HomeMy WebLinkAboutSDP202000065 Court Record of Approval - Agencies Health Department Approval 2020-10-05VIRGINIA LAND RECORD COVER SHEET
FORM A - COVER SHEET CONTENT
Instrument Date: 12/1112018
Instrument Type: OTHER
Number of Parcels: 1 Number of Pages:
[ J City X County
ALBEMARLE
TAX EXEMPT? VIRGINIA/FEDERAL LAW
[ ] Grantor:
[ ] Grantee:
Consideration: $0.00
Existing Debt: $0.00
Actual Value/Assumed: $0.00
PRIOR INSTRUMENT UNDER § 58.1-803(D):
Original Principal: $0.00
Fair Market Value Increase: $0.00
2
Original Book Number: Original Page Number:
Prior Recording At: [ ] City [ ] County
(Area Above Reserved For Deed Stamp Only)
Original Instrument Number:
Percentage In This Jurisdiction:
BUSINESS / NAME
1 OQ Grantor: BMC HOLD
NGS LC
[ ] Grantor:
1 Da Grantee: BMC HOLD
NGS LC
2 N Grantee: ALBEMAR
E COUNTY HEALTH DEPARTMENT
GRANTEE ADDRESS
Name: BMC HOLDINGS LC
Address: 400 LOCUST AVENUF
SUITE 3
City: CHARLOTTESVILLE
State: VA Zip Code:
Book Number: Page Number: Instrument Number:
Parcel Identification Number (PIN): 058A2-00-00-01400 Tax Map Number: 058A2-00-00-01400
Short Property Description: ACREAGE
Current Property Address IVY ROAD
City: CHARLOTTESVILLE
Instrument Prepared By: MICHELE R NAPPER
Recording Returned To: BMC HOLDINGS LC
Address: 400 LOCUST AVENUE SUITE 3
City: CHARLOTTESVILLE
FORM CC-1570 Rev: 7/15
§§ 17.1-223, 17.1-227.1,17.1.249
State: VA Zip Code:
Recording Paid By: GRANTOR
1 of 1
State: VA Zip Code:
100%
22902
22903
22902
Cover Sheet A
Copyright i 2014 Office of the Executive Secretary, Supreme Court of Virginia. All rights reserved.
Page] of 3
V VIRGINIA Albemarle County Health Department
1138 Rose Hill Drive
DEPARTMENT Charlottesville, VA 22903
OF HEALTH (434) 972-6219
Protecting You and Your Environment (434) 972-4310 Fax
PE Sewage Disposal System Construction Permit Letter (COV 32.1-163.6)
December 05, 2018
BMC Holdings, LC
400 Locust Avenue Suite 3
Charlottesville, VA 22902
Tax Map: 58A2-14 & 20
HDID: 101-18-0506 Reserve: 100% reserve area provided
System Capacity: Non -Residential, Flow equalized to disperse 875 gallons per day max
System Description: AOSS to serve a commercial office complex to include a physical therapy office
along with other potential uses as outlined in the design
Well Class: Class IIIB (Cased and grouted 50' minimum)
Permit Notes: Existing well MUST be abandoned prior to system installation
Dear BMC Holdings, LC :
This letter and the attached drawings, specifications and calculations dated November 19, 2018
constitute your permit to install a sewage disposal system and private well on the property referenced
above. Your application for a permit was submitted pursuant to §32.1-163.6 of the Code of Virginia,
which requires the Virginia Department of Health (VDH) to accept designs for onsite sewage systems
from individuals licensed as Professional Engineers (PEs). This law allows PEs to design onsite sewage
systems that do not fully comply with the Sewage Handling and Disposal Regulations (12 VAC
5-610-10 et seq.) and requires VDH to accept such designs provided they comply with standard
engineering practices, performance requirements set by the Board of Health, and certain horizontal
setback requirements necessary to protect public health and the environment. VDH hereby recognizes
that the design submitted by Michael Craun, P.E. complies with the requirements of the Code of
Virginia and the applicable regulations and grants permission to install the system as designed in the
area shown on the attached plans and specifications.
