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RBPR-11-2023-46107.TIF
Permit#: 4980 Kiser Island Rd This Section for Local Health Department Use Only Initial submittal received: 11/22/2023 by RP Date Initials G.S. 130A-335(a5)states the following: When an applicant for a Construction Authorization,or an Improvement Permit and Construction Authorization together,submits a Construction Authorization,or an Improvement Permit and Construction Authorization application together,the permit fee charged by the local health department,the common form developed by the Department,and any necessary signed and sealed plans or evaluations conducted by a person licensed pursuant to Chapter 89C of the General Statutes as a licensed engineer or a person certified pursuant to Article 5 of Chapter 90A of the General Statutes as an Authorized On-Site Wastewater Evaluator,the local health department shall,within five business days of receiving the application,conduct a completeness review of the submittal.A determination of completeness means that the Construction Authorization or Improvement Permit and Construction Authorization includes all of the required components.If the local health department I determines that the Construction Authorization or Improvement Permit and Construction Authorization is incomplete,the local health department shall notify the applicant of the components needed to complete the Construction Authorization or improvement Permit and Construction Authorization.The applicant may submit additional information to the local health department to cure the deficiencies in the Construction Authorization or Improvement Permit and Construction Authorization.The local health department shall make a final determination as to whether the Construction Authorization or Improvement Permit and Construction Authorization is complete within five business days after the local health department receives the additional information from the applicant.if the local health department fails to act within any period set out in this subsection,the applicant may treat the failure to act as a determination of completeness.The applicant may apply for the building permit for the project upon the decision of completeness of the Construction Authorization or Improvement Permit and Construction Authorization by the local health department or if the local health department fails to act within five business days.The Authorized On-Site Wastewater Evaluator or licensed engineer submitting the evaluation pursuant to this subsection may request that the local health department revoke or suspend the Construction Authorization or Improvement Permit and Construction Authorization for cause.Upon written request of the Authorized On-Site Wastewater Evaluator or licensed engineer,the local health department shall suspend or revoke the Construction Authorization or Improvement Permit and Construction Authorization pursuant to G.S. 130A-23.The Department shall develop a common form for use as the Construction Authorization. The review for completeness of this Construction Authorization was conducted in accordance with G.S. 130A-335(a5). This Construction Authorization is determined to be: ©Incomplete(If box is checked, information in this section is required.) The following items are missing: Tank size and soil cover. Copies of this were sent to the AOWE/PE and the Applicant on Date State Authorized Agent: 711 Date: 11/30/2023 ❑Complete State Authorized Agent: Date of Issuance: This Construction Authorization is issued pursuant to G.S.130A-335(a2)and(a5)using the signed and sealed plans or evaluations attached here.This Construction Authorization is subject to revocation if the site plan,plat,or the intended use changes. The Construction Authorization shall not be affected by a change in ownership of the site. This Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. 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 plans,evaluations,preconstruction conference findings,submittals,or actions from a person licensed pursuant to Chapter 89C of the General Statutes as a licensed engineer or a person certified pursuant to Article 5 of Chapter 90A of the General Statutes as an Authorized On-Site Wastewater Evaluator in GS 130A-335(a2),(a5),and(a7).The Department,the Department's authorized agents,and the local health departments shall be responsible and bear liability for their actions and evaluations and other obligations under State law or rule,including the issuance of the operations permit pursuant to GS 130A-337. Construction Authorization Expiration Date: *See attached site sketch* G.S. 130A-335(a2)Common Form 5 V.2023.07