie Cronin, Office of General Counsel, Department of Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001. catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive PO Box 389 Newton NC 28658 828.465.8270 MAKING. LIVING. BETTER. Do not serve the petition on your local health department. Sending a copy of your petition to the local health department will not satisfy the legal requirement in General Statute 150B-23 that you send a copy to the Office of General Counsel, 2001 Mail Service Center, Department of Health and Human Services. Respectfully, //11 Robbie Phelps, REHS Environmental Health Supervisor Catawba County Public Health (: ) catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: 11/12/2025 Owner(s): Gordon Family Investment Inc Mailing Address: 15720 Brixham Hill Ave Ste 300 Charlotte,NC 28277-4784 Property location/site legal description: 3542 Mt. Pleasant,Sherrills Ford NC 28673 PIN: 460701175286 Well Permit: Well-05-2023-195058 Date Issued:05/05/2Q23 1, Albert Gordon ,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 I30A-24 and 150B-23 and all other applicable provisions of Chapter 150B for the above referenced permit(s)in order for the authorized agent/local health department to issue the applicable permit( Well permit)for the site. I understand by completing this form that the permit(s)for a New well (well permit type) 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 Well Permit that the current Well Permit must be revoked. I understand that the local health department's revocation of the Well Permit 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 o take effect. I Signature of Property Owner: i,� i A /�'f2/7 L Date Signed: 11/13/2025 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. r • C .3 `°� ('A'I'AWILA('O1'N EN. .. Public Ito;lth Department Subdivision • � I,nvnunntcnlal Ilcalth Division PINl1 460701175286 l Pt)Boy 389,25 Government Drive,Newton,NC 25(i55 LO'l'H B q, W Site Address: 3542 MT PLEASANT RD, SHERRILLS FORD NC 28673 Name on Permit: 'HELMSMAN HOMES LLC Property Size: Acres 4.46 Directions: Hwy 150 to Mt Pleasant Rd after crossing Lt Mt Rd and Lake Norman, Right into property, Property adjoins Dockside Storage 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 ‘i the property described above. rAs the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service 1411PIR-06-2022-41364, by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) JElectronic Image Transmittal/E-mail (Return receipt required) (..iAs the property owner or authorized representative I have reviewed and understand the specific conditions (lithe permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems (I5A 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: 05/05/2023 Owner/Authorized Representative Signature n..' Date 6-2-23 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (nun)C of person,sending permit) n Signature Date/lime 6/31?3 I Method: Fax J 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 yoaPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService r +atStne f . ,r ( n5 in;)n11 1 ttI) 1� C• CATAWBACOUNTY Casc# WELL-05-2023-195058 Public Health Department Subdivision i Environmental Ilealth Division PIN# 460701175286 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# B w Site Address: 3542 MT PLEASANT RD, SHERRILLS FORD NC 28673 Name on Permit: *HELMSMAN HOMES LLC Property Size: Acres 4.46 Directions: Hwy 150 to Mt Pleasant Rd after crossing Lt Mt Rd and Lake Norman, Right into property, Property adjoins Dockside Storage NEW WELL PERMIT REQUIRED WELL SETBACKS: Septic Systems and Repair Areas for Single Family Dwellings 50 ft. Septic Systems and Repair Areas for Businesses and Multi-Family Residences 100 ft. Underground Storage Tanks 100 ft. Animal Barns 100 ft. Lakes/Ponds 50 ft. Streams/Brooks/Creeks/Rivers 25 ft. Building Foundations 25 ft. All Other Sources of Groundwater Contamination 100 ft. Saprolite Septic Systems and Repair Areas 100 ft. Septic Systems and