If modifications or revisions are necessary between now and when the system is constructed, please
contact the PE who designed the system upon which this permit is based. Should revisions be necessary
during construction, your contractor should consult with the PE. The PE is authorized to make minor
adjustments in the location or design of the system provided that adequate documentation is provided to
the Albemarle County Health Department.
The PE that submitted the design for this permit is required by the Sewage Handling and Disposal
Regulations to conduct a final inspection of this sewage system when it is installed and to submit an
inspection report and completion statement to the Albemarle County Health Department. The health
department is not required to inspect the installation, but may do so at its sole discretion. The sewage
system may not be placed into operation until you have obtained an Operation Permit from the Albemarle
County Health Department.
Tax Map/GPIN: 58A2-14 & 20
HDID: 101-18-0506
Page 2 of 3
This Construction Permit is null and void if site and soil conditions are changed from those shown on
your application or if conditions are changed from those shown on the attached plans and specifications.
VDH may revoke or modify any permit if, at a later date, it finds that 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
http://www.vdh.vir inia.eov/environmental-health/gmp-2015-01-forms/ .
If you have any questions, please contact me.
This permit expires June 05, 2020.
Sincerely,
Josh Kirtley
Environmental Health Technical Specialist
Cc: Craun, Michael, P.E.
Tax Map/GPIN #: 58A2-14 & 20 Page 3 of 3
HDID#: 101-18-0506
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 the
designer of your permitted system, a private OSE or PE. Your OSE or PE 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 your permit is for an alternative system, you must sign, have notarized, and record the attached Notice
of Recordation in your locality's land records. Please bring proof of this recordation to the local Health
Department
IF YOUR PERMIT IS FOR BOTH A SEPTIC SYSTEM
AND WELL YOU WILL ALSO NEED
• Your well must have satisfactory inspection results after installation. Please give the Health Department
several days notice to schedule this inspection before your Operation Permit will be requested.
• The Health Department must receive a copy of your water sample test result being negative/satisfactory
for coliform bacteria. You are responsible for performing this test and ensuring the results are received at
the Health Department
Please ensure that your Well Driller submits a Uniform Water Well Completion Statement or GW-2 to
the Health Department, including documentation of a proper well abandonment if required by permit
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 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.
Page 1 of
VIH OF HEALTH VIRGINIA Albemarle County Health Department
DEPARTMENT 1138 Rose Hill Drive
Charlottesville, 22e03
(434) 972-6219 Voice
Protecting You and Your Environment (434) 972-4310 Fax
December 05, 2018
Notice for Recordation: AOSS Operation and Maintenance Required
TO: BMC Holdings, LC
FROM: Josh Kirtley, Environmental Health Specialist Senior
Property Identification: TM/GPIN#: 58A2-14 & 20
HDID #: 101-18-0506
Address: Ivy
Locality: Charlottesville, VA 22903, Albemarle
TO WHOM IT MAY CONCERN:
The Albemarle County Health Department has approved an alternative onsite sewage system (AOSS) for
use for the property identified above as long as the system is properly operated and maintained and
performs in accordance with the Sewage Handling and Disposal Regulations (12 VAC 5-610-10 et seq.)
and the Regulations for Alternative On -Site Sewage Systems (12 VAC 5-613-10 et seq)
This permit is issued in accordance with the provisions of Title 32.1, Chapter 6 of the Code of Virginia as
Amended, and §12VAC5-610-340 of the Sewage Handling and Disposal Regulations of the Virginia
Department of Health. The continued validity of this permit is contingent upon compliance with the
operation and maintenance requirements contained in the Owner's Operation and Maintenance Manual
and the Regulations for Alternative Onsite Sewage Systems of the Virginia Department of Health
(12VAC5-613-100 et seq.). Owners are advised to be aware of the operation and maintenance
instructions for their alternative onsite sewage system and to follow them. Copies of the operation and
maintenance instructions should have been given to the original owner by the system designer and should
be passed on from owner to owner; they can also be found by contacting the local health department for
the locality where the onsite sewage disposal system is located.
