HomeMy WebLinkAboutSDP201800046 Approval - Agencies Minor Amendment 2019-02-13RGINIA
VXDHOFIHEALTH NT
Protecting You and Your Environment
Page 1 of
Albemarle County Health Department
1138 Rose Hill Drive
Charlottesville, VA 22903
(434) 972-6219 Voice
(434) 9724310 Fees
OSE Construction Permit
Well and Sewage Contractors: Please notify Health Department and OSE or PE 48 hours prior to
installation to arrange for inspection
November 13, 2018
County of Albemarle �,���
Dept of Facilities and Environmental Services 4JI(if�"J�d1LSU
401 McIntire Road Room 420 WI( I(I7e"�l dl LSU
Charlottesville, VA 22902
RE: Tax Map: 55-28 (Albemarle County)
HDID: 101-18-0492 Reserve: 100% reserve area provided
System Capacity: Non -Residential, 140 gallons per day
System Description: Conditional Permit limiting the daily water usage to 140 gallons
Dear County of Albemarle Dept of Facilities and Environmental Services :
This letter and the attached drawings, specifications, and calculations (0 pages) dated October
13, 2018, constitute your permit to install a sewage disposal system and on the property referenced
above. Your application for a permit was submitted pursuant to §32.1-163.5 of the Code of Virginia,
which requires the Health Department to accept private soil evaluations and designs from an Onsite Soil
Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential
development. VDH is not required to perform a field check to verify the private evaluations of OSEs or
PEs and such a field check may not have been conducted for the issuance of this permit.
The soil absorption area ("site"), sewage system design, were certified by Stephen P. Gooch,
Private OSE as substantially complying with the Board of Health's regulations (and local ordinances if
the locality has authorized the local health department to accept private evaluations for compliance with
local ordinances). This permit is issued in reliance upon that cenification. VDH hereby recognizes that
the soil and site conditions acknowledged by this permit are suitable for the installation of an onsite
sewage system. The attached plat shows the approved area for the sewage disposal system; there are
additional records on file with the Albemarle County Health Department pertaining to this permit,
including the Site and Soil Evaluation Report. This construction permit is null and void if any substantial
physical change in the soil or site conditions occurs where a sewage disposal system is to be located.
If modifications or revisions are necessary between now and when you construct your dwelling,
please contact the OSE/PE who performed the evaluation and design on which this pernit is based.
Should revisions be necessary during construction, your contractor should consult with the OSE/PE that
submitted the site evaluation or site evaluation and design. The OSE/PE is authorized to make minor
adjustments in the location or design of the system at the time of construction provided adequate
documentation is provided to the Albemarle County Health Department.
The OSE/PE that submitted the certified design for this permit is required to conduct a final
inspection of this sewage system when it is installed and to submit an inspection report and completion
statement. As the owner, you are responsible for giving reasonable notice to the OSE/PE of the need for a
final inspection. If the designer is unable to perform the required inspection, you may provide an
inspection report and
Tax Map/GPM: 55-28 `"� Page 2 of 3
HDID:101-18-0492
completion statement executed by another OSE/PE. The Albemarle County Health Department is not
required to inspect the installation but may perform an inspection at its sole discretion. No part of this
installation shall be covered until it has been inspected by the OSE /PE as noted herein. The sewage
system may not be placed into operation until you have obtained an Operation Permit from the Albemarle
County Health Department.
This Construction Permit is null and void if conditions are changed from those shown on your
application or if conditions are changed from those shown on the Site and Soil Evaluation Report and the
attached construction drawings, specifications, and calculations. VDH may revoke or modify any permit
if, at a later date, it finds that the site and soil conditions and/or design do not substantially comply with
the Sewage Handling and Disposal Regulations, 12 VAC 5-610-20 et seq., or if the system would
threaten public health or the environment.
This permit approval has been issued in accordance with applicable regulations based on the
information and materials provided at the time of application. There may be other local, state, or federal
laws or regulations that apply to the proposed construction of this onsite sewage system. The owner is
responsible at all times for complying with all applicable local, state, and federal laws and regulations.
This construction permit is transferrable until expired or deemed null and void. A permit transfer form
may be found on the VDH website at
hgp://www.vdh.virginia.gov/environmental-health/jzmR-201 5 -01 -forms/ .
If you have any questions, please contact me.
This permit expires: .
Sincerely,
Jos Kirtley
Environmental Health Technical Specialist
AlXm4 Coun Health Department
Cartlynn D e
Environme tal Health Specialist
Albemarle County Health Department
Cc: Gooch, Stephen P. Private OSE
Tax Map/GPIN #: 55-28
HDID#: 101-18-0492
�--J Page 3 of 3
WHAT YOU WILL NEED TO GET YOUR
SEPTIC SYSTEM OPERATION PERMIT
• Your system must have a satisfactory inspection at the time of installation. This will be done by either a
representative of the local Health Department, a private OSE, or a PE, depending on the designer of your
permitted system. If your system is designed/inspected by an OSE or PE, they must submit a copy of the
inspection results, complete with an as -built diagram, to the Health Department.
• Please ensure that your contractor turns in a Completion Statement to the local Health Department after
installation.
• If you have a conditional permit then you must sign, have notarized, and record the permit in your
locality's land records. Please bring proof of this recordation to the Health Department.
Allow 5 business days after the last piece of documentation is received for the Operation Permit to be
issued. To avoid delays,•clearly label each piece of documentation with the property Tax Map/GPIN
number and HDID number shown above and on your construction permit. Please note that due to the
individual circumstances of your permit there may be additional required items not covered by this
checklist.
If you have any questions about any of the items on this list, please do not hesitate to contact the
Albemarle County Health Department at (434) 972-6219.