HomeMy WebLinkAboutBNB201900001 Approval - Agencies 2019-02-08 (2)ayor�tot�g
THOMAS JEFFERSON HEALTH DISTRICT
�al�iyruni�► 1138 Robe Hill Drive. PO Box 7546 TRANSIENT LODGING REVIEW
CharMu syllte, Virginia 2=6
Operating Name of Business: AA A 131V3
Facility Address: Z 0 s! 13 ✓ck Movini w Ab Vivia it/
Tax Map Number: U 2 900 - 00 - 00 •- o Y o A 0
Subdivision: Section: Lot:
Owner/Agent: 4D uyA" * � 7� ller ama wb HomePhone: 4101 3 5-13 9WE%
Address: SOS/ St/ot 14"V IKIN A , Cell Phone: 6 u 7 S-12—L37 7
oWi ✓A 22 4 y Email: e �• it �isro�+ci / �+a / Co n
Will food be prepared for guests? AfO
Total Number Bedrooms: Owner -occupied: Guest: /
Water Source (check appropriate): Public Water System Private Well >/
Other (please specify):
Sewage Disposal (check appropriate): Public Sewer Private Septic ✓
Will the proposed lodging involve any new construction? /l0
If so, please specify:
Signature (owner or agent) SjWa-jj404Wj Date: -2
Health Deaartment Use
VDH PERMITTING REQUIRED: _ B&B Permit
SEWAGE DISPOSAL SYSTEM:
X ADEQUATE
Hotel Permit X None Required
A review of our records and/or assessment by a licensed professional, and all other
information available, has indicated that the existing sewage disposal system (SDS)
and reserve area (where indicated) appears to have been designed with adequate
capacity for the proposed use. This does not imply that the existing SDS will
continue to function properly for any minimum period. A site visit and inspection
may not have been performed.
• Note: For optimum preventative care, septic tanks should be pumped out by a licensed
sewage hauler every 3 to 5 years.
INADEQUATE
A review of our records and/or assessment by a licensed professional, and all other
information available, has Indicated that the existing sewage disposal system is not
adequate for the proposed use.
WATER SOURCE: X Approved Not Approved
• B&B (w/ food service) & Hotel: coliform bacteria & nitrate testing required
initially, then annually thereafter, prior to permit renewal.
• Transient lodging w/o food service: coliform bacteria & nitrate testing
recommended initially, then annually thereafter.
COMMENTS:
Health Department Chficial
1 /29/19
uate