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HomeMy WebLinkAboutSUB201800180 Certified Engineer's Report 2018-12-19 Soils Study for Drain Field Sites Lot A and Residue A Division of Tax Map 20-6A Albemarle County SUB 2018-180 s K Prepared for: Baliff Investments,LLC 170 S. Pantops Drive Charlottesville, VA 22911 Prepared by: Steve Gooch Consulting Geologist, Inc. 703 Oliver Creek Road Troy, Virginia 22974 December 18, 2018 Page 1 of 5 OSE/PE Report for: Construction Permit t l Certification Letter 11 Subdivision Approval Property Location: 911 Address: 620 Frays Ridge Road City: Lot A Section Subdivision GPIN or Tax Map# 20-6A Health Dept ID# Latitude Longitude Applicant or Client Mailing Address: Name: Baliff Investments, LLC Street: 170 s. Pantops Drive City:Charlottesville State VA Zip Code 22911 Prepared by: OSE Name Steve Gooch License# 1940001284 Address 703 Oliver Creek Road City Troy State VA Zip Code 22974 PE Name: License# Address City State Zip Code Date of Report 12/18/18 Date of Revision#1 OSE/PE Job# Date of Revision#2 Contents/Index of this report(e.g.,Site Evaluation Summary,Soil Profile Descriptions,Site Sketch,Abbreviated Design,etc.) OSE Cover Page Abbreviated Design Form Soil Profile Sheet Survey Plat Soil Information Summary Sheet Certification Statement I hereby certify that the evaluations and/or designs contained herein were conducted in accordance with the Sewage Handling and Disposal Regulations(12 VAC5-610),the Private Well Regulations(12 VAC5-630)and all other applicable laws,regulations and policies implemented by the Virginia Department of Health. I further certify that I currently possess any professional license required by the laws and regulations of the Commonwealth that have been duly issued by the applicable agency charged with licensure to perform the work contained herein. The work attached to this cover page has been conducted under an exemption to the practice of engineering,specifically the exemption in Code of Virginia Section 54.1-402.11 I recommend that a(select one): Anstruction permit❑ certification letter subdivision approval be(select one)issued denied U. OSE/PE Signature J�).P�2_ y0��t�� Date /2/(7l/,— z iIK Soil Profile Lot A A Division of Tax Map 20-6A Advance Mills Farm Albemarle County Hole Depth Horizon Material Description Soil Texture (in.) Group 1 0-12 Ap Reddish brown(2.5YR 4/4) clay loam, friable 3 12-40 Bt Red(10R 4/6) silty clay loam, firm 3 40-84 C Red(10R 4/6) sandy loam, friable 2 2 0-12 Ap Reddish brown (2.5YR 4/4) clay loam, friable 3 12-54 Bt Red (10R 4/6) silty clay loam, firm 3 54-61 2Bt Red(10R 5/8) silty clay loam, firm 3 61-74 2Bt2 Red(2.5 YR 5/8) sandy clay loam, friable 2 74-84 C Reddish yellow(7.5YR 6/8) sandy loam, friable 2 3 0-7 Ap Brown(7.5YR 5/4)clay loam, friable 3 7-31 Bt Red (1OR 4/6) silty clay loam, firm 3 31-62 Bt2 Red (2.5YR 5/8) clay loam, friable 3 62-84 C Strong brown(7.5YR 5/8) sandy loam, friable 2 4 0-4 Ap Brown(7.5YR 5/4) clay loam, friable 3 4-38 Bt Red (10R 4/6) silty clay loam, firm 3 38-64 Bt2 Red (2.5YR 5/8) clay loam, friable 3 64-84 C Strong brown(7.5YR 5/8) sandy loam, friable 2 5 0-13 Ap Brown (7.5YR 5/4) clay loam, friable 3 13-44 Bt Red (10R 4/6) silty clay loam, firm 3 44-60 Bt2 Red(2.5YR 5/8) clay loam, friable 3 60-84 C Yellowish red(5YR 5/8) sandy loam, friable 2 6 0-12 Ap Brown(7.5YR 5/4)clay loam, friable 3 12-44 Bt Red(1OR 4/6) silty