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HomeMy WebLinkAboutSUB202200125 Approval - Agencies 2023-01-31VIDHOFVIRGINIA DEPAR HEALTH NT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Page I of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434)972-6219 Voice (434) 972-43 10 Fax AP FR 0VIE0 Tax Map Number: 69-19D RD ID: 101-22-0299 Well Class: Class IIIC (Cased and grouted 20' minimum) PERMIT NOTE: Well Nranber "311" * (Well Number per site sketch and not indicative of Well Class) Dear Alan Taylor: This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IIIC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris IIeltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19D HDID:101-22-0299 Page 2 of 2 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.virLinia.gov/environmental-health/i my-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Maley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System n Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c)o Alan Taylor Mailing Address: 455 2nd Street BE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Afton, VA 22920 Directions to Property: Subdivision: Tax Map: Comer of Route 25D 6 Route 151 WELL 313 69-19D Section: Other Property Info: VDH USE ONLY Health Dept ID# Due Date: Phone: 512-426.4728 Fax: Phone: Phone: 434-981-3634 Fax: Email: simpson@adasconstructlonmanagemwt.wm Block: Lot: Acreage: 4.56 Sewage System ,pe of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage stem and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter El Construction Permit ❑ Subdivison Approval ❑ Repair oposed Use: ngle Family Home (Number of Bedrooms) 5 Multifamily Home (Total # of Bedrooms) :her (Describe): Basement I] Yes Walk -Out Basement? Yes Fixtures in Basement? 21 Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes- 121 No "There is a $50 fee for determination of eligibility. Water Supply Will the water supply be ❑ Public or ❑.r Private Is the water supply ❑ Existing or I] Proposed If proposed, is this a replacement well? ❑ Yes No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes No All Applicants Is this a private sector OSE/PE application? El Yes ❑ No If yes, is the OSE package attached? Yes ❑ No Is the property intended to serve as your (the owners') principal place of residence? ❑ Yes ❑ No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water supplies, a plat of the property is recommenced and a site sketch is required. The site sketch should show your property lines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the proposgdAWI&W yewage skes must be clearly marked and the property sufficiently visible to see the topography. I give 16a to the Virgifr"%, artment of Health to enter onto the property described during normal business hours for the purpose of pro this application and fG rm quality assurance checks of evaluations and designs certified by a private sector Onslte Soil Evaluator or sional Enggine��eciiO until the sewage disposal system and/or private water supply has been constructed and approved. O CFiRiSTO � U t�'LTZf>1- z (3 ^1 yr yic Ne• 1940001460 too/ l� I f e ( ` 1 Stan eP Date -Mbr a err...wwW.ewausw..�.,L.ta..a.�arrr.eu..x,a wawtecnMt limn? ..DvrdD=,_....._..._._,_ Fogs HDW N Finawiu ODA 6 P+tyonm076t 0—MW# Racetpt8 Page�_ I of _(O_ Fil Construction Permit ❑ Repair Permit OSEIPE Report For: ❑ Voluntary Upgrade ❑ Certification Permit Letter ❑ Subdivision Approval Property location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 3B GPI or Tax Map #: 69-19D Health Dept. ID #: Latitude: Longitude: Owner: Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltzel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22694 PE Name: License # Address: Date of Report: 8=2022 Date of Revision #1: Date of Revision #2: Contentslindex of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Specifications 4. Well location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations andfor designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling 6 Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC5-613)and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. 1 further certify that I currently posses 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 potential for both conventional and aftemative onsite sewage systems has been discussed with the ownerlapplicant. ❑ The 1t+R ver page has been conducted under an exemption to the practice of engineering, specifically the eX hAniCode oft ' Section 54.1-402.A.1 I �� rr I recommend ell- ❑� Construction Pyt� ❑ Subdivision Approval be: ❑ Issued 1t .ontte7 1Et1Permit ❑ r ❑ Repair PermVoluntary Upgrade ❑ Denied A. `icIO 19tOlt0l4b0 OSEIPE Signat � . Date: t TrW F oNsrv* 4 The form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12101114 Heltzel Soil Consulting Page 2 of G VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19D Property Address. TBD Subdivision: WELL 3B Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): 0 Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit Page r� of The proposed well site shown herein, F7 1. Is located a minimum of 50 feet from all property lines. FTJ 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. 0 i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. QX H. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot 0 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) 0 Q i. Written permission from the adjacent property owner's) for the well construction. 0 ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm t my property is not used for an Agricultural Operation as defined in § 3A-2 .29 gFfhe Coop ofVirgrnia Date Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC 1412 SaumsvAle Road, Mauredown, VA 22644 WELL LOCATION SKETCH TM # 69-19D ALBEMARLE COUNTY, VA T.M.69-19D REVISED LOT 3 4.56 ACRES mc ZJLsrrR134 WELL #3B VDH I A �s I I I ern I—r August 12, 2022 DRAWN BY: SNV Page ` of 4931 VD MONU FO ISO, 240' Heltzel Soil Consulting, LLC POfi 5M.WmasbA.VAPZ854 TAI.69-6L STUARTTAm'0AR SMACK D.B.52/6-50 D.B.3415-704.707 PLAT PROPOSED LOT LAYOUT/SANITARY SURVEY STOCKTON CREEK SBD,ALBEMARLE CO, VA ST.RT.750 (3O71ascRmn+re EAgMEN� 7---OLD MiN+IXE ROAD A �!�'' —�- LOCAA7710N°sreuM: k lk. TT 11 II < PanD I I II 7.AL59 LOT REND ] I EC. o�B�47DEAN -23 UST I I DA4733-M & 0 PLAT I I DD.4L95-444 D.B.3530-1M PLAT I 1 - 11 I I STATE ROUTE 803 I `--• (30'PRESCRO EASTUIENT) WI �, �,• 60LOE LANE my um 36 T.M.69-6D I I LOT I FRANK DUN.ET & DONI T 85 & 85 PUT VDN T�—,,FOUND MMUMEN V U60�E y i p. VON MONUMENT FOUND ldl 0., pap 57 ofb ALLIONowW &DRADiPiBI.0 SI'17L4 fLTTI@1 "OF m mO"*m OBA6YP®LO6 A6B fiIN19•N. NOT TO SCALE us R% No 2S0 La�o�4 r Heltzel Soil Consulting, LLC PO Boa SM, ft.& dt VA33954 TMAY-6L LDT 6 SMART TAMAR SMACK D.B.534-521 D.B.3A15-704.]0] P"T 4.68-0M RENSm LOT ] E.GAdfEAMAN TRUST D.B.A 0.8.47.B-3 & V Y1 PLAT - D.8.3530-214 wAi STATE ROUTE UO3 (3D'PR I IV urAi�IT") T.LL6B-eO LOT 1 FRANK DONLEY 3 OARLA DONLEY O.B.33BD-B] is' wA VON MONUMENT EXISTING LOT LAYOUT / SANITARY SURVEY Pa" w DT b STOCKTON CREEK SBD, ALBEMARLE CO, VA AIL B1iO" WELLS R ARAINFIE SITES WITHIN 200' OF THE PROPDS EIT DRATiFiF1l15 ARA SFIOW N. ST.RT.750 (3°PREscRiPnvE EASEMErr) NOT TO SCALE ........................... . ........................... _ . ....................... 'SROU U O y aann _ OVERHEAD OBEY LINE WON LM.IW-IN . 3:'\ F1 V e RLMSD Lore „n APo;S)y°i35ii::v.. "- 283AORc5 e nMYY-IYH __ ..... . 11.6%/- AtlIFS I OVERHEAD UlR1TY o a MR MONUI rr.aY-Sa Pai nn ACES T.M.01"N' T.W a Tlw Q\ TJ `I DT 5O LOT e to AGESYW(- ACES - m ppl' �C i _ UME T FOUND VON 5 Y .MAY-1FE y1EV1�Em1 MONUMENT lM i yµ A003 FOUND W AM'EE EYC IEMSEDED MIT Y T.A ALILS COW1E MOH FENCE P POSS T O MONUMENT wN FOUND V MONUMENT FOUND IN o_ - nYAY UXr wM REMSm ID3 a 0 DNUM -^ ax ArnER �9�+ FouxD / 21\) wH V oAR�'��lp\RU MONUMENT *IPM3" August 21, 2022 FOUND H—.vmn.r.— THE PLATTING OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T.M.69-508.REVISED LOT L REVISED LOT 2.REVISEO LOT 3, REVISED LOT 4,REVISEO LOT 5.REVISED LOT S.REVISED LOT 7 0 REVISED LOT 8 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S). PROPRIETORS.ANO/OR TRUSTEES, IF ANY. 9---- FOR: STOCKTON rRtEK, LLC CITY/COUNTY OF Cian.(ri�Roi�it STATE OF V: ^a.:s THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS DAY OF F44rm� 2022. BY fi,./..., D&.As FOR STOCKTON CREEK�LLCC NOTARY PUBLIC �`�^� * 0740 MY COMMISSION EXPIRES :' 1-214. 31- 2pLl APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC I TANGENT CHORD CHORD BEARING Cl 15'48'16' 1964.86 541.98 272.72 540.27 S63-33.04"E C2 4*44*04" 1090.92 90.14 45.10 90.12 SIS'39'29'W C3. 9'59'39" 1085.92 189.42 94.95 169.18 S3B'31'21"W C4 14'56'55' 1090.92 2B4.62 143.12 283.82 S55'59'54'W C5 1'20'52' 14B7.79 35.00 17.50 35.00 872'22'45'W C5 22'41'29' 1487.79 589.22 298.52 585.38 S60'21'35'W C7 21*31*58' 167.57 62.9E 31.86 52.61 N0535'15'E CB 3253'50' 94.14 54.05 27.79 53.31 N32.48'10"E C9 8113,55, 94.14 13.53 6.77 13.51 W53'22'027 CSO 15'57'08' 184.27 51.30 25.82 51.14 N65'27'33"E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B STATE STATE D SCALE: 1' = 200' DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4.2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3.2022 FOR COLLINS ENGINEERING ROGER W.RAY G ASSOC..INC. 663 SERKMAR COURT CH TELEPibN LL(43 )RGINIA 293 3195903 RAYSURVEYTNG. CON BRTAN S. RAY Lic. No. OM281 02/03/2022 750 2rjp OLO ROCKFISH TURNPIKE GAP ROAD TURNPIKE 003 GOOOLOE LANE 151 637 CRITZERS DICK SHOP WOODS ROAD ROAD CRITZERS SHOP VICINITY MAP 1'-2000'4/- SHEET 1 OF 3 A. T.M.69-198, 19C. 19D, 19E & 196 ARE ZONED RA (ENTRANCE CORRIDOR). T.M.69-19F IS ZONED RA. T.M.59-19H. 19J &. 