This Notice must be recorded in the owner's name in the grantor's index of the land records of the Clerk
of the Circuit Court of the county having jurisdiction over the property. You must furnish the Albemarle
County Health Department with certification from the Clerk of the Circuit Court showing the deed book
and page number or the instrument number upon which the notice was recorded before you can receive
your permit to operate the on -site sewage treatment and disposal system.
Tax Map/GPIN:58A2-14 & 20
HDID#: 101-18-0506
Notice for Recordation
Page 2 of 2
As owner of the property, I acknowledge that the sewage disposal system designed to serve the
dwelling requires adherence to the Owner's Operation and Maintenance Manual and to Part III,
Operation and Maintenance, found in the Regulations for Alternative Onsite Sewage Systems of the
Virgini CpRrtment of He. tl 12VAC5-613-100 et seq.).
BMC Holdings, LC Date
COMMONWEALTH OF VIRGINIA, COUNTY/CITY OF Cha �SVi1/e
0-f Zo
Subscribed and acknowledged before me this /; day of jtt Pl- 3kr8 by
LC .
�Cc
OT ARI
PUBLf or the
COMMONWEALTH OF VIRGINIA AT LARGE
NOTARY -'•��
�;. PUBLIC 'C
V REG.#70D9854
MY COMMISSION
EXPIRES • c
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, to wit:
BMC Holdings,
Registration #: -y D 09 c s -i
My Commission expires I C 3 1 2y 2 S
Page I of
VDDEEPARPAR TMM
ENT
OF HEALTH
Protecting You and Your Environment
BMC Holdings, LC
400 Locust Avenue Suite 3
Charlottesville, VA 22902
Albemarle County Health Department
1138 Rose Hill Drive
Charlottesville, VA
22903
(434) 972-6219 Voice
(434)972-4310 Fax
December 05. 2018
Subject: Alternative Onsite Sewage Disposal System, Owner Responsibilities
Health Department 1D Number: 101-18-0506
Tax Map Number/GPIN: 58A2-14 & 20
Physical Address: Ivy
Charlottesville, Albemarle County, VA 22903
Dear BMC Holdings, LC :
Records on file at the Albemarle County Health Department indicate that you are the owner of an
Alternative Onsite Sewage System (AOSS) located at Ivy, Charlottesville, VA. This letter is to provide
you with important information regarding owner responsibilities for the operation and maintenance of
your AOSS.
The Regulations for Alternative Onsite Sewage Systems (the "AOSS Regulations," 12 VAC 5-613)
became effective on December 7, 2011. These regulations can be found online at
http://www.vdh.vir ig nia.gov/EnvironmentatHealth/Onsite/regulations/index.htm.
The Commonwealth of Virginia State Board of Health Alternative Onsite Sewage Regulations outline the
owner's responsibilities for alternative onsite sewage systems. Owners are now required to:
1. Have the AOSS operated and maintained by a licensed operator. A list of licensed operators can
be obtained by visiting the Department of Professional and Occupational Regulation at
www.dpor.virginia.gov. Select "License Lookup" from the menu, type an asterisk (*) in the name field,
check the "Operators" box under "Onsite Sewage Systems Professionals" and click "search."
2. Have a licensed operator visit the AOSS at the frequency required by the regulations.
3. Have a licensed operator collect any samples required by the regulations (specific laboratory sampling
requirements depend on the date your application was filed, the size of the treatment system, the approval
status of the treatment unit, whether or not disinfection was required, and whether or not there is direct
dispersal to groundwater. Laboratory sampling is not required for any small AOSS with an installed soil
treatment area that is sized for septic tank effluent and complies with the requirements of 12VAC5-610
for septic tank effluent. Please consult your Operation and Maintenance Manual, the system designer, an
Operator, or the Health Department if you have questions.).