clay loam, firm 3 44-76 Bt2 Red(2.5YR 5/8) sandy clay loam, friable 2 76-84 C Yellowish brown(10YR 5/8) sandy loam, friable 2 Page 3 of 4- Appendix 2 Soil Summary Report GENERAL INFORMATION Date 12/18/18 Submitted to Albemarle County Health Department Applicant Baliff Investments, LLC Telephone Number (434) 962-5158 Address 170 S. Pantops Drive Charlottesville, VA 22911 Owner same Address same Location 620 Frays Ridge Road Tax Map 20-6A Subdivision Block/Section Lot A SOIL INFORMATION SUMMARY 1. Position in landscape satisfactory? IX Yes r No Describe shoulder _ 2. Slope 14 % 3. Depth to rock or impervious strata: Max. Min. None x 4. Depth to seasonal water table (gray mottling or gray color) rX No I Yes inches Free water present IX No F Yes range in inches o. Soil percolation rate estimated Ix Yes Texture group I II ® IV r N• o Estimated rate 55 min/inch 7. Permeability test performed f Y• es iX N• o If yes, note type of test performed and attach rx Site Approved: Drainfield to be placed at 66" depth at site designated on permit. r Site Disapproved: Reasons for rejection: 1. Position in landscape subject to flooding or periodic saturation. 2. I— Insufficient depth of suitable soil over hard rock. 3. I— Insufficient depth of suitable soil to seansonal water table. 4. r Rates of absorption too slow. 5. r Insufficient area of acceptable soil for required drainfield, and/or Reverse Area. 6. E Proposed system too close to well. r Other Specify (attach additional pages if necessary) Abbreviated Design Form This form is for use with gravity,pump to gravity,enhanced flow,and low pressure distribution(LPD)sewage system designs and when applying for a certification letter or subdivision approval. This abbreviated design covers the D'primary and reserve area, 0 only the primary area, D only the reserve area(check one)for Lot A- A Division of TM 20-6A Design Basis Total length of available area: 100' Total width of available area: 150' Estimated Perc. Rate: 55 at 66" in. (depth) Number of bedrooms(or GPD): 5 1 2 Conveyance Method : Gravity Distribution method (specify): Gravity 3c Dispersal system basis Table 5.4 LGMI required? No (Yes/No) Effluent quality required: Primary (Primary, Secondary,Advanced Secondary) Square feet per bedroom: 412 Total trench bottom area required: 4120 Area Calculations Number of trenches 14 Length of trenches: 100' Width of trenches: 3' Center to center spacing: 10' Reserve required? Yes Percent reserve area required: 100 Total width of absorption area required 130' Total trench bottom area provided:_4200_ The required width is calculated by multiplying the center-to-center spacing by one less than the number of trenches and adding 1 trench width plus any required reserve area. If the topography is not uniform across the length of the site the trenches will need to flare apart on one end to maintain contour. When this occurs it is necessary to use a center-to-center spacing that accounts for the flair or the installer will not be able to fit the system within the approved area. It is perfectly acceptable to have more area available,especially up and down the slope,than is required. Page of AOSE Form E Revised July 18,2007 > N'a -— SEE NOTES 3 & 12.—'-- I7 / ; N5r4738'E / RESIDUE LO! + / TYP 20-6A // 21.000 AC. ,rrTrw t,oTB 95 { --- 1 �� ��. . -� EXISTING 20' DRAINAGE �( i EXISTING EASEMENweiT Well PROPERTY LDIE iS CENTER OF + _ _�'�" —E)(ISIING '+ '4,2 s O,� RIVER AS iT MEANDERS + CRAVEN DRIVE p ��`��� �I�r i So`�` BOUNDARY CALLS SHOW + ALONG RIVER FOR CLOSURE + _ Slims AND AREA CALCULATIONS.