50B ARE ZONED RA(ENTRANCE CORRIDOR & FLOOD HAZARD OVERLAY). B. T.M.69-198(REVISED LOT !)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. 0. T.M.69-19D(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T. M. 69-19E(REVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.59-19F(REVISED LOT S)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-19G(REVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. II. T.M.69-19J(REVISED LOT S)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND KAY BE FURTHER DIVIDED.. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1980 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 19BO BOUNDARIES. J. REVISED T.M.69-50B RETAINS TWO DEVELOPMENT RIGHTS AND MAY 6E FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA,EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REOUIREMENTS:FRONT= 75',SIDE= 25' & REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIB OATA.THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS ARE NOT LOCATED IN AN AG-FDRESTAL DISTRICT. D. THE APPROXIMATE LOCATION OF THE STREAM AMC STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS, ADDRESS & LEGAL REFERENCES: T. M.69-19B, 19C, 19D, 19E, 19F, 19G, 19H, 19J & 50B STOCKTON CREEK,LLC 455 SECOND STREET,5TH FLOOR,CHARLOTTESVILLE,VIRGINIA 22902 D.B.5657-263. O.B.B92-159 PLAT & O.B.663-44 PLAT. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.254-409 & INST.#202200001316).. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY(D.B.232-585). 4. T.M.69-50B IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(D.B.209-251). B. T.M.59-19D,19E,19F.190.19H & 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-404) G. T.M.69-19D, ISE. 19F, 19G. 19H & 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EXIST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR EXTINGUISH DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN BY ME ARE SHOWN 09 NOTED HEREON. THESE PROPERTIES ARE SUBJECT TO ANY ADDITIONAL CONOITIONS,UTILITIES.EASEMENTS AND/OR COVENANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T_M.69-198(LOT 1) - 5..51+/- ACRES T.N.69-19C(LOT 2) = 5.77+/- ACRES T,14.69-190(LOT 3) - 5.15+/- ACRES T,M.69-19E(.OT 4) - 5.45+/- ACRES T. M.59-19F(LOT 5) - 6.68+/- ACRES T.M.69-19G(LOT 6) - 5.88+/- ACRES T.M.69-19H(LOT 7) - 5.12+/- ACRES T.M.59-19J(LOT 8) = 6.56+/- ACRES T.M.59-509 - 9.35+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY & ASSOC.,INC. 663 SERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 14912A LEGEND: IF IRON FOUND IS IRON SET .......,, EXISTING LOT LINES HEREBY EXTINGUISHED 0 OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TD THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 02250. GL T. M. 69-SL LOT 6 STUART TAYLOR SMACK D.B.5246-521 D.B.3415-704,707 PLAT N05'10'43"W 155.F NO5'10'43"W 7.05 N05'10'43'W 23.2 NO2'36'21'W 29.23' NO2'36'21•W 100.42' T. M. 69-SM NOS'56'25'B REVISED LOT 7 166.07' E.C.ACKERMAN TRUST D.B.4733-23 0.8.4733-20 G 21 PLAT N04'54'11 D.B.4456-444 71. 02' D.B.3530-234 PLAT N04'54'11 5.37' STATE ROUTE B03 (30'PRESCRIPTIVE EASEMENT) GOODLOE LANE T. M. 59-66 LOT 1 FRANK DONLEY G CARLA DONLEY D.B.3380-82, 55 S 86 PLAT GRAPHIC SCALE i"=200' 0 200 400 S70'00'00'E 35.00' — N05'50'52-11� 7.49' N04'26' 19"11--"' 245.20' S85'19'28"M--� 26.09' N10'02.00"Wl 50.95' VDH MONUMENT FOUND M03'34'29'W — 224.63' VON MONUMENT FOUND S70'OO' OO'E 102.98' T.M.69-19G REVISED LOT 6 2.63 ACRES 15.nn• (2.55 AC.) T.M.69-19F REVISED LOT 5 4.63 ACRES WOO AC.) [4.55 AC.) " T.M.59-19E REVISED LOT 4 4.62 ACRES (0.07 AC.)-,1 4) T.M.69-i90 "y REVISED LOT 3 4.56 ACRES (o,Os (4.51 AC.) (3.33 AC.) (30•PRESCF DLO TURNPIKE ROAC LOT 7 m LOT 6 To (5.72 AC. 0.26 AC.) T.M.69-19C REVISED LOT 2 7.70 ACRES OVERHEAD Pd UTILITY LINE (6.56+/- ACRES) (2.35 AC.) j&r.9 \fit j9kw E A2� rn � D�. m REVISED F (3.01 AC.) T.M.69-50B Q 8.73 ACRES T.M.69-198 mPOL REVISED $ IS AT ~ \ LOT 1 Al 0, " ACRES IK.A 226. 3.64 31 M l VON MONUMENT FOUND 3i `M T '' A2'Z�• �,af(E Sj1 P� A°pIM FOUND SCALE: i' - 200' 21„ REVISED. NOVEMBER vo��14 4, 021 REVISED: NOVEMBER MONUMENT B•'r 29.2021 REVISED: FEBRUARY 3, FOUND w'P' 2022 ROGER W.RAY G AS90C- INC. 663 BERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING. CON SHEET 3 OF 3 14912A VIRGINIA V/DHOF HEALTH DEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19E RD ID: 101-22-0300 Well Class: Class IIIB (Cased and grouted 50' minimum) PERMIT NOTE: Well Number 9 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IIIB private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19E HDID:101-22-0300 Page 2 of 2 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-healthJkmn-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027 Sincerely, / Ole Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System n Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 465 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 465 2nd Street BE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Directions to Property: Subdivision: Tax Map: VA 22920 WELL 9 69-19E VDH USE ONLY Health Dept. ID# Due Date: Phone: 512-426.4728 Fax: Phone: Phone: 434-981.3034 Fax: Email: simpson@oft�onsbuctionmenagemem.Com Section: Block: Lot: Other Property Info: Acreage: 4.62 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter ED Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 5 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement Yes Walk -Out Basement? 171 Yes Fixtures in Basement? ID Yes ❑ No ❑ No [] No Conditional Permit Desired? ❑ Yes p No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter/ ❑ Yes" 21 No '"There is a $50 fee for determination of Minihitil Water Supply Will the water supply be ❑ Public or ❑,: Private Is the water supply ❑ Existing or ❑ Proposed If proposed, is this a replacement well? ❑ Yes No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within SU of the well be termite treated? ❑ Yes ED No All Applicants Is this a private sector OSE/PE application? Yes ❑ No If yes, Is the OSE package attached? Yes Is the property intended to serve as your (the owners) principal place of residence? ❑ Yes n No El No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water supplies, a - - - - - o .o4uucu. 1110 one ana.cn arwmra snow your property tines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the p sewage sites must be dearly marked and the property sufficiently visible to see the topography - Sion too the Virg'artment of Health to enter onto the property described during normal business hours for the purpose of p g this application an doo rrorm quality assurance checks of evaluations and designs certified by a private sector Onsite Soil Evaluator or sional E i�5 �gpec s until the sewage dispose! system and/or privets water supply has been constructed and approved. CMIS0 HELTZEL U w �f Lic 1940001460 R gat t Sign �. Ag t 4 Date 7�yee.eWrr p....e1rw.Mar.eti ar rn..�fvrrAuaesr6a»r.6.. an. ardwTtmi! XUUMptCIah OVAE"WW- Dow Daa Fees HDID# FStGtnpiul+isotY.------- type c 9 SHD 0 �_� Rraeipe Y Page I of t0 ❑ Construction Permit ❑ Repair Permit OSEIPE Report For: ❑ Voluntary Upgrade ❑ Ceri fcation Permit Letter ❑ Subdivision Approval Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 9 GPIN or Tax Map # 69-19E Health Dept. ID #* Latitude: Longitude, Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Chadotfesvl/le, VA 22902 Prepared by: OSE Name: Chris Helttel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: 6/22/2022 Date of Revision #1: Date of Revision #2: Contentstindex of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Specifications 4. Well Location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAtfemative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and alternative onsite sewage systems has been discussed with the ownedapphcant. C The we cover page has been conducted under an. exemption to the practice of engineering, specifically the axe Lki tf1%ireyl�iyu Section 54.1-402.A.11 7 I recommend the V� Construction Vet ❑ Subdivision Approval be: 0 Issued p aawgwft Lette i ❑ Repair Permi ❑ Voluntary Upgrade ❑ Denied >� Lic No. I94000I460 oariFE signam „ N, Date: ( C � The form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12/01/14 Heltzel Soil Consulting Page of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax MapjGPIN #: 69-19E Property Address: TBD Subdivision: WELL 9 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3B Minimum Casing Depth: 50 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: c50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit Page S of The proposed well site shown herein, 0 1. Is located a minimum of 50 feet from all property lines. Q X 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. [� i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. Q ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q L Written permission from the adjacent property owner's) for the well construction. 