HomeMy WebLinkAboutBNB201900013 Approval - Agencies 2019-07-24aetsctn Hewn
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1138 Rose Hill Dnve. PO Boa 75•11,
Cnarlonesville, Virginia 22906
THOMAS JEFFERSON HEALTH DISTRICT
TRANSIENT LODGING REVIEW
Operating Name of Business: 0�4-m(N `i -o L ' ' 1- .r"2 i1A
Facility Address: 5 7- l). c. R431-qV-1-KC'
Tax Map Number: 7M 014 oo-gn6r� dlitit olSao-oo-olo:o
Subdivision: —Y Section: _ Lot: _
owner/Agent: VAN C
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Home Phone:
Address: `� 29 S i `'n"'"
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Cell Phone:
Email: ra
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Will food be prepared for guests? �j o
Total Number Bedrooms:
Owner -occupied: I 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? W J
If so, please specify:
^ -- C Date: Prk cV z:319
Signature (owner or agent) `�J^" —
Health Department Use
VDH PERMITTING REQUIRED: _ B&B Permit _ Hotel Permit X None Required
SEWAGE DISPOSAL SYSTEM:
X ADEQUATE
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: Septic systems and water source approved for B&B use, total of
5 bedrooms- 2 bedrooms in main house, 3 bedrooms in cottage.
Health Department dKoal
July 24, 2019
Date