---�` DRAINAGE AND /458/ H:%-: EASEMENTI �,' . 0 PG r7 ` ` _ _ • ` Q EXISTING SHED TO 21.O10 ., P 43. �o BE DEMOUSNED House '- . AREA E HEREBY ADDED a44''� m NEE LOT '�' � ai3 ��trc�rU .N -10.4 oral� 0.186 ACRES r 91.87. `P ! R erne} _ _ —— AREA 'X' '+N 1.313. •- ?MIRY ADDED .r • �2,a, TO RE7T LOT 'A. _ ,i 4\ 0.535 ACRES '04 _ ► ``' �15M _ , g AREA 'r I \\ • i, _` — — _ HEREBY ADDED TO LOT 19 + `1s yt> . ��� O.721 ACRES + �s M" i i �\ // + e2� 0 \` >�X LOT 19 }Z. \ �1.. EXISTING TYP 20-61 ' $�' \`;" GRAVEL DRIVE 21.000 AC. i r + EXISTING 20' DRAINAGE e 1 EASEMENT l --___ i i yH p C4 p > r• = C \` \ ./ ./" - " DB 2432 PG 222 / '.______. '�� . O < < y 63 N:3955054.45( \`3 / SPC -� \ + C �. r •� \.. �` �"s E 11497937.2t / =. (') I n o -- o ss3•Sg'34'TM l,564.89' • \ T 18 ,If I 1 Nx .+ � Q I 7d O + ' A Mu0T Of CONSENT i'20-4i SWIIISIELOLis ° .=., < A)• •• AGATE ALL ENCUMBRANCES ON THE PROPERTY SHOW�- n ' TINE PLATTING OR DEDICATION OF THE FOLLOW DESCRIBED LAND KNORR BY THE PLATTING OR DEDICATION OF THE FOLLOMIING DESCRIBED U Dcl OF THE IS N '�7 p MIS FOUND TO EXIST AT THE ilE OF THIS SURVEY. COUNTY RECORDS AS TAX MAP 20• PARCEL 6A IS WIN THE FREE CONSENT AND COUNTY RECORDS AS TAX MAP 20, PARCEL IN ACCORDANCE iN1H THE OM OF THE UIOERSIGNE!] ' NIX IS NNED THE FR C) . O C' .-: 0.2%ANNUAL CHANCE FLOOD PLAIN AS SHOW ON AND TRUSIFES. E ANY. PROPRIETORS IN MA THE DESKOMEN! DE BY EL£VATON SHAY MO TRUSTEES, IF ANY. ]N MA VI &' CD Ew OF IiUE51ME?1T3, LLC P 170 S. PANTOPS DRIVE SOUTHERN PROPERTY. uC 4) 0 CHARLOTTESWIE, VA 22911 1CHARLOTTFSNiLE, VA 22911 Page 1 of 5 OSE/PE Report for: Construction Permit D Certification Letter_I I Subdivision Approval El Property Location: 911 Address: 620 Frays Ridge Road City: Lot Residue Section Subdivision GPIN or Tax Map# 20-6A Health Dept ID# Latitude Longitude Applicant or Client Mailing Address: Name: Baliff Investments, LLC Street: 170 s. Pantops Drive City:Charlottesville State VA Zip Code 22911 Prepared by: OSE Name Steve Gooch License# 1940001284 Address 703 Oliver Creek Road City Troy State VA Zip Code 22974 PE Name: License# Address City State Zip Code Date of Report 12/18/18 Date of Revision#1 OSE/PE Job# Date of Revision#2 Contents/Index of this report(e.g.,Site Evaluation Summary,Soil Profile Descriptions,Site Sketch,Abbreviated Design,etc.) OSE Cover Page Abbreviated Design Form Soil Profile Sheet Survey Plat Soil Information Summary Sheet Certification Statement I hereby certify that the evaluations and/or designs contained herein were conducted in accordance with the Sewage Handling and Disposal Regulations(12 VAC5-610),the Private Well Regulations(12 VAC5-630)and all other applicable laws,regulations and policies implemented by the Virginia Department of Health. I further certify that I currently possess any professional license required by the laws and regulations of the Commonwealth that have been duly issued by the applicable agency charged with licensure to perform the work contained herein. EiThe work attached to this cover page has been conducted under an exemption to the practice of engineering,specifically the exemption in Code of Virginia Section 54.1-402.11 I recommend that a(select one): nstruction permit certification letter subdivision approval❑✓ be(select one)issuedi denied U OSE/PE Signature -.A)-2- Date /14/27/�' Pale Z#F4.