0 ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that rpy�property is not used for an Agricultural Operation as defined in Dat Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC 1412 Seums0le Road, Maurertown, VA 22644 MM 17.2 WELL LOCATION SKETCH TM # 69-19E ALBEMARLE COUNTY, VA A�O z w 100.00, c WELL AREA August 12, 2022 DRAWN BY: SNV #10 / 21 N W #23 /T.M.69-19E EVISED LOT 4 4.62 ACRES Page ` of b REI \ gnE141\ � O' BO' 160' 240' PROPOSED LOT LAYOUT / SANITARY SURVEY �'-°T b e554. 1A1 d9bG. VA 229M l Soil Consulting, LLC MBev 99A, STOCKTON CREEK SBD, ALBEMARLE CO, VA PD IIIII'OFTBB➢ROPo9ED DRADiPIBiJ)3 ABH 9BOWfi. ST.RT.750 (30TW25m"VE EASEMENT) NOT TO SCALE SMART TAILOR SMACK i 0.13.5m-521 0.0.3415-704.707 PUT / x' II I I. am POlID I I 11 >am .,,m e TERMM 11 RE+ASED LOT T EC 1RUM Sl 0.9.4 3 O.B.g53-20 t 21 PLOT 1 I mo. 9 23A PLAT I 1 II 1 STATE ROUTE 803 11 1 (30`Ts DE I COODI LANES �e alb T.0 e9-BD I I FRANK C MEY t - 0 8.aw 9S6 Fa191RCA DT (/ y� wB WOBUMFNT FOUND wB 00. 0U OURD-/ LINE a�uSRpb YaM�q�O SAN FLTNMIT EXISTING LOT LAYOUT 1 SANITARY SURVEY P6P a Pr 4, Heltzel Soil Consulting, LLC AIL %NDWN WFL $6DRAD FIIMD 9RSS RlR3@ Pow 5B0,va,,m�,VAz STOCKTON CREEK SBD, ALBEMARLE CO, VA NpOF' TEPRDPOfiEDD& N HISARESRO N. �`ST.RT.750 (30PRESLRIPRVE EASEMENT) OlD NRNPIKE ROAD NOT TO SCALE T.M.B9-SL WT6 STUART TAILOR RUCK D.9.5246-521 D.B.3415-704,707 PLAT Mal) am POND REMISED LOT 7 E.C.ACKERMAN TRUST 0.8.4733-23 0.8.4733-20 @ 21 PLAT D.R.44B6-d D.B.Si10-234 PµT STATE ROUTE 803 c3D w� � FNT) T.u.e9-w LOT 1 FRANK D MAW D.R.33BD-62, 85 k B6PAT ON MONNUMINT FOUND i ..ocim "F PER::. : .... ..... ..... $ _ o ^ r OVERHEAD ... P .U,y�_ Oq �' 2 rV\ UUNE O��iBfgMD N�R4�0 .:ii...:.J@� MM 263 AQ9F5 iPOLE.c.. OVERHEAD 0� UDeUTY uNEs MOND Foul OS ACRES Mail MA9-IN REMSFD LOT O IR.Ml4D A9 A6T ACNE$ V MWED 7 5 VVV UME VDH FWND9T a 59-1AB VOR NEt13RtDT 1 MONUMENT SEDUn4 T.M.W-18C 1944CN6 FOUND AW ACNFS REMSED LOT 2 T.A AC CORNER IN FENCE POST W14 MONUMENT FOUND N FOUND MONUMENT FgMD rA1.W-190 VON NCN6' SSP�RaPO� FWVFN7 NEDN CFO'�p$F-�SNg B .ptl / WH (V �041Y� 3HM10 / MaOUNpr W111Pg 2 ^August 21,2022 THE PLATTINGIOR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T.M.59-508,REVISED LOT 1,REVISED LOT 2,REVISEO LOT 3. REVISED LOT 4,REVISEO LOT 5,REVISED LOT 6,REVISED LOT 7 G REVISED LOT 8 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S). PROPRIETORS. AND/OR TRUSTEES,IF ANY. FOR: STOCKTON CREEK, LLC CITY/COUNTY OF C(:o.1.Nrr.Gfe STATE OF V:a,4s THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME TH�IS'3 DAY OF Fily 2022. BY A:../e 04,6. FOR: STOCKTON CREEK, LLC NOTARY PUBLIC : f7YQj(p7 MY COMMISSION EXPIRES : �%�- Xµ 2o2j APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC I TANGENT CHORD CHORD BEARING Ci 15.'48'.16' 1964.66 541.981 272,72 540.27 563'33'04-E C2 4'44'04' 1090.92 90.14 45.10 90.12 Si8'39'29'W C3 9'59'39' 1085.92 199.42 94.95 169.18 S38'31'21'W C4 14'56'55' 1090.92 284.62 143.12 263.82 955'59'54'W C5 1'20'52' 1487.79 35.00 17.50 35.00 S72'22'45"W C6 22'41'29' 1487.79 589.22 298.52 585.38 S60'21'35"W C7 21'31'58' 167.57 52.98 31.B6 62.61 N05'35'i6"E CS 32'53'50' 94.14, 54.05 27.79 53.31 N32'48'10'E C9 8-13'55- 94.14 13.53 6.77 13.51 N53-22.02-E C10 15-57'08- 184.27 51.30 25.82 51. 14 N65'27'33'E BOUNDARY LINE REVISED REVISED LOTS THE PROPERTIES LOCATED ON U.S. ROUTE STATE ROUTE 151 STATE ROUTE 75( AND STATE ROW SCALE: i' = PLAT 69-508 DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29,2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY G ASSOC.,INC, 563 BERKMAR COURT CH TELEPHONE LL(434) 293 3195901 RAYSURVEYING.CCM �- BRIAN S. RAY Lk. No. OD2281 02/03/2022 75a 250 OLD ROCKFISH I TURNPIKE GAF 7ly(C ROAD. PJfWPIKE BD3 GOODLOE ::;GITE:':::7 LANE I5i 637'. CRITZERS DICK SHOP :WOWS ROAD ROAD .:CRITZERS SHOP VICINITY MAP 1'=2000'+/- SHEET 1 OF 3 BYEPLACIINGSHIS%HER SIGNATURETONSTHISTPLAT HE/SH[DHAS DEEMED THAT THEY ICORRECT OAF NDLIN ING. ACCORDANCE WITH THE ALBEMARLE COUNTY ZONING ORDINANCE IN EFFECT THIS DATE. THESE NOTES ARE NOT RESTRICTIVE COVENANTS RUNNING WITH THE LAND AND THEIR APPEARANCE ON THIS PLAT IB NOT INTENDED TO IMPOSE THEM AS SUCH. ANY REFERENCE TO FUTURE DEVELOPMENT RIGHTS SHOWN HEREON IS THEORETICAL. A. T.M.59-198, 19C. 190. 19E S 196 ARE ZONED RAIENTRANCE CORRIDOR). T.M.59-19F IS ZC EO RA. T. M. 59-19H, 190 6 508 ARE ZONED RA (ENTRANCE CORRIDOR G FLOOD HAZARD OVERLAY). B. T. M.59-19B(REVISED LOT 0 RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-19D(PEVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED- E. T.M.69-19E(REVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISEO LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M,69-19G (REVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. H. 'I. T. M.69-19J(REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-190 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 19BO BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.59-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FARTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA. EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4. 2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE.. L. SETBACK REQUIREMENTS: FRONT- 75'. SIDE= 25' 6 REAR= 35'. 'M. ACCORDING TD THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS, ADDRESS 6 LEGAL REFERENCES: T. M. 69-19B, 19C, 19D, ISE, 19F, 19G. 19H, 191 G BOB STOCKTON CREEK,LLC 455 SECOND STREET,57H FLOOR,CHARLOTTESVILLE.VIRBINIA 22902 D.8.5657-263, D.B.892-159 PLAT G 0.8.683-,4 PLAT. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY.. 3. T.M.69-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-409 G INST.A202200001316)., B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEI COMPANY W.B.232-585). 4. T.M.69-500 IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(D.B.209-261). 5. T.M.69-190. ISE. 1SF, 196, 19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-4041 B. T.M.69-19D. 19E, 19F, 19G, 19H G 19J ARE SUBJECT TO, AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D-8.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF CORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIG�ITS IST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELSIOR EXBINGUISH DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJECTi TO A Y ADDITIONAL CONDITIONS.UTILITIES.EASEMENTS AND/OR COVENANT THAT MAY EXIST- S. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS T.M.69-19B(LOT 1) = 6..51+/- ACRES T,.N.69-1SC OT 2 - 5.77+/- ACRES T,.M.69-190 ILOT 3 - 5..15+/- ACRES TM.69-19EILOT 41 - 5..45+/- ACRES T.M. 69-19F ROT 5) = 6.68+/- ACRES T.,M.69-19G(LOT 6) - 5,88+/- ACRES T.M.69-19H(LOT 7 = 5.12+/- ACRES T.M.69-19J(LOT 81 = 6..56+/- ACRES T:M.69-500 - 9.:35+/- ACRES DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY G ASSOC.,INC. 663 BERKMAN COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (434) 293-3125 RAYSURVEYING.COM SHEET 2 OF 3 14912A LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(f00 YEAR FLOOD PLAIN) ACCORDING TO THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 D2250. 0 a m N T.M. 69-BL LOT 5 N73'26'07' STUART TAYLOR SMACK 2.53' D.B.5246-521 D.B.3415-704,707 PLAT �( NO510'43'W 155.57'— N05'SO'43'W 7.09.E N05'10'43"W 23.271-_ NO2'36'21'W 29.23'� NO2'36'21'W 100.42' T. M. 69-GM N08'55'25'0 .K REVISED LOT 7 E.C.ACKERMAN TRUST 166.07' 0-9.4733-23 r O.B.4733-20 G 21 PLAT N04'54'11 a D.B.4456-444 71.02' z D.B.3530-234 PLAT o N04'54'11 5, 37' NO3'44'OE 154. 34' STATE ROUTE 803 (30'PRESCRIPTIVE EASEMENT) --- GDOOLOE LANE N05'50'E 115.2. E5CR ROAD S70'00' 00'E 102.98' YOH O.OB AC. IS "..... G �'t LOT 7 m (6.56+/- ACRES) e ti f / . MONUMENT �i , T.M.69-196 �Y �A1 LOT 6 o T T" 1 REVISED LDT 6 om ( '� m 1 y v 51 33 99' 2.63 ACRES m to P e5.e0• 12.55 AC ) SLn I3. 33 AC.) !�?C% I y a IS T.M.69-19F REVISED LOT 5 4.53 ACRES WOO AC.) (4,55 AC.) T.M.69-19E REVISED LOT 4 4.62 ACRES (0.07 AC.), 1 . I5.72 (2.36 AC.) REVISED (3.01 Ac. ) : T. A4. 69-50B B.7 ACRES T.M.69-198 m REVISED $ LOT 1 N7� �.A It 1 0.26 AC.) T.M.69-19C REVISED LOT 2 : 7.70 ACRES i n 'W VDH �.,_24.01 "1.57` ' °' •.� Oi 66 VON FOUND ! MONUMENT 7.49' l AA is IS ND I N04'25'19'W f. T.M. 69-19D REVISED LOT 3 Ff7Q? IF` 59' S71'33•II339O(W 183.01f' T. M.69-fiG 245.20' ) l 4.56 ACRES b 3iA' .Zi M ,SR3AL MONUMENT LOT 1 (- - (0.05 AC.1' A2 E, p FOUND FRANK DONLEY 6 CARLA 0ONLEY SB5'19'28"M. 26.09' IF (4.51 AC.) �� SS STD *SE 9tI7.t4s v1LD7gi_Z,il SCALE: 1 �' = 200 DATE: SEPTEMBER 27.2021 D.8.3380-82, 85 G 85 PLAT NS5025' 50.95' YDM t1 i3-��Yof1 Bye REVISED: INOVEMBER 4, 2021 NOVEMBER YDH V M I G6 MfFOU� T o REVISED: 29.2021 FOUND ,_ MCt •F'e REVISED: 'FEBRUARY 3, 2022 � GRAPHIC SCALE 1"=200' N0224.53' 224.63' ROGER W, RAY INC. •'{,, J ATy A6 •Yd D 200 400 VDH MONUMENT FOUND - VOH MAR COC.. 663 ERKMpR, COURT CHARLOTTESYILLE, VIRGINIA 22901 W.h% N66'37'2f'M 24.79' MONUMENT FO(11� TELEPHON : (4T) 293-3195 RAY URV Y NG.COM SHEET 3 OF 3 149 VIRGINIA VIDHOF HEALTH DEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number. 