Page 2 of 2
4. Keep a copy of the maintenance log provided by the operator on the property where the AOSS is
located, make the log available to the health department upon request, and transfer the log to any future
owner of the property.
5. Keep a copy of the Operation and Maintenance (O&M) Manual for the AOSS on the property
where the system is located, make the manual available to the health department upon request, and
transfer the O&M Manual to any future owner.
6. Comply with the onsite sewage disposal requirements contained in any local ordinance adopted
pursuant to the Chesapeake Bay Preservation Act (§ 10.1-2100 of the Code of Virginia) and the
Chesapeake Bay Preservation Area Designation and Management Regulations (9 VAC 10-20) if the
AOSS is located within a designated Chesapeake Bay preservation area.
Proper operation and maintenance of an AOSS is required by law and is necessary to ensure continued
functioning of the system and may prevent premature failure of the system. Operation and maintenance
information for your system may be found by contacting the system designer, the local health
department, or by visiting the VDH website at
http://www. vdh.v irginia.gov/EnvironmentalHealth/Onsite/newsofinterest/index. htm.
If you have any questions regarding this letter or believe that you received this letter in error, please
contact me at (434) 972-6219. Your cooperation and timely response will be appreciated.
Sincerely,
Virginia Department of Health
VRG
VDHOFI
HEALTH DEPARTMENT
Protecting You and Your Environment
December 05, 2018
BMC Holdings, LC
400 Locust Avenue Suite 3
Charlottesville, VA 22902
Albemarle County Health Department
1138 Rose Hill Drive
Charlottesville, VA
22903
(434)972-6219 Voice
(434) 972-4310 Fax
Subject: Recordation of Future Operation Permit
Health Department ID Number. 101-18-0506; Tax Map Number/GPIN: 58A2-14 & 20
Locality: Ivy, Charlottesville, VA 22903,
Albemarle County
Dear BMC Holdings, LC :
Your application to construct an alternative sewage disposal system to serve a residence at the above location, filed
on November 20, 2018 with the Albemarle County Health Department, has been evaluated in accordance with the
requirements contained in Section 32.1-164.1 of the Code of Virginia, 12 VAC 5-610-250 of the Sewage Handling
and Disposal Regulations, and current agency policies and procedures
Your application is approved and your construction permit is attached to this letter. After your alternative sewage
disposal system is constructed and approved for use, the local health department will issue an Operation Permit The
Operation Permit will be valid as long the sewage disposal system is properly operated and maintained. In
accordance with Section 15.2-2157 of the Code of Virginia, operation permits for alternative systems serving
residential facilities must be conditioned. Before you receive an operation permit for your alternative onsite sewage
disposal system, you must record a notice in the land records of the Clerk of the Circuit Court in the locality where
the system is located. You must furnish to the local health department a certification from the Clerk of the Circuit
showing the deed book number and page number (or instrument number) upon which the notice was recorded. The
notice must be indexed in the grantor index under your name
The notice will state the following
This permit is issued in accordance with the provisions of Title 32.1, Chapter 6 of the Code of Virginia as
Amended, and § 12VAC5-610-340 of the Sewage Handling and Disposal Regulations of the Virginia Department
of Health. The continued validity of this permit is contingent upon compliance with the operation and maintenance
requirements contained in the Owner's Operation and Maintenance Manual and Regulations for Alternative Onsite_
Sewage Systems of the Virginia Department of Health (11VAC5-613-100 et seq.). Owners are advised to be aware
of the operation and maintenance instructions for their alternative onsite sewage system and to follow them.
Copies of the operation and maintenance instructions can be found by contacting the local health department for
the locality where the onsite sewage disposal system is located.
If you have any questions or if this office can be of further service to you please call us at (434) 972-6219.
Sincerely,
Josh Kirtley
Environmental Health Technical Specialist