- Soil Profile Reserve Drain Field Residue A Division of Tax Map 20-6A Advance Mills Farm Albemarle County Hole Depth Horizon Material Description Soil Texture (in.) Group 1 0-4 A Dark gray(10YR 4/1)loam, friable 2 4-15 E Brown(7.5YR 5/4) sandy loam, friable 2 15-34 Bt Red (10R 5/8) sandy clay loam, friable 2 34-84 C Light yellowish brown(10YR 6/4) sandy loam, friable 2 2 0-3 A Dark gray(10YR 4/1) loam, friable 2 3-12 E Brown (7.5YR 5/4) sandy loam, friable 2 12-40 Bt Red (10R 5/8) silty clay loam, firm 3 40-58 Cl Yellowish red(5YR 5/8)clay loam, friable 3 58-84 C2 Yellow(10YR 7/8) sandy loam, friable 2 3 0-4 A Dark gray(10YR 4/1) loam, friable 2 4-14 E Brown(7.5YR 5/4) sandy loam, friable 2 14-32 Bt Red(10R 5/8) silty clay loam, firm 3 32-51 Cl Yellowish red(5YR 5/8) sandy clay loam, friable 2 51-84 C2 Yellow(10YR 7/8) loamy sand, very friable, 15% 1 weathered gneiss fragments 60"-78" 4 0-5 A Dark gray(1OYR 4/1) loam, friable 2 5-12 E Light brown(7.5YR 6/4) sandy loam, friable 2 12-30 Bt Yellowish red(5YR 5/8) clay loam, friable 2 30-84 C Dark yellowish brown(10YR 4/6) sandy loam, friable, 2 25% weathered gneiss fragments below 66" 5 0-4 A Dark gray(10YR 4/1) loam, friable 2 4-13 E Brown (7.5YR 5/4) sandy loam, friable 2 13-34 Bt Red (10R 5/8) silty clay loam, firm 3 34-47 Bt2 Red (2.5YR 5/8) clay loam, friable 3 47-64 CI Yellowish red (5YR 5/8) sandy loam, friable 2 64-84 C2 Yellow(10YR 7/8)loamy sand, very friable 1 Page 3 of Appendix 2 Soil Summary Report GENERAL INFORMATION Date 12/18/18 Submitted to Albemarle County Health Department Applicant Baliff Investments, LLC Telephone Number (434) 962-5158 Address 170 S. Pantops Drive Charlottesville, VA 22911 Owner same Address same Location 620 Frays Ridge Road Tax Map 20-6A Subdivision Block/Section Lot Residue SOIL INFORMATION SUMMARY 1. Position in landscape satisfactory? fx Yes (- No Describe shoulder 2. Slope 14 % 3. Depth to rock or impervious strata: Max. Min. None x 4. Depth to seasonal water table (gray mottling or gray color) Cx No P Yes inches Free water present iX No r Yes range in inches 6. Soil percolation rate estimated 15 Yes Texture group I II III IV r No Estimated rate 50 ` min/inch 7. Permeability test performed E Yes rx No If yes, note type of test performed and attach 1 Site Approved: Drainfield to be placed at 60" depth at site designated on permit. P Site Disapproved: Reasons for rejection: 1. I Position in landscape subject to flooding or periodic saturation. 2. P Insufficient depth of suitable soil over hard rock. 3. P Insufficient depth of suitable soil to seansonal water table. 4. I— Rates of absorption too slow. 5. f Insufficient area of acceptable soil for required drainfield, and/or Reverse Area. 6. E Proposed system too close to well. E Other Specify (attach additional pages if necessary) rci yb Abbreviated Design Form This form is for use with gravity,pump to gravity,enhanced flow,and low pressure distribution(LPD)sewage system designs and when applying for a certification letter or subdivision approval. This abbreviated design covers the 0 primary and reserve area, 0 only the primary area, ( only the reserve area(check one)for Residue- A Division of TM 20-6A Design Basis Total length of available area: 100' Total width of available area: 55' Estimated Perc. Rate: 50 at 60" in.