69-19F HD ID: 10 1 -22-03 01 Well Class: Class IIIB (Cased and grouted 50' minimum) PERMIT NOTE. Well Number 10 Dear Alan Taylor: Page 1 of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-43 10 Fax This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IIIB private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19F HDID:101-22-0301 Page 2 of 2 This construction permit is transferrable until expired or deemed null and void. A permit transfer form may be found on the VDH website at littp://www.vdli.vir2inia.sov/environmental-health/gmp-2015-01- fonns/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to constrict a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System El Water Supply Owner: Stockton Creek LLC Go Alan Taylor Mailing Address: 455 Second Streat SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 495 2nd Street BE, Suite 201 Charlottesville, VA 22902 Site Address: TeD Directions to Property: Subdivision: Tax Map: VA 22920 WELL 1 69-19F VDH USE ONLY Health Dept IDB U - 22.0 361 Due Date: Phone: 512-426-4728 Fax: Phone: Phone: 434-9813634 Fax: Email: gimp$on@adaswnstruceonmanagementwm Section: Block: Lot: Other Property Info: Acracnc• a Al Sewage System rpe of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage stem and to apply for a oomstruction permit (valid for 18 months; only when ready to build. ❑ Certification Letter ❑� Construction Permit ❑ Subdivison Approval ❑ Repair •oposed Use: ngle Family Home (Number of Bedrooms) 5 Multifamily Home (Total S of Bedrooms) :her (Describe): Basement 0 Yes Walk -Out Basement? C] Yes Fixtures in Basement? El Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. ma)imum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes— 0 No "There is a $50 fee for determination of elinihillty Water Supply Will the water supply be ❑ Public or E) Private Is the water supply ❑ Existing or I] Proposed If proposed, is this a replacement well? ❑ Yes 0 No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildin s within 50' of the well be termite treated? ❑ Yes No All Applicants Is this a private sector OSE/PE application? Yes ❑ No If yes, is the OSE package attached? (] Yes Is the properly intended to serve as your (the owners') principal place of residence? ❑ Yes ❑.� No El No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water supplies, a nru" M ON. ., ,,,,,,,,, , — a,ra ,, 11 auvuw snow your property lines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location, and the proposed well and sewage sftes must be clearly marked and the property sufficiently visible to see the topography. I give pemi r Qtq 6gitt,r�partment of Health to enter onto the property described during normal business hours for the purpose of processi ^ 4 si' piirztion a d� igrr, quality assurance checks of evaluations and designs certified by a private sector Onsde Soil Evaluator . or Pro 71311 Engineer as nede's until the sewage disposal system and/or private water supply has been constructed and approved. CIIRISTUPNL S � L } y{ELT%E�I Z r,ZZ— Z�3o (o400014G0 I Date sa+a+ueaaYarrna:7�wla.gal11r+r�wranf.frriaiaaarwafLie.rraA9, inr4ar'at4�19 VIOntiftonlR Dm 8aaarcd• • Fse 8,�,,,,� �� HDID # lttrtenoBaf sues 0 Pa;'nk#a 4~ O M* _ _ -s - , — p4milpt R -- Page 1 of OSE/PE Report For: 0 Construction Permit ❑ Repair ❑ Voluntary Upgrade ❑ Certification ❑ Subdivision Approval Permit Permit Letter Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 10 GPIN or Tax Map #: 69-19F Health Dept. ID #: ( i - 2 2-0301 Latitude: Longitude: Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltrel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Date of Report: 8/22/2022 Date of Revision #1: _ Date of Revision #2: of this report: Sheet 6. Existing Lot Sanitary Survey 14. Well Location Sketch �eraurrauon araiemenc I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5.610), the Private Well Regulations (12VAC5-630), the Regulations forAttemative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and alternative onsite sewage systems has been discussed with the owner/applicant. G The work attacned to this cover page has been conducted under an exemption to the practice of engineering, specifically the exemption in Cod irginia Section 54.1-402.A.11 1 recommend that a: t�1 ❑ Subdivision Approval be: ❑ Issued Certification LetttRepair Permit ❑ Voluntary upgrade ❑ Denied oacn-esignature o +°vo°XQ(A Dater �z \`44 x oustTt �sa The fans contains personal information subject to disclosure under the Freedom of Information Act. Revised 12/01/14 Heltzel Soil Consulting Page '�L of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: /01- Z 2 -0301 Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19F Property Address: TBD Subdivision: WELL f0 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): p Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3B Minimum Casing Depth: 50 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act Addendum to AOSE/PE Certification Statement For Private Well Construction Permit Page � of The proposed well site shown herein, Q 1. Is located a minimum of 50 feet from all property lines. 1=1 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. i ] i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. OX ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, 1 have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. Q ii. I certify that no other site on the property compiles with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm tha�y property is not used for an Agricultural Operation as defined in § 3.1-22.2 the Coae of Virginia . O to Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to amply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner pate Heltzel Soil Consulting, LLC 1412 Saumsvllle Road, Maun:rtown, VA 22644 z w LL 51T 100.00, c WELL AREA August 12, 2022 DRAWN BY: SNV WELL LOCATION SKETCH TM # 69-19F ALBEMARLE COUNTY, VA T.M.69-19F REVISED LOT 5 4.63 ACRES V40 WELL #23 21 Page �( of M� 17' /T.M.69-19E EVISED LOT 4 T. �' BO' 160' 24o' Heltzel Soil Consulting, LLC PD BOF SSM1, WaotlebA. VA 2RN NMSEeD LOT RE7 EC ERMM TRUST D.8.4733-23 D.B4733-20 B m PLAT D.B.M 2M D.B.3530-236 FIAT STATE ROUTE 803 (WPR CEO PW C&S MOMT) PROPOSED LOT LAYOUT / SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA NOT TO SCALE Heltzel Soil Consulting, LLC PD Bax 554. WmEebd, VA2 T.M.69-BL LOT 6 SMART TAR SMACK D.R.5246-521 D.R.3415-704.707 PLAT TA.69-BM POND REMSED LOT 7 E.C.ACKERNAN TRUST D.9.4733 23 D.9.473 20 a 21 PUT D.R.443fi-4K 0.9.3536-234 PU' STATE ROUTE 803 (30'PRE'O7iA�OPn4EEASSDAENT) r:x � FRANK DMaEY CARD DONRET A x' S M7 MJN MCNUMFAT EXISTING LOT LAYOUT / SANITARY SURVEY Pw_,P of 8 STOCKTON CREEK SBD, ALBEMARLE CO, VA Aux owN weE saoxpwnE nsr Fswmm 200' OF 771E eRDP03®DILAMFlELp3 APS SRO W N. ST.RT.750 (30PRFSCRIPT1W EASEMENT) -OLD MRNPIKE ROAO NOT TO SCALE NOT 1 1J l.�CYLL NmmE T 4PPRonwTE / -.. .. .._.. : :cr.. camMFF .. e.:.. ... UlUTf WE �R •" O �. °"° Pe P� H uo R/w LY.6 lw ..� MCN 4RFl SPD LOT 8 _ 20 AWES Y D /-1TRIS V I OREAMEAB Umm Q I 4FOU T,Y M FOUI an Awns 3 TN49-1RF LY.�-19J m Q\ S R LM 6 RF45ED LOT B bry 4.0 {.63 AOR6o fl9R1/-ACRESLE �ry P� FOUND _ WH v .YAB-196�LOT�t MONUMENT 9D) LM 4 tM69-IBC � FW0 4.6T AWES RENSFD mcmER T T.A AGFS �`� FENCE POST TM1 Q MONUMEN 4DN FOUND ua mT WH FOUND T.Y.69-f9Y UM RE1LM ] 15\ IXIU Am 36 AAM R�� A9 FWND SDAt6'�f.E9 R TT11 IR' 41r }N8D MONUME T p.e.Y26R TAugust 21, 2022 THE PLATTING.OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED 7.9.69-508.REVISED LOT S,REVISEO LOT 2,REVISEO LOT 3. REVISED LOT 4.REVISEO LOT 5.REVISED LDT G,REVISEO LOT 7 G REVISED LOT 8 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S). PROPRIETORS.AND/OR TRUSTEES IF ANY. FOR: STOCKTON CREEK, LLC CITY/COUNTY OF GGs.�rk6rh STATE OF W.t.�,Ini� THE FOREGOING 10 WAS ACKNOWLEDGED BEFORE ME TMBS' DAY OF f"tWg' 2022. BY 4 r, �o.l.,.. FOR: _STTOOCC,KTTON CREEKK.. LLLL'CC NOTARY PUBLIC - ({� 0Z� MY COMMISSION EXPIRES :�e% 71rr q,pZTps~ �7-1 APPROVED FOR RECORDATION : GL NOTARY SEAL LOCA CURVE DATA .LINE DELTA RADIUS ARC I TANGENT CHORD :CHORD GEARING Cl 15'48116" 1964.86 541.98 272.72 540.27 S63'33'04'E C2 4'44'04" 1090.92 90.14 45.10 90.12 SIB'39'29"W C3 . 9'59'39 f085.92.: 159.42 94.95 189.18 S38'31'21"W C4 14'56'55" 1090.92 294.62 143.12 263.82 S55'59'54"W C5 1'20'52" 1407.79 - 35.00 17.50 35.00 S72'22'45'W C6 22'41'29' 1487.79 589.22 298.52 585.38 S60"21'35-W C7 21'31'58- 157.57 62.98 31.86 62.61 N05'35'16"E CG 32'53'50". 44.14 44.05 27.79 53.31 N32-48.10"E C9 8'13'55" 94.14 13.53 6.77 13.51 N53'22'02"E Cf0 15'57'OB" 18 4.27" 51.30 25.82 51.14 N65'27'33"E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND IEVISED LOTS 1.2.3.4.5. S. 7 6 B SCALE: 1' = DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29,2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY B ASSDC..INC. 563 BERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: 1434) 293-3195 RAYSURV PING. COM RRTAN S. RAY I&. No. 002281 02/03/2022 GOODLOE LANE 15 637 CRITZERS DICK SHOP '.WOODS ROAD ROAD ro.rvmc VICINITY MAP 1'=2000'+/- SHEET 1 OF 3 A. T.M.69-19B. 19C. 19D, 19E G 196 ARE ZONED RA (ENTRANCE CORRIDOR). T.M.59-19F IS ZONED RA. T.M.69-19H,19J 6. 