Repair Areas to Wells with 2 or more connections 100 ft. Wells shall be constructed in accordance with state regulations: Article I5A North Carolina Administrative Code Subchapter 2C The well driller must verify all setbacks before drilling the well.lithe well driller is unable to maintain any of the above setbacks,contact Catawba County Environmental Health at 828-465-8270,before drilling the well. Grouting Depth:20 feet minimum Casing Height: 12 inches minimum above finished grade All newly constructed private drinking water wells arc required to be sampled in accordance with the North Carolina Rules Regarding Private Drinking Water Well Testing(15A NCAC 18A.3800).The fee for this sampling is included in the cost of the well permit.It is the applicant or property owner's responsibility to notify Environmental Health when the well is ready for sampling.Water samples will be drawn from an outside faucet unless otherwise specified.For questions or for more information,please contact Environmental Health. 4:5, , _______ 05/05/2023 Authorized State Agent Permit Issuance Date 5/5/2028 Pennit Expiration Date dai, ,It1 05/082023 13:43 — �P,' -_�c.�I 213PQ ot•-2.2._-_A1364 1 LINE BEARING DISTANCE Am.* Dr-2D23- ►4SDby L1' I N 30°07'41"E 125.01' kk 1, a 2ot3— I"J N 30° 04'04"E 113.99' g N 34°28'38"E 110.27' L4 N 37°06'58"E 141.15' L5, S 47° 12'55"W 92 7 L6 S 73° 31'21"W 162 9' n a \ Si v / J�1� \jS ��0. 1 ) \ F .:.:s.1%\._ ?-.6,7 26.9't -0 1,?. i3 le t 1.7...0 et.. \ e go. 4,4;) or ,j e 'il--**- -- ;*? mkt', \ \ • p / I // ,, -- `, 0 , �� ea �O / / F .y / ��G r / \chi / il►M�apa / �p4j# ��yy�11 / L.:>...- / � b �,'o / / / f �b .fir i7 100 Year Flood Line cb et.,' 0/.4, i 4, to oi 4 i�/ // fin`'S" • £ O cv scale WO' 011 r rya •41 . - 1 1 / -- Field Located 760' 4�c4 q,� Contour n, _ co - .�— _.- _ — 3542 Mt Pleasant Road Septic Site Plan 3.16.23 Catawba County Parcel ID: 460701175286 Base site plan from Jordan Grant and Associates. Proposed septic system and well must be permitted by the CCHD. reC) WPDT Report Area of Interest (AOI) Information Area : 3,134,508.74 ft2 May 5 2023 9:17:36 Eastern Daylight Time \ / !J a / ''( ......_ I ,. • • 2 /• 7\ S� JJ sue° lam\ / 5„-1r,as Y J. f/1 7 / ' .. ±..._________V 1 -\ ir eo;lit . Z— /0' f / I �+t' t ---- -. , /I' \--...„... / / 1:4,514 i /Parcels IPotygonsl-Parcels '-' Projected Route G 03 0.06 0.12 m I 1 1 5 • 1 4 'l Non-System Roads — Other State Agency Route 0 0.06 0.1 9.2 km — Federal Route — Secondary Route Non-System Primary Roads Other System Roads — Interstate Ern Cunnwny Kola CU5bu1Ml.1,1401 cagily.6uae or MAP Gwen• 001 0 CpmSewNAep t*o ooU F.vi, MERE, G.r.m SaraGr h - Ramps,Rest Areas.Non-Mainline — US Route 0ApPrecht‘Ann0 I.:t.EltUAU,USes.EPA MPS Us Cemous S, o USCA SCOOT GtS Unit Bourses Es, Arhus OS USGS 1GA,NASA NC Route 3542 mt pleasant rd All North Carolina Department of Environmental Quality(NCDEQ)GIS data is expressly provided"AS IS"and"WITH ALL FAULTS".The NCDEQ makes no warranty of any kind, express or implied, concerning this information, including but not limited to any warranties of merchantability or witness for any particular purpose.The NCDEQ assumes no responsibility or legal liability concerning the Data's accuracy, reliability,completeness,timeliness,or usefulness.The data is not intended to constitute advice nor is it to be used as a substitute for specific advice from a professional. Users should not act(or refrain from acting)based upon information in the Data without independently verifying the information and obtaining any necessary professional advice. Users are solely responsible for ensuring the accuracy,currency and other qualities of any products derived from or in connection with the NCDEQ's Data.The Data is collected from various sources and may be modified over time without notice to improve spatial andattribute accuracy.The NCDEQ disclaims responsibility for the spatial accuracy and attribution of GIS features and makes no warranty concerning same.