(depth) Number of bedrooms(or GPD): 4 2 Conveyance Method : Pump Distribution method (specify): Pump_ 3c Dispersal system basis Table 5.4 LGMI required? No (Yes/No) Effluent quality required: Primary (Primary, Secondary,Advanced Secondary) Square feet per bedroom: 376 _ Total trench bottom area required: 1504 Area Calculations Number of trenches 6 Length of trenches: 85' Width of trenches: 3' Center to center spacing: 9' Reserve required? This is reserve Percent reserve area required: 100 Total width of absorption area required 45' Total trench bottom area provided: 1530 The required width is calculated by multiplying the center-to-center spacing by one less than the number of trenches and adding 1 trench width plus any required reserve area. If the topography is not uniform across the length of the site the trenches will need to flare apart on one end to maintain contour. When this occurs it is necessary to use a center-to-center spacing that accounts for the flair or the installer will not be able to fit the system within the approved area. It is perfectly acceptable to have more area available,especially up and down the slope,than is required. Page of AOSE Form E Revised July 18,2007 "-- —_ '/ �� \ •• ilf0 O 1 800 p. t • s.`\ 9CJIi 1'= tow RON PIN F0 1 IFOUND/ \ y MOW'aMMT Millis dit \` LOT 2J \ . orw �.�. odr T•o•�t w.+e q� \ IMP.id--sal 1 a > alrY4er bur N . \ 1.K 1 � war two N mot N y \a , MANAGE • 1 war no nut is as . a EA 24' 1t a EAWAFJIT i a * Rex/ * nv. a M stow es low tr OB 3130 P6 37\. • `, // LOT `\ APPRC *MOW.'�. Za-8t♦8 L 1149?51144 • / 45'��' 7M�U s SEE u 39^E > 1I - -RDUI Let 21.000 AC. ' ' Flroposed Wen, , . c MENEM •1.:•i- .1. UMW Vika 04 EU MONO N� \ \ r� `\\ GRAM.OWE • , Y •• i 1 M C 2L000 • URITY EASE `` ! •) • ! •21000 OB 3130 PG 7 ` —' ;; tO 0 EIOStNC 91ED TO .21.0,10 AC. '/.'/? S. Houser--13 •-:-?› c4 > r = erf ‘x; --4, - — ___./ Prmosed owg5rowom \ _, „ it-1 .75,4141ig .,.. . , o u w y�33 t_ (P_i l-8 F ,= p 1 MAY NOT ,x 143" • E. n n o °� C MU ''°�3b''N a. r MR�11a ttix' ° p TOWOLOT 'A' V. 6- < y • 'IE �. 4 • 5,444 , ��'�r' _I —-—— V—,� ,r QC.• o .71 o /' -- -- r _ = __ MOT ADDED MILLSLOT a 0. b 4 a.n, ACRES \--Disnic R ?MP 20-6I wvtNwa.c ) \ ` PILLS FARMLL$ FARM St) ® s EASEREWT MANAGE '�� ./ OB 2432 PG 222 _ ---- 150 0 150 300 4ao ©Pi a ------- LEGEND SCALE: 1"�1438'roo` jmimiwomm i ' \ It /7/// — - - .--____ _ ..... IF IRON PIN FOUND \ BOUNDARY CURVE TABLE * #�p� .` LOT 23 / 1 4.1 j 'A 'z'N''' R 1 `O a 2 / \ Curio Length Radius Orta Tanqont Chad Chord 8�ori�qOt) \\ \ TYP 20-6AC / , ' c w g 1 Z et mar 552.59' 3028'40* 150.37' 290.16' N 56'32bo'w i , g " ° •• -i C2 193.64' 2908.17' 3Y9"03' 96.66' 193.80' N 73'40'02'w R/4) EX. 20' DRAINAGE • / i c OrJ \ C3 307.04 9041.04' 1'54'45' 153.54 307.03' N 76'33'23'w / Og . C4 60.32' 205.00' 1631'29' 30.36' 60.10' N 65'S7'05'w DBS31t30 PG 37 ENT _�'� • \... / / }+E ' i �10012' - -a O°o •jl • I cid �� LOT 22 �� APPROXIMATE LOCATION OF \ .. VW 20-� E:3956318.96 /� $1' 100 •YEAR FLOOD PLAIN R O f • 4` AND STREAM BUFFER - aea �'�`� µf�'16"� ........................L:e.g i SEE NOTES 3 & 12. i Tti wa _ •. W. O u. N53'4738"E t,328 t7 / RESIDUE LOT U 1 a4 =i aw ' �� .• � TYP 20-6A '1o'17'w 1,078.95' I 0 I :4 i '`°° � � /.�. 21.000 AC. i I 1 "� n • `` `\ — ��edIA1 • N `� �,\. EXISTING 20' DRAINAGE proposed• t r %\ ^ EXISTINGa�� Well l 1� RIVER AS IT MEANDERS TER OF i D °' '3 '� \.. .