508 ARE ZONED RA(ENTRAMCE CORRIDOR G FLOOD HAZARD OVERLAY). R. T.M.69-19B(REVISED LOT 1)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATIDN. C. T.M.59-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. 0. T.M.69-190(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.69-19E(REVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.59-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.59-19G(REVISEO LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. H. T.M.69-19H(REVISEO LOT 7)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. T.M.59-19H. WHEN I. T.M.69-19J(REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 19BO BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.iM.69-50B RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIS DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REQUIREMENTS: FRONT- 75'. SIDE- 25' G REAR= 35'. M. ACCORDING TD THE COUNTY OF ALBEMARLE GIS DATA,THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N, ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA. THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIB DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS. ADDRESS B LEGAL REFERENCES: T.M.69-196. 19C. f9D. ISE 19F. 19G, 19H. 19J 6 508 STOCKTON CREEK, LLC 455 SECOND STREET. STH FLOOR, CHARLOTTESVILLE. VIRGINIA 22902 0.9.5657-263. D.B.892-159 PLAT S D.B.683-44 PLAT. 2, THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.254-409 G INST.A'202200001316).. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICE. COMPANY(D.B.232-585). 4. T.M.59-508 IS SUBJECT TO AN EASEMENT TO THE CHPAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAYI APPLY(0.3.209-261). 5. T.M.69-194 19E,19F,19G.19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY (a. B.264-404) 5. T.M.69-19D. ISE. 19F, 190. 19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF jp1ECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS E%IIST.TNE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELSIOR E%XRRINGUISM DEVELOPMENT RIGHTS. S. NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN Y ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJECT TO A�IY ADDITIONAL CONDITIONS.UTILITIES,EASEMENTS AND/OR COVENANTS TRAT MAY EXIST- S. ACREAGES BEFORE THIS BOUNDARY LIME ADJUSTMENT AS PER TAXATION RECORDS: T.M.69-19B LOT 1 - 6.51+/- ACRES T,M.69-19C HOT 2 - 5.77+/- ACRES T.M.69-190 OT 3 - 5.d5+/- ACRES T,M.69-19E(LOT 4) - 5.45+/- ACRES T.M. 59-19F(LOT 5) - 5:68+/- ACRES T,M.69-19G(LOT 6 - 5,80+/- ACRES T.M.69-19H (LOT 7 = 5.12+/- ACRES T.M.69-19JO-OT B) 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4.2021 REVISED: NOVEMBER 29. 2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY G ASSOC.,INC. 653 BERKMAR COURT CHARLOTTESVILLE VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM LEGEND: IF IRON FOUND IS IRON SET ......- EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION -OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO THE FEMA FLOOD INSURANCE RATE MAP, EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 51000B 02250. y m i� x 0 STATE ROUTE B03 (30'PRESCRIPTIVE EASEMENT) GOOOLOE LANE T. M. 69-56 LOT 1 FRANK DONLEY 6 CARLA DONLEY D.B.3380-82, 85 6 86 PLAT GRAPHIC SCALE i'=200' 0 200 400 S70'00.00"E 35.00, T'. M.69-fiL S70'00'00'E LOT 6 N73 26'07"E f02.9B' '. STUART TAILOR SMACK D. B.5246-521 2.6`'1j� •( D.B.3415-704 707 PLAT .�01 ND5'10'43'M 155. N05'10'43"W 7. N05'10 43'W 23. M02'36'21'W 29.2: NO2'36'21'W 100. 42' NO2'35'21'W 40.00' T. M. 69-6M NOB'55'25'W REVISED LOT 7 166.07, E C ACKERMAN TRUST O 8. 4733-23 D. B.4733-20 6 21 PLAT N04'54'11" 0. B.4456-444 71.02' O. B.3530-234 PLAT N04'54' 11 5.37' N04'26'19'W-� 245.20' SBS-19'28"W_ 26.09' N10'02'GO'M'�- 50.95' " MONUMENT FOUND VOH MONUMENT T.M.69-196 REVISED LOT 6 2.63 ACRES 15t00- (2.55 AC.) T.M.69-19F REVISED LOT 5 4.63 ACRES (4.00 AC.) ,.�4.34'E _ . T E 14.55 AC! T.M.69-19E REVISED LOT 4 4.62 ACRES Jk 1A (0,07 AC T.M.69-19D REVISED LOT 3 4.56 ACRES (0.05 IF (4.51 AC.) OVERHEAD T•;' UTILITY A j +.. `p ''f+ •. L07 7 I1'm 16.66+/- ACRES) j, m 4} j Mp OUDH 7 } �UND SLOT 6 To ,._ i• m .......: `.�ap•� v 33.99' 13.33 AC.) iiax?S�v i1'S OVERHEAD . B F c ULINES R� S69 b0(2 66 AC .j ,'" ....:T C .¢ b y VDH di MONUMENT IS s w �; l0T 1 . •_ ••••y�, `n FOUND '54'02'E �2 AC.) c : R 19. 15' 4`''is IS ``ev> low A' Is y hod REVISED POLE 63 AC, m* 1 • (3.01 AC.) v T. M. 69-508 >L°,�•D`a 15s.e7 IF :. 8.73 ACRES d" ,• Is m ."e' Is (5.72 aC-! T.M.69-196 MONUMENT d g y REVISED y Is A, 1 FOUND is 3,64 LOT 1,VON N76•�13fi+WAi MONUMENT (0.26 AC.) ` N ACRES I�•31 '...-FOUND T M 69-19C 1. 43.00.47'W T w REVISED LOT 2 * i e' .. CORNER f IN O�O�{ ,S 7.70 ACRES n VDH FENCE POST "� •� i 0 MONUMENT qc o 0, + , �.• NVOH UMERT FOUND MDFOUPD Fou�1m r 13� t ��gw » i SCAL : i" = 200' DATE: SE TENSER 27, 2021 2021 IN�"s•il�tY'! REVISED: OVEMBEREVISEMINOVEMSR 29, 2021 1!(/' REVISED: IFEBRUARY 3, 2022 ROGER W.RAY 6 ASSOC..INC. 653 PERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 'FT.All TELEPHONE: (4-E4) 293-3195 RAYBURVEYING.COM SHEET 3 OF 3 149 RGINIA VDHOFIHEALMH DEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19H HD ID: 101-22-0303 Well Class: Class IIIB (Cased and grouted 50' minimum) PERMIT NOTE: Well Number 11 Dear Alan Taylor: Page t of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434)972-6219 Voice (434) 972-43 10 Fax F1,32, a 1 1 This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IIIB private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets sey.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. Phis authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19H HDID:101-22-0303 Page 2 of 2 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.virainia.gov/environmental-health/vymp-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel Application for: ❑ Sewage System COMMONWEALTH OF VIRGINIA Ej Water Supply Owner: Stockton Creek LLC 0/0 Alan Taylor Mailing Address: 455 Second Street SE, 9 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville VA 22902 Site Address: TBD Afton, VA 2292D Directions to Property: Subdivision: Comer of Route 250 6 Route 151 WCr r „ VDH USE ONLY Health Dept. IDO Due Date: Phone: 512.4264728 Fax: Phone: Phone: 434-9813634 Fax: Email: slmpson*auesconstructionmanagemmtwm oewon; Block: Lot: Tax Map: 69-19H Other Property Info: Acreage: 11.03 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage System and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter R1 Construction Permit ❑ Subdivison Ap proval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 4 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement 0 Yes Walk -Out Basement? 10 Yes Fixtures in Basement? Q Yes ❑ No ❑ No ❑ No Conditional Permit Desired? El Reduced Water Flow ❑ Yes ❑' No If yes, what type of conditions are desired? ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use 1 Po rY (yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑Yes— F±1 No "There is a $50 fee for determinafi�, of snare, Water Supply Will the water supply be ❑ Public or ❑ Private Is the water supply ❑ Existing or El Proposed If proposed, is this a replacement well? ❑ Yes No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildin s within 50' of the well be termite treated? ❑ Yes LD No All Applicants Is this a private sector OSE/PE application? Yes ❑ No If yes, is the OSE package attached? [0 Yes Is the property intended to serve as our the owners' ❑ No Y ( ) Principal place of residence? El Yes � No igi�40i��gwage sites must be clearry marked and the property suffixiently visible to see the topography. rlsrslon to the artment of Health to enter onto the property described during norm! business hours for the puryosa of this application rid orm quality assurance checks of evaluations and designs certified by a private sector Oneite-Soil Evaluator oriel E " - _- - - until the sewage disposal system and/or private water sup ply ppty has been constructed and approval. L,cN0.194�p1460 j 122(22�. Date 'cars.�uarrr.�raYkr6ur-pMia,pa.Aia.ws..eraaFrnsrw.rlWna.oy 6tl. t4,prr4laetf 31= 11111n t9 DWA Ensued: Drto Dan Fee S HDID 9 FttANW twos Y NYMM MWabeak 9 OW @ _ ` Receipt # page— ( of Construction Permit ❑ Repair Permit Property Location: 911 Address: TBD Lot: or Tax Map M Section: 69-19H owner: Name: Address: Stockton Creek LLC c/o Alai 455 Second Street SE, # 201 Prepared by: OSE Name: Chris Hehzel Address: PO Box 554, Woodstock, VA PE Name: Address: mtentsMdex of this report - Cover Sheet 1 Well Specifications Well Location Sketch Proposed Lot Sanitary San OSE/PE Report For: ❑ Voluntary Upgrade Permit ❑ Certification Letter Subdivision: WELL 11 Health Dept. ID #: Longitude: Date of Revision #1: Dale of Revision #2: 6. Existing Lot Sanitary Survey City, State, Zip: 22902 License # License # ❑ Subdivision Approval VA I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Weil Regulations (12VAC5.630), the Regulations for Alternative Onsite Systems (12VAC5.613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and alternative 7naite sewage systems has been discussed with the ownertapplicant. 