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Home My WebLink AboutIMPV-08-2023-203537.TIF catawba county public health September 19,2024 Kolby Smith 128 Brookhollow Dr Mount Holly, NC 28609 Subject: Notice of Intent to REVOKE the Improvement Permit for 3125 Winfield Dr, Maiden NC 28650; PIN:367803229032. Catawba County Permit IMPV-08-2023-203537. Dear Mr.Smith: The Environmental Health Division of Catawba County Public Health intends to revoke your Improvement Permit 30 days from the date of this notice. You must apply for a new Improvement Permit(shich you have already done) and meet the requirements of the current laws and rules necessary to obtain a new Improvement 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- 24and 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 September 19, 2024. 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 I PO Box 389 I Newton NC 28658 1828.465.8270 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, .2)111 , pi,L, Steven Price, REHS Environmental Health Specialist Catawba County Public Health Pr 1‘111A Njer catawba county public health VOLUNTARY RELINQUISHMENT OF ADMINISTRATIVE APPEAL RIGHTS Date prepared: September 19,2024 Owner(s): Kolby Smith Mailing Address: 128 Brookhollow Dr Mount Holly,NC 28609 Property location/site legal description: 3125 Winfield Dr PIN: 367803229032 Improvement Permit(IP) IMPV-08-2023-203537 Date Issued: 08/28/2023 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 in order for the authorized agent/local health department to issue the applicable permit(new IP)for the site. I understand by completing this form that the permit for a IIb 25%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 that the current IP must be revoked. I understand that the local health department's revocation of an IP 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: 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. I., , t. , tc so.do�Y CATAWBA CODA"t•Y �� Public Hralth Ueparlmctit Case u' 1MPV-08=2023.203537 3�� )S 6nvirenmenln[HcalikDivisron SulxJivision 0 sox 389,•25 Government.Drivc,.Nowton'.NC 286SB.. t'1Ap 367803229032 �f: fr w 1.011:1 Site Address: :3125 W1NFIELD DR. MAIDEN:.NC 28650 Name on Permit IZOLBY SMITH Property Size: Acres 12.41 Directions: S NC 16 Hwy.on left past Buffalo Shoals Rd Owner/Authorized Representative Acknowledgement of Permit Receipt a. rtily that I am.the owner 6r authorized agent(owner's authOri-/ tion.required)representing.theowner•of the properly described above: • K.�� As the propertyOwner or authorized representative, I have received the.above referenced pennit(s)as requested in the application for service EHPR-06-2023-44653,by the following.method(s): Received in Person _ Facsimile Transmittal(Return.form with signature required) Electronic Image Transmittal/E-mail (Return.receipt.required) 04 i� s the property•owner or authorized representative.I have reviewed and understand the specific conditions of th permit issued, and furfher:understand that all applicable regulatory requirements specified under the• North Carolina Laws and Rules for-Sewage Treatment and Disposal Systems(15A NCAC 1.8A.1900), and/or We1l Construction Standards(15A NCAC 2C.0to0.), shall apply•to the issuance of this permit and the construction of the wastewater system and/or water supply well permitted. ..Permit Issue Date:08/28/2023 Owner/Authorized Representative Signature__. G_k��1__S _ ___,...9.m.xxl,'. • kA,�,t+ �-_. Date _p Documentation of Permit(?)Transmittal (permit transmitted by electronic or other means) Permit transmitted by __ _. Mame ofperspn sending permit) Signature Date/Time / 11/23 - Method: Fax J Email US Mail Other Ownerls request to.send by the above indicated method of transmittal in lieu of signature 'We wantttto hear from yo&Please ttake a few momentts.tto complette our custtomer service survey aft http://www.surveymonkey.con/s/EHCusttomerServtce 4171 bi . 1. 5NvAlognw... e i'i°"'mt 0812912023 10:53