----• ---- EASEMENTEj t �/ppg `� ��9 `` ���. EXISTING RE � 1 �`. BOUNDARY CALLS SHOWN i 1 `6' O i7 AM; \ \ SPC r` GRAVEL DRIVE •20 Q , ALONG RIVER FOR CLOSURE ( a Sr N:3955453.9004 4201a •44 AND AREA CALCULATIONS.---�` i i 21.000• S'�- E:11496846.46 `= SITED ,,,� I , , I N. EX. 10' DRAINAGE AND ' 1 21.000 UTILITY EASEMENT �' NEW L • `� t r, ,fH 21.000 DB 31C.,,...... 1.010 AC. • ' 'I '' 21.010 =` �-EXISTING SHED TO � m �` ' BE DEMOLISHED AREA 'Z' � // , OUNDED BY RIVER. AREAS SHOWN \ it `�. ��p ;,• HEREBY ADDED + ;' �_PPRO)aMATE CENTERLINE OF RIVER. ` - iJ>;?6�{.1 111J41 •' TO NEW LOT 'A' Br rAYIS . �',.wars LOT J4 \ \ p ` ^ . ,:° 0.186 ACRES ' _ No. 3334 , 2 DEVELOPMENT RIGHTS. \\ . N75'3� +w 1\44 ! Proposed ICI Site "c `� , t `' 1 20-2`1�11 1 DEVELOPMENT RIGHT. .. \ 91.87' SbA— 9--- (P1 tr ay_an Reserve) — — '�►��...,,-. .1,., tDIVIDED.ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT •�. %,.� • AREA x S5 •�r•w 1'343.SD' r '- �' ' IT OF 1W 20-6A RETAINS ONE DEVELOPMENT RIGHT AND , � , HEREBY ADDED — I , ' E FURTHER DIVIDED. TO NEW LOT 'A' -- I TANS ONE DEVELOPMENT RIGHT AND MAY NOT BE \ 0.535 ACRES , - I �" AIDED. \ 4 . 104* _ _ — _— \...._ AREA 'Y. I I ~ 3 _ o z +•- „,.,� _ ` ° `` _ _ _ HEREBY ADDED i le J BLUE HILLS ..��! / .- _ 0 1 ACRES TO LOT 19 I N cc W 5 N :� X .--- \ ADVANCE .t� \ti3 �•. ,�r LOT 19 g`"g. �Z� I -e (� SITE LI. CO \ � 1!3,/ EXISTING TV 20-6X i `" I I .r = '� Fa µ dp / GRAVEL DRIVE 21.000 AC. i , , ,,a,, W < Uj Uj ADVANCE "4° �` � �� I �� z Cr)VJ W co MILLS FARM EXISTING 20' DRAINAGE i ry w V 0 ...4 CC u. (31 LEASEMENT i F _J -� 0 '} ,� -�-. ''� \ DB 2432 PG 222 I �a 8 W cf, LOT 15 \ ��- ��. / \�- . _ "\ i I \ r+ I) U Z �3 / SPC "__ '' -. I I. Z G '\ N:3955054.45 `-� _ I W c E:11497937.21 i / 9 U I' �°`x.. 1 S53.58'3 1'564.99. \\.. TY 0201 6X 8 I ` I Z Q N U VICINITY MAP �� Scale 1"=200' •- Soil Profile Hole � > —"� � % ,p � SCALE. i'=2000' \ b Houses, Wells and Drain Field Sites J STdT a rr OP coNS8Nr rYP 20-sd Sett OP c Lot A and Residue r 1AS BEEN PREPARED WITHOUT THE BENEFIT OF A 1111E REPORT AND DOES NOT THEREFORE NECESSARILY INDICATE ALL ENCUMBRANCES ON THE PROPERTY SHOWN THE PLATTING OR DEDICATION'OF THE FOLLOWING DESCRIBED LAND KNOWN BY THE PLATTING OR I Q W I- 1 1AS BEEN PREPARED FROM AN ACTUAL FlE1 D SURVEY DONE AS PER THE DATE OF THIS PLAT USING MONUMENTS FOUND TO EXIST AT THE TIME OF THIS SURVEY. IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNERS, PROPRIETORS IN ACCORDANCE val. Albemarle County,Virginia COUNTY RECORDS AS TAX MAP 20, PARCEL 6A IS NM THE FREE CONSENT AND COUNTY RECORDS , A Division of Tax Map 20-6A Or) OF THE AREA SHOWN HEREON APPEARS TO BE LOCATED IN ZONE 'A' AREA DETERMINED TO BE WITHIN THE 0.2x ANNUAL CHANCE F1000 PLAIN AS SHOWN ONQ I AND TRUSTEES _ NUMBERS 51003C01400 & 51003C01500, EFFECTIVE DATE FEBRUARY 4, 2005. THIS DETERMINATION HAS BEEN MADE BY GRAPHIC METHODS, NO ELEVATION STUDY AND TRUSTEES, IF ANY. , IF . 'ERFORMED AS A PORTION OF THIS PRD,ECT. a. Steve Gooch Consulting Geologist 3 X:LS DO NOT LIE WITHIN AN AGRICULTURAL/FORESTAL DISTRICT. 