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COUNTY .
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OF ALBEMARLI /
Department of Zoning � -'� �
401 McIntire Road
Charlottesville. Virginia 22901-45C l �_.�/i�
(804) 296-5875
T777
MEMO TO: Thomas Jefferson Health District - � z���
Environmental Health Division
1138 Rose Hill Drive /
Charlottesville, VA 22.902 91 #. /2
Phone: 972-6259
FROM: - • ktiielia :G::, McCulley, Zonirig -Administrator --
RE: Request for Zoning Clearance for Change of Use
or Additional�{ Use
DATE: / o .E
. This memo is to obtain approval for the specific use proposed by
this applicant as follows:
Tax Map . 4 Ct Parcel V--1 Acreage 1 ' 1 S 0
Location: ri D31.--- Cr)(,)1,- 1 Y) urC < , '�'`� 7
Owner of Property: PmermAile, 1( L -,,,r i' K
• Existing Use: reA-ol.k` ,`� C.p
�y� ,
Proposed Use: �-+'�(E \S C-Q
Name of Business: -- h trrWi\e Cr r r <
4 ,
Contact Person: I f �,�o( ,,,, k' PI'LAC)(
f J Li Lp � 5.5 ,
# of Employees: ` Day Phone: 1 k 9roO -IL &9
// _--.4
Zoning Staff: . i(4� '' �0-014'—'
Approved By: �--t ;` ����� Gi�d� I Date: a
ki-Ac c3
Comments: 1551-), )ulv,d Cutin1c1�-.0L Sfwn(f )fi($I')C SsiSft,\ P(LM\r e- oPCc.ori,wf
Pc.tr rn 1 r i 1 U' - r-,3- `-^ 1 S >
**APPLICANT RESPONSIBLE FOR 'CONTACTING HEALTH DEPARTMENT
Health Department Hours - 8 a.m. to 4 : 30 p.m.
Sanitarians Available - 8 a.m. to 9 a.m. , 1: 00 p.m. to 1: 30 p.m.
and 4 p.m. to 4 : 30 p.m.
REVISED: 10-14-92
* moo' L
,or (0,, ','
COMMONWEALTH of VIRGINIA
In Cooperation with the Thomas Jefferson Health District ALBEMARLE- CHARLOTTESVILLE
State Department of Health 1138 Rose Hill Drive FLUVANNA COUNTY (PALMYRA)
GREENE COUNTY (STANARDSVILLE)
Office of Environmental Health P. O. Box 7546 LOUISA COUNTY (LOUISA)
Phone (804) 972-6259 NELSON COUNTY(LOVINGSTON)
FAX (804) 972-4310 Charlottesville, Virginia 22906
August 28, 2003
Albemarle First Bank
do E.Marshall Pryor,Ill
1265 Seminole Trail
Charlottesville, VA 22901
RE: Sewage Disposal Construction Permit with Conditions
Health Department Identification# 101—03—0515
(Replaces Permit#101 —99—0667)
Location: Intersection of Route 250 and Route 22;Albemarle County, VA
Tax Map#: 79-19
Dear Mr. Pryor:
Your application for a Conditional Sewage Disposal System Construction Permit which was filed
on August22,2003 with the Albemarle County Health Department was evaluated in accordance
with the requirements contained in the Code of Virginia, Section 32.1-164.1 and Section 3.13.06 of
the Sewage Handling and Disposal Regulations, (2000).
Based on the information filed with your application, soil and site evaluations conducted by the
department's representative(s), and review and study of all data presented and available, your
application for a Conditional Sewage Disposal Construction Permit is approved. All items listed
below are a part of the permit and include the conditions that have been applied to the approval,
installation and use of the sewage disposal system.
1. This letter is a part ofthe Conditional Sewage Disposal Construction Permit issued for the
above referenced location.
2. The permit shall be recorded and indexed in the grantor index under your name in the land
records of the Clerk of the Circuit Court of Albemarle
3. You must furnish to the Albemarle County Health Department certification,by the Clerk of the
Circuit Court, indicating the deed book number and page number upon which the permit and all
conditions have been recorded. A copy of the certification shall be attached to all copies of the
permit.
4. The sewage disposal system for.the smaller westernmost building(formerly known as the Tea
Room) is approved for a peak daily wastewater flow of 630 gallons per day. The anticipated
average daily flow should not exceed 315 gallons per day. Wastewater strength shall not
exceed residential wastewater characteristics.
5. In the event that wastewater flow or strength exceeds the design limitations as specified by this
permit,the owner shall take whatever actions necessary to assure compliance of the design
parameters.
6. The sewage disposal system for the larger easternmost building(formerly known as the
Antiquary building) is approved for a peak daily wastewater flow of 500 gallons per day. The
anticipated average daily flow should not exceed 250 gallons per day.
7. No public restroom facilities shall be provided in either of the buildings. Restroom facilities
are for employee use only.
8. The water supply distribution system and sewage disposal system were installed according to
plans and specifications from Kurt Gloeckner-, Professional Engineer, dated November 5, 1999.
Any proposed changes in the design of either, shall be submitted,with the necessary
application, by a licensed professional engineer and reviewed and approved by the Albemarle
County Health Department prior to the change(s) being made.
9. Failure to comply with any of these conditions shall render this permit null and void.
10. This conditional permit and the accompanying operations permit, replaces the previously
issued conditional permit(Health Department Identification #101-99-0667) which was
recorded on November 4, 1999, and the accompanying operations permit dated June 29,
2000 as well as all revisions to said permit.
In accordance with the Virginia Administrative Process Act, the Health Laws of Virginia Section
32.1-164.1 of the Code of Virginia and Section 3.08 and 3.10 of the Sewage Handling and Disposal
Regulations,this letter is to further inform you of your right to appeal to obtain a modification or
elimination of the conditions established in and for the issuance of this revised permit. If you
desire to pursue this appeal, you should submit a written request to Susan McLeod, MD, MPH at P.
O. Box 7546, Charlottesville, Virginia 22906. This written request should detail and outline all of
the facts, and such.other data or information_which forms the basis of your appeal for a review of
the decision establishing the conditions outlined above. The request should be made within 30
days.
If this office may be of further service to you, please contact us at(434) 972 -6259.
Sincerely,
'''4 111 ica-i(
Jack D. McClelland
Environmental Health Technical Consultant
pc: On-Site Sewage and Water Program File
County of Albemarle Department of Building Code and Zoning Services
I certify the information provided herein is true and accurate to the best of my knowledge and
belief
dJLQ:211U1E4/
Ja D. McClelland, Technical Consultant
State of Virginia, County of Albemarle,to-wit:
Subscrib d, acknowledged, and sworn to before me 's_8
day of, ,QpG(J7' , 10s03 by JOCK 0. eCff'/flat?
1
yipid&of � -
Notary Public
My commission expires day Of , /"Tc _
l authorize that this permit and letter be recorded in the grantee index of the Clerk of the Circuit
Court of Albemarle under my name. P t L ►^n -c.t� -V
t> - v.-el v
Owner
State of Virginia,.County of Albemarle,to-wit
Subscribed, acknowledged, and sworn to before me this
clay of by
Notary Public
My commission expires ,
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