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.A.11 recommend that a: Permit Subdivision Approval be: El Issued � r El ❑ Repair Permit ❑ Voluntary Upgrade ❑ Denied S. 7 Lic`'o.119400.091ao� .' T Tr4 �'�� EOVSrfEf'��`• The form contalna personallnkume8on'au ' to disclosure underthe Freedom oflnformation Act. Date: (� Revised 12101114 Heltzel Soil Consulting Page of SYSTEM SPECIFICATIONS VDH USE ONLY HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19H Property Address: TBD Subdivision: WELL 11 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): Q Domestic Drinking Water ❑ Agricultural ❑ Irigiation ❑ IndustriallCommerical ❑ Geothermal Well Class: 38 Minimum Casing Depth: 50 ft. Estimated Water Usage: 600 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit r, The proposed well site shown herein, Page I of Q 1 Is located a minimum of 50 feet from all property lines. I X 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. E Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. EKI ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. Q ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s). I affirm tha my property is not used for an Agricultural Operation as defined in § 3. t-22. )4the Node of Virginia. ate Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission. I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting LLC 1412 Saumoville Road, Maurertown, VA 22644 19G _OT 6 RES i T.M.69-19F EVISED LOT 5 4.63 ACRES WELL #10 r? any, August 12, 2022 DRAWN BY: SNV WELL LOCATION SKETCH TM # 69-19H ALBEMARLE COUNTY, VA .................. �REpM BUFFER 363, T.M.69-19H REVISED LOT 7 11.03+/— ACRES 16V Page \ of OVERH UTILI LIN T. M REVI`. 8.924 o' IOo' ROW moo' Heltzel Soil ConsultinPROPOSED LOT LAYOUT 1 SANITARY SURVEY Page �uf b g, LLC ALLRNOWNNV&tsk DAA NR �0B TB9 WFTfl PO DOR 694 W dlWtl,. VA 22804 STOCKTON CREEK SBD, ALBEMARLE CO, VA 2WOFTl4 PROPoBED DRAINPIP.f.D3 ARP. SRO0.RV. ST.RT.750 (JD'PRESMIPTTW EASE MT) NOT TO SCALE T. LOT 6� SNM4 TAnOR SYAp( D.fl.5246-621 .., ..... / ... PE ,H, BUFFER i D.&J ?T5 .IOT RAT / OY HF"8:::.: .:: 1 F4I'�•��1 UTlUTy URE I II p0N0 11 'nm i- T.M.6 T.sw 1 1 vm um LBM R LOT 1 OT EC o DCR RUST 1 ( D.B.47J}_20 & 21 PLAT I 1 DE.416B-M 0.6.05JD-2U PUT I STATE ROUTE 8 I (JOPRmE3 n Lo T.M.69- . ) LOT 1 FRANK DO R ° , 91f'6 M CARD OWLEY O.&JJBo-02 _ 65 & ✓38 PJAi MaIW T �g1 STff Nq M .D\i `AN MONUkNT FOURDcoo YDM Ky(!pe' OV HEAD UTIuw UNEs LCORNER M VaH FENCE PORT �� T Heltzel Soil Consulting, LLC PO eox s54, wem.rod. va 2iRe4 TM.89-EL LOT 8 SMART TAYLOR SLAW D.8.UO-521 D.E.3415-T04.T07 RAT T.N.SR-BM POND RE`IM LOT 7 E.GACItFRMAN TRU57 D.8.4733-23 D.8.4733-20 h 21 PLAT D.8.4 -444 0.8.3830-234 PLAT STATE ROUTE 803 (JOT'RF OIPOVELANE Flit) T.M.W-m LOT 1 FRANK DONLEY 0.8.3.i80- RS k BB PLOT VON MONUMENT EXISTING LOT LAYOUT / SANITARY SURVEY pD �' of STOCKTON CREEK SBD, ALBEMARLE CO, VA "T] NNDwRwR sanRnwnmDsrnswmm 200'DE 1T@PROPOSPD DRADiFffiIDS ARE SROWN. STRT.7DRI 50 (3O'PRESPnw LA.SEMCNT) 7� NOT TO SCALE OVUFAIu1FTMA0 ��ZSO R MONUMENT MND V REMSm LOT B 7� '. •Y- T.M.69-IN LOT O EAD _ a Mm I OUN MONUMENT a. ADD TAI.B UW RENSEO LOT s e o - 92./➢AI a pgb'Z' AV AO8.5 d8N/- ADffi3 .8'M O r ry 'N M' `m m _ Z WI WENT _ FOUND 5 _- .M.ee-19[ pEM'52�LOI N MONUMENT SED LOT 1H AL18S FOUND A(]i5 TL.BB-IBB 4A2 REVSD OT 2 e 7.70 AQffi ENCE IN FNCE POST VON Q MONUMENT VON FOUND MONUMENT FOUND TJL82-18D li1H Rcm I M] Aoul4-Rp t ONF(MMO T 4AD 6 StP' 6Ps a 0 / MONUMENT p9?" August 21, 2022 FOUND I .... ----....— THE PLATTING�OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED T. M. 69-508. REVISED LOT 1, REVISED LOT 2, REVISED LOT 3. REVISED LOT 4.REVISEO LOT 5, REVISED LOT 5 REVISED LOT 76 REVISED LOT 8 IS WITH THE PREE CONSENT AA IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETORS.ANO/OR TRUSTEES, IF ANY. FOR: STOCKTON CREEK, LLC CITY/CDUNTY OF -ck"I 04 STATE OF 9;q"°s THE FOREGOINGi ♦N�1OFIEM7 WAS ACKNOWLEDGED BEFORE ME THSS' DAY OF F 2022. BY Ajl� D:. . FOR: STOCKTON CREEK.LLC NOTARY PUBLIC"" r•� t !+ rr MY COMMISSION EKPIRES : 1ZF'�• F 7�) APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING Cl. 15'40'15' 1964.86 541.98 272.72 540.27 963'33'04'E C2 4'44'04" 1090.92` R0. 14 45.f0 90. 12- S1B'39'29'N C3. 9'59'39'. S085.92-. 399.42 94.95 1G9.18 S38-31.21-W C4 14'56'55' 1090.92 284.52 143.12 283.82 S55'59'546W C5 1-20.52- 148779 55.00 17.50 35.00 S72'22'45'W C5 22'41'29' 1497.79 589.22 298.52 585,38 S80'21635"W C7 21'31'58' 167.57 52.98 31.86 62.61 N05'35'16'.E CS 32'53'50' 44.14 54.05 27.79 53.31 N32'48'10"E C9 8'13'SB' 94..14 .13. 53 6.77 13.51 N53'22'02"E Lf 15'57'OB' 104.2 51:30 25.82 51. 14 N6-27'33'E A"' BRiAN S. RAY LAC. No. 002281 02/03/2022 803 GOODLOE LANE THE BOARD OF SUPERVISORS DATE _ YICINITY MAP 3-=2000'+/- BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-506 LOCATED STATE ROUTE 75O(OLD TURNPIKE ROAD), AND STATE ROUTE 803(GOODLOE LANE) NEAR CRITZERS SHOP WHITE HALL MAGISTERIAL DISTRICT ALBEMARLE COUNTY,VIRGINIA SCALE: 1' = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4.2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W. RAY G ASSOC„ INC. 553 BERK14AR COURT CHARLOTTESVILLE VIRGINIA 22901 TELEPHONE: (134) 293-3195 RAYSURVEYING.COM A. T.M.69-198, 19C, ISO. 19E 6 19G ARE ZONED RA(ENTRANCE CORRIDOR). T.M.S9-19F IS ZONED RA. T. M. 69-19H, 19J G, 509 ARE ZONED RA (ENTRANCE CORRIDOR G FLOOD HAZARD OVEALAY)• B. T. 4.59-199(REVISED LOT !)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. iC. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-19D(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.59-19E(REVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-19G(REVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND HAY NOT BE FURTHER DIVIDED. H. T.M.B9-19H(REVISED LOT_7)IS_ ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. I. T. M. 69-ISJ(REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-19B AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 19BO BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.,M.69-50B RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REGUIREMENTS:FRDNT- 75'.SIDE= 25' G REAR= 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA. THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA. THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS, ADDRESS G LEGAL REFERENCES: T.M.69-f9B.19C.19D. 19E, l9F, f9G. 19H, 19J G 50B STOCKTON CREEK LLC 455 SECOND STREET, 5TH FLOOR, CHARLOTTESVILLE. VIRGINIA 22902 13.8.5557-253, D.B.092-159 PLAT 6 0.8.603-44 PLAT, 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY.: 3. T.M.59-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND PC H R COA(PANY (O.B.264-409 G INST J2022000013l6)..- B. AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY(O.B.232-5B5). 4. 7.M.59-500 IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(O.B.209-261). 5. T.M.69-390, ISE, 19F, 19G. ISM G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.284-404) 5. T.M.69-19D, ISE, 19F, 190. 19H G 1961 ARE SUBJECT TO, AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EXIIST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELSIOR E INGUISH DEVELOPMENT RIGHTS- B. NO TITLE REPORT FURNISHED. ALL EASEMENTS (71OWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONDITIONS,UTILITIES.EASEMENTS AND/OR CDV NANTSI THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T_M.69-198(LOT 1) - 6.5W- ACRES T,M.69-19C(LOT 2) - 5.77+/- ACRES T..M. B9-19D (LOT 31 - 5,15+/- ACRES T.M.69-19E "T 4) - 5.A5+/- ACRES T.M. 59-19F(LOT 51 - 6.68+/- ACRES T.M.69-19G LOT fi - 5.68+/- ACRES T.M.69-19H LOT 7 - 5.12+/- ACRES T_M.69-19JILOT 8) - 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY G ASSOC..INC. 663 BERKMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 aF 3 f49S2A LEGEND: IF IRON FOUND IS IRON SET ........ EXISTING LOT LINES HEREBY EXTINGUISHED D OVERHEAD UTILITY LINE APPROXIMATE LOCATION :OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO THE FENA FLOOD INSURANCE RATE MAP, EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 0225D. 6L S70'00'00"E 35.00'— T.M. 69-6L LOT 6 STUART TAYLOR SMACK 0. 8.5246-521 D.B.34f5-704.737 PLAT N05'10'43'W 155.57' N05'10'43'W 7.09' NO5'10'43-W 23.271. NO2'36'21"W 29.23'-- NO2'36' 21'W 100.42' NO2'36'21'W- 40.00' T. M. 69-6M NOB'56'25'W REVISED LOT 7 i66. 07' E.C.ACKERMAN TRUST 0.8.4733-23 O.B.4733-20 G 21 PLAT N0454'11' U.S.4456-444 71.02' D.B.3530-234 PLAT N04.54'11 5.37' NO3'44'OE 154.34' STATE ROUTE 803 (30'PRESCRIPTIVE EASEMENT) — GOODLOE LANE N05'SO'5 115.24 T. M. 69-66 LOT 1 FRANK DONLEY 6 CARLA DONEEY D.B.336o-82. 05 6 06 PLAT GRAPHIC SCALE 1"-200' 0 200 400 N05'50 7.4 VOH I" MONUMENT FOUND YOM MONUMENT FGUNC NS0'17'21 24.79' S70'00' 00'E 102.98' ; —(0.08 A T.M.69-196 REVISED LOT 6 2.63 ACRES 25-.00' (2.55 AC.) T.M.69-19F REVISED LOT 5 4.53 ACRES WOO AC.) E4.55 AC.) T.M.69-19E REVISED LOT 4 4.62 ACRES (047 AC) 1 T.M.69-190 "ny REVISED LOT 3 4.56 ACRES f0.05 (4.51 AC.1 13.33 AC,.) 