703 s LOCATED IN THE NORTH FORK RIVANNA RIVER WATERSHED. AND IS WITHN BAWF INVESTMENTS LLC SOUTHERN PROPERI A WATER SUPPLY PROTECTION AREA. Tro Oliver Creek Road OPERTY DOES NOT LIE WITHIN THE DAM BREAK INUNDATION ZONE. 170 S. PANTOPS DRIVE 170 SOUTH PANTOP Troy, Virginia 22974 :L CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. ruJAPI()TTccun I c VA 01011 ("MARI ATTF'cuI I c 1, t , Commonwealth of Virginia VDH Use Only Health Department ID# Application for Subdivision Review Due Date (Page 1 of 2 to be filled out by the Owner or Agent) Owner Baliff Investments,LLC Phone (434)962-5158 Mailing Address 170 S.Pantops Drive Phone Charlottesville,VA 22911 Fax Developer/Agent Steve Gooch,Consulting Geologist Phone (434)531-0487 Mailing Address 703 Oliver Creek Road Phone Troy,VA 22974 Fax AOSE Steve Gooch Phone (434)531-0487 Mailing Address 703 Oliver Creek Road Phone Troy,VA 22974 Fax Directions to Property: From Earlsyville General Store bear right on Advance Mills Road, left on Frays Ridge Road to 620 Frays Ridge Road on right Name of Proposed Subdivision Tax Map 20-6A Other Property Identification Dimension/Acreage of Property 42.01 Ac. Number of lots proposed 2 Proposed water source(note:new or existing,public or individual) new,existing,individual General size of lots 21 Ac.&21.01 Ac (give range if appropriate) Additional description of subdivision Overview of soils and geology(optional but encouraged) In order for VDH to process a subdivision application you must attach a plat of the property showing the location of the proposed onsite sewage disposal systems and the reserve absorption areas(if required)and the location of the water supply system on each lot,if applicable. Each plat or subsection of a subdivision shall be accompanied by specific soil information for each lot(absorption area and reserve area). If not provided by the local subdivision ordinance,the district or local health department may require the plat to show streets,utilities,storm drainage,water supplies,easements,lot lines,and original topographic contour lines by detail survey or other information as required. When the AOSE site evaluations are reviewed,the property lines,building location and the proposed well and sewage system sites must be clearly marked and the property sufficiently visible to see the topography,otherwise this application will be denied. I give permission to the Virginia Department of Health(VDH)to enter onto the property described during normal business hours for the purpose of processing this application and to perform quality assurance checks of evaluations and designs certified by an Authorized Onsite Soil Evaluator(AOSE)or a Professional Engineer(PE)as necessary until the sewage disposal system has been constructed and approved. v/}101r,4- "ILP Signature of Owner/Agent Date CommonwealthVDH Use Only of Virginia HealthDemotion1DN Application for Subdivision Review Due Date (page 2 of 2 to be filled out by the county official requesting a VDH review) County Office initiating request Contact Individual Phone Local offices of the Virginia Department of Health may review subdivision applications for compliance with state rules and regulations governing sewage treatment and dispersal and private water supplies,compliance with local ordinance governing sewage treatment and dispersal and private water supplies and potentially for compliance with other local ordinances. Please indicate the nature of review you are asking the health department to conduct. I, Review for conformance with the Sewage Handling and Disposal Regulations 2. Review for conformance with local onsite wastewater ordinances 3. Other(describe below) Name and title of requester Date OSE Form F Revised 7/02/09