0 (6.55+/- ACRES) (2.36 AC.) m IF '•or- 'T z REVISED ' (3. Of AC.) T. 69-506 :-1 e. ACRES IS 45.72 0.0 IF n T.M.69-19B Z : REVISED H Is AT 3aT I rA N7B(3g1 kW ,AA:t 0.26 AC.) w'.. ACRES '•'31 T.M.59-19C REVISED LOT 2 ' s ' , 20 c 7.70 ACRES r c i Ana ' FE .. VON VMY' .W .W SCALE: I- = 200' DATE: SEPTEMBER 27.2021 REVISED: INOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: IFEBRUARY 3, 2022 ROGER N.RAY 6 ASSOC.. INC. 553 PERKMAR COURT 1� ry1/ I'd k wYl CHARLOTTESYILLE.YIROINIA 2290f 3 VIRGINIA VIDHOFDEPAR HEALTH Ni Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Tavlor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19H HD ID: 101-22-0304 Well Class: Class IIIB (Cased and grouted 50' minimum) PERMIT NOTE: Well Number 12 Dear Alan Tavlor: Page 1 of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IIIB private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 els seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file atthe local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void ifthere is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this pen -nit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19H 14DID:101-22-0304 Page 2 of 2 This construction permit is transferrable until expired or deemed null and void. A permit transfer form may be found on the VDH website at hqp://www.vdii.Virslinia.itov/environmental-healtil formst. No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System 2] Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 456 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Afton, VA 22920 Directions to Property: VON USE ONLY Health Dept. IDN Due Date: Phone: 5124264728 Fax: Phone: Phone: 434-981-3634 Fax: Email: simpson@,admeonsuuctbnmanagemonLoom Subdivision: WELL 12 Section: Block: Lot: Tax Map: 69-19H Other Property Info: Acreage: 11.03 Sewage System Type of Approval: Applicants for new construction are advised to apply for a Certification letter to determine if the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 4 Multifamily Home (Total # of Bedrooms) Other (Descrlbe): Basement 21 Yes Walk -Out Basement? (] Yes Fixtures in Basement? Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes Ij No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" 121 No "There is a $50 fee for determination of elioihility_ Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ Existing or i] Proposed If proposed, Is this a replacement well? ❑ Yes El No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes 21 No All Applicants Is this a private sector OSE/PE application? Yes ❑ No If yes, is the OSE package attached? Yes ❑ Is the property intended to serve as your (the owners') principal place of residence? El Yes 0 No No In order for VDH of process your application for a sewage system, you must attach a plat of the prooertv and a she sketch. For water sunnl'wa a pLar of um piupeny is recommencea ana a site sketch is required. The she sketch should show your property lines, actual and/or proposed buildings, a cation of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location grad She ;,et�it+3>0n(i�i a sites must be clearly marked and Ore property sufficiently visible to see the topography. � rG. I gi - potmisslon to the VITInl8/Q rtment of Heahh to enter onto the property described during normal business hours for the purpose of pr ,. Ding this a `$t and fC orn qualtty assurance checks of evaluations and designs certified by a private sector Onshe Soil Evaluator or tr- sa a' �nRce4s until the sewage disposal system and/or private water supply has been constructed and approved. :J `4raoo Date far,r. tmbdit + *&i.wiww#Muoherns..&Wa Fnnd mrbenw sm. 4r4W V190U = um D*W Braere Dirmr Dax _ Fees H=# Pin�mria8 # PayfatmtypNcbaok# EKEIAA _ _�__ _Reeeipt# Page bi OSEIPE Report For: ❑ Construction Permit ❑ Repair ❑ Voluntary Upgrade ❑ Certification ❑ Subdivision Approval Peimit Permit Letter Property Location: 911 Address: iBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 12 GPIN or Tax Map #: 89-1914 Health Dept. ID # Latitude: Longitude: Owner: Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltrel License # 1940.001460 Address: PO Box 5-54, Woodstock, VA 22664 PE Name: License # Address: Date of Report: &22 mtents/Index of this report: Cover Sheet T. Well Spermcations Well Location Sketch Proposed Lot Sanftary Sun rtification Statement Date of Revision #1: Date of Revision #2: 6. Existing Lot Sanitary Survey I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling B Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations for Alternative Onsfte Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and aftemative nsite sewage systems has ith the owner/applicant. OF ❑ The w Oached to this cov4 exe Wn Code of Virginia d is PH recommend that a. Cons Perrht bor2�anibtonett�o mP DSE/PE Signature: y9� ONS r�iti 5` 1"" has been conducted under an exemotion to the practice of engineering, specifically 54.1-402.A.11 — ❑ Subdivision Approval be: 0 Issued Repair Permit ❑ Voluntary Upgrade ❑ Denied Date: The form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12(01/14 Heltzel Soil Consulting Page IL of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Sfockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax MaplGPIN #: 69-19H Property Address: TBD Subdivision: WELL 12 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3B Minimum Casing Depth: 50 ft. Estimated Water Usage: 600 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit /�2y Page J of The proposed well site shown herein, '— — 0 1. Is located a minimum of 50 feet from all property lines. fX 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. 0 i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation- 0 ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, 1 have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction.. Q ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that my property is not used for an Agricultural Operation as defined in § 3.1-22.2 Co ofVirfginia. 00 L 4 Sign re of Property O er Date Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consultinq, LLC 1412 Saumsvllle Road, MaureAown, VA 22644 19C LOT 6 RES I I T.M.69-19F EVISED LOT 5 4.63 ACRES WELL LOCATION SKETCH TM # 69-19H ALBEMARLE COUNTY, VA ..... �RVAM BUFFER 363' a p5' A MM" rl WELL #] 0 — August 12, 2022 DRAWN BY: SNV T.M.69-19H REVISED LOT 7 11.03+/— ACRES Pb-um 161V Page � of `0 OVERH UTILI LIN T. M RI 8.92 Heltzel Soil Consulting, LLC F B SM, WpeWbQ, VA 2Y PROPOSED LOT LAYOUT / SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA ST.RT.7Sp (BDrREscRiPRMc EAsalwn >/ti` -OLD NwPIXE RGAO LOT B SNNRTA�.Sm- SMACK i .� GAFFER D.8.3415-M707 vur II II v li II II PwD iI II T.M.DD-BM REMSD LDT T EC. 0R I 1 1 4 40 D.B.4M-M k 0 FLAT I I D.B.N D.B.asTo-2M sx PLAT ur I 1 14 1 STATE ROUTE Bpi I m `-�• (N/T'RESGRNONE TbSwT)w GOODLOE �AkE ; 1q1�� um '"• ,„e 1=L7 T.MAR-W LOT I I I FRANK M. k gLAy DC Y •m,Y,6 0 k SB put MDI UM FOUND SS�GPY' B q,11 MR/ MONIRIENi FdD1D NMI Won USq� OUM-]MEAU TUTY UK ' p „ f PPO�ST l MA6 FOMND NOT TO SCALE Heltzel Soil Consulting, LLC POBoxW �.VA22651 T.M.6B-6L SMART TAnoR WAOK D.8.S2/6-521 D.B.SM!5-704.707 PLAT T.M.69-6M PAID REVISED LOT 7 E.GAMf AN TRUST D.E.�733-23 D.8.4733-2D k 21 PLAT D.B.""s-444 D.B.353 E4 PLAT STATE ROUTE 803 ) (3OPRc) inveOE LAR� EXISTING LOT LAYOUT / SANITARY SURVEY PB 0 of 6 STOCKTON CREEK SBD, ALBEMARLE CO, VA A azD"T vQ saDRADMELD 200 OF THE PROPOSED DAANFTELO S AR8 SBOW N. STAT.750 (30'PRESORIPIW EASWNT) 7��D NOT TO SCALE T.M.6B m LOT 1 FRANK DONUE k (AREA DONUE D.B33& n r5 S 86 PLAT "WENT FOND %ON KNUMENT FOUND— ..... ._ APGRUf01UlE FOOD TPo' B FER UNE vN MONUMMEI TMeB-IBC � 'O ...'1. FOUND PFYSD UN a La AM r 11W AGWE4 ODUulu D u1uo ONES Q sED MOt OtNT I UN rr.eB-we FOUND an AM TALeB TxeB-iw 3 y\ RF w LOT s UFT AV AOLSO 0./-IA a LBB4/- AtlL4 bry �Fry }4' VON UM T _ FOOD W NO 5 W L.eB-fBE BB-IBB VON MONUMENT T.Y. -19C 164AM FOUND A API ILS` IL%4D LOT 3 7.70 AM DDRNER M FLNOE POST O1 MONUMENT O /\ L\\ iWND Maar FOUND T.Y.B0.1BO 1 `+IONW BEYSED LD 3 cmAMROUE \5 \ EONT aoND 'LL /VON .4 y0B S'•aa MONUNNETNT e.ey7. August 21, 2022 FOUND aRn ..... .. ...... THE PLATTING .OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T. M. 69-500. REVISED LOT 1, REVISED LOT 2, REVISED LOT 3. REVISED LOT 4.REVISEO LOT 5,REVISED LOT 6,REVISED LOT 7 G REVISED LOT 8 IS WITH THE FREE CONSEN- AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER (Sf. PROPRIETORS, AND/OR TRUSTEES.IF ANY. FOR: STOCKTON CREEK. LLC CITY/COUNTY OF Ckw-48r * STATE OF u;mAg� THE FOREGOING INTUMEHT WAS ACKNONLED'iED BEFORE ME THIS 3 DAY OF Ig"n!q 2022. BY ,4,;, wyo4- FOR. STOCKTON CREEK�LLCC NOTARY PUBLIC a r MY COMNISSIOM EXPIRES APPROVED FOR RECORDATION : THE BOARD OF GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT' CHORD CHORD BEARING C1 15'48'16' 1964.86 541.98 272.72 540.27 S63'33'04'E C2 4'44'04- 1090.92 90.14 45.10 90.12 S1B'39'29'W C3 9'59.39' 1085.92 189.42 94,95 189.18 S38'31'21'W C4 14'56'55' 1090.92 284.62 143.12 283.82 S55-59.54'W C5 1'20'52" 1487.79 35.00 17.50 35.OD S72'22'45"W C5 22'41'29' 1487.79 SB9.22 298.52 585.38 S60'21'35"W C7 21'31'58' 157.57 62.98 31.86 62.61 N05'35'16'E CB 32053'50'. 94.14 54.05 27.79 53.31 N32'48'10'E C9 B'13*55' 94..14 13.53 6.77 13. 51 N53'22'02'E C10 15'S7'OB' SB4.27 53.30 25.82 5f.14 Nfi5'27'33'E BOUNDARY LINE ADJUSTMENT REVISED T.M.69-50B PLAT B WHITE HALL MAGISTERIAL DISTRICT ALBEMARLE COUNTY.VIRGINIA SCALE: 1' = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4.2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3. 2022 FOR COLLINS ENGINEERING ROGER W.RAY G ASSOC.,INC. 663 BERKMAR COURT CHAR ELLR Of LEPHONE:(434)293-3 95 RAYSURVEYING.COM A-.."d BRIAN S. RAY LAC. No. 002281 02/03/2022 750 \ 250 OLD ROCKFISH B03 GOOOLOE LANE VICINITY MAP 1'-2000'1/- SHEET 1 OF 3 THE LAND USE NOTES SHOWN ON THIS PLAT ARE IMPOSED AT THE REQUEST OF THE DIRECTOR OF PLANNING., NOTES: BY PLACING HIS/HER SIGNATURE ON THIS PLAT HE/SHE HAS DEEMED THAT THEY ARE CORRECT AND IN ACCORDANCE WITH THE ALBEMARLE COUNTY ZONING ORDINANCE IN EFFECT THIS DATE. THESE NOTES 1. OWNERS. ADDRESS & LEGAL REFERENCES: ARE NOT RESTRICTIVE COVENANTS RUNNING WITH THE LAND AND THEIR APPEARANCE ON THIS PLAT IS NOT T.M. 69-198, 19C, 190. 19E. 19F. 19G. IBM, 19J & 506 INTENDED TO IMPOSE THEM AS SUCH. ANY REFERENCE TO FUTURE DEVELOPMENT RIGHTS SHOWN HEREON IS STOCKTON CREEK LLC THEORETICAL. 455 SECOND STR0. 5TH FLOOR.CHARLOTTESVIL4,VIRGINIA 22902 O.9.5657-253, D.B.M-159 PLAT & 0.8.683-44 PLAT. A. T.M.69-198,19C.19D.19E & 196 ARE ZONED RA(ENTRANCE CORRIDOR)- T.M.59-19F IS ZONED PA. T.M.59-19H, 19J &. 50B ARE ZONED RA:ENTRANCE CORRIDOR & FLOW HAZARD OVERLAY). B. T.M.69-19B(REVISED LOT 1)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)PETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-19D(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.69-19E(REVISEO LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-196(REVISED LOT S)IS ASSIGNEE ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. H. T.M.59-19H(REVISEO LOT 7)IS ASSIGNEE FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. I. T. M. 69-19J(REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.35 ACRES FROM T.M.69-190 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1980 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.iM.69-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA. EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE.. L. SETBACK REGUIREMENTS: FRONT- 75'. SIDE= 25' & REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA. THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE 6I3 DATA, THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-508 IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-409 & INST.0202200001315),. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEI COMPANY (O.B.232-585). 4, T.M.69-50B I5 SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLYCO.S.209-261). 5. T.M.59-190. ISE. 19F. 19G, 19H & 19J ARE SUBJECT TO, AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-404) 5. T.M.69-190, ISE, 19F, 19G. 19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS ANO/OR DEVELOPMENT RIG S ST. THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR E)G INGUISH DEVELOPMENT RIGHTS. NTSKK B. NOTEDTLE REPORT HEREON. THEESENISHED. ALL PROPERTIES ARE SUBJECTNTONBY ME ANY ADDITIONAOMN OR CONOITIONS,UTILITIES. EASEMENTS AND/ CDVFFNANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T.M.69-19B OT 1) - 6..51+/- ACRES T.M.69-19C OT - 5..77+/- ACRES T.M.69-19D ((LOT 3 - 5..15+/- ACRES T M.69-19E(LOT 4 - 5.45+/- ACRES T.M.69-19F(LOT 5) - 6.68+/- ACRES T.M.69-19G(LOT 51 = 5.88+/- ACRES T.M.69-19H(LOT 71 = 5.12+/- ACRES T..M.69-19J(LDT 61 - 6.56+/- ACRES T.M.69-50B - 9.35+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4.2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY & ASSOC.,INC. 663 BERKMAR COURT CHARLOTTESVILLE, VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 149iPA LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(i00 YEAR FLOOD PLAIN) ACCORDING TO THE FENA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 0225D. T.M. 59-6L LOT 6 STUART TAYLOR SMACK D.B.5246-521 D.B.3415-704,707 PLAT N05'10'43'W 155.67' N05'10'43'W 7.091 ND3'10'43'W 23.27 NO2'35'21'W 29.23'- NO2'36'21'W- 100.42' NO2'35'21'W- 40.OD' T. M.69-6M MOO'56'25' REVISED LOT 7 166.07, E.C.ACKERMAN TRUST 0.8.4733-23 0.8,4733-20 C 2f PLAT N0454'1. 0.5.4456-444 71.02' 0.0.3530-234 PLAT N04'54'1 5.37' NO3'44'( 154.3� STATE ROUTE B03 (30'PRESCRIPTIVE EASEMENT) GOOOLOE LANE. T. M. 59-GE LOT 1 FRANK DONLEY G CARLA DONLEY D.B.3380-82, 85 6 86 PLAT GRAPHIC SCALE 1"-200' D 200 400 S70'00'00'E 102.90, -( I T.M.69-l90 I REVISED LOT 6 gm 2.63 ACRES I= o� nn• (2. 55 AL.) �Lq I3.33 AC.) N04'25'19'W� 245.20' S05'19' 28'W 26.09' �{ N10'02'GO'W �} 50.95VOH MUNUENT FOUND NO3'34' 29' W -�• 224.63' VOH MONUMENT FOUND T.M.69-19F si9.54'o REVISED LOT 5 89. 15' P 4.63 ACRES 1 WOO AC.) I � K55 AC,T -" T.M.69-ISE REVISED LOT 4 4.62 ACRES (0,07 ACJ- 1 T.M.69-19D REVISED LOT 3 4.56 ACRES 10.05 F (4.51 AC.) G6 VOH 1 E m (6.56+/- ACRES) I 1 B IF � LOT': ............... 0 (2.36 AC.) - c o T9' c `S F Apt IY � v4 yr� VDH MONUMENT FOUND 919'30'59' m IF '01, Tw' g REVISED ' m3�.2*•.. (3.01AC.) o; T.M.69-508 p 8.73 ACRES k IS (5.72 AC_) f IF e T.M.69-19B m e Z , REVISED g Is A. s LOT 1 N>.00 ' 1 iAN 3,64 36 10.25 AC.) 1 �'.. ACRES IG .31 REVISm IOTC 200 Cl 7.70 ACRES i To r%�0.6�'► VOH FE g11'A? .2AVDH it N p MONUMENT 9FOUND SCAM : 1' = 200' DATE: SEPTEMBER 27, 2021 REVISED: INOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: IFEBRUARY 3, 2022 ROGER W.RAY 6 ASSOC.,INC. 653 ERKMAR COURT CHARLOTTES ILLE.YIROINIA 22901 TELEPHONE: (434) 293-3195 RAY$URVEYING.COM ,- b MONUMENT n FOUND r tw Cg'Ofi SHEET 3 OF 3 149 VIRGINIA DEPARTMENT VYDHOF HEALTH Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, 4201 Charlottesville, VA 22902 Tax Map Number: 69-19H HD ID: 10 1 -22-03 02 Well Class: Class IIIC (Cased and grouted 20' minimum) PERMIT NOTE: Well Number 13 Dear .Alan Taylor: Page] of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class MC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12YAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19H HDID:101-22-0302 Page 2 of 2 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.virginia.gov/environmental-health/amp-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. 1f you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, /11.1 Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System 0 Water Supply Owner.. Stockton Creek LLC c/o Alan Taylor Mailing Address: 465 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TBID Directions to Property: Subdivision: Tax Map: Afton, VA 22920 Comer of Route 250 & Route 151 VDH USE ONLY Health Dept. ID#16),22.0302 Due Date: Phone: 5124264728 Fax: Phone: Phone: 434-981-3634 Fax: Email: simpaon@auuwnstmctionmanagementwm WELL 13 Section: Block: Lot: 69-19H Other Property info: Acreaae: 11.02 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter 0 Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 4 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement Yes Walk -Out Basement? 0 Yes Fixtures In Basement? 0 Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes 0 No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. ma)imum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" No Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ Existing or 0 Proposed If proposed, is this a replacement well? ❑ Yes 0 No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildin s within 50' of the well be termite treated? ❑ Yes 0 No All Applicants Is this a private sector OSE/PE application? 0 Yes ❑ No If yes, is the OSE package attached? 0 Yes Is the property Intended to serve as your (the owners') principal place of residence? ❑ Yes 0 No ❑ No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water suoolies. a r--- — --- -- •••�• �-� a ��•� ��_��� ,e eyunnu. , ne ant, srcerc i snoui0 snow your property lines, actual andlor proposed buildin a r - lion of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and ' r tpy�sed we`El ryd sr a sires must be clearly marked and the property sufficiently visible to see the topography. 1 armi5511110n�to 12 In artment of Health to enter onto the property described during normal business hours for the purpose of aessingttshk�a on and.'P- dorm quality assurance checks of evaluations and designs rert'fiied by a private sector Onsfte Soil Evaluator fessiondl rnee �pgece ry until the sewage dis ' 19>1Pln�t��' g posai s m and/or private water supply has been constructed and approved. Licriu _ Date Thhh 4mai l.yrOAft 201AWIVIM" Vntr Un oidy Delp tom: � Dwa Doo;- FeIi-SMAID 4 !?Snr1,11W "d 0 APPROVED Pap I Of OSEIPE Report For: El Construction Permit ❑ Repair ❑ Voluntary Upgrade ❑ Certification ❑ Subdivision Approval Permit Permit Letter Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 13 GPIN or Tax Map # 69.19H Health Dept. ID A / J 2 Latltude: Longitude: Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltzel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: &22/2022 Date of Revision #1: Date of Revision #2: Contents/Index of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Specifications 4. Well Location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and aftemative onsite sewage systems has been discussed with the owner/applicant. 0 The work attached to this cover page has been conducted under an exemption to the practice of engineering, specifically the exempt - 'e of Virginia Section 54.1-407_?.11 I recommend the Mi6i r ermlt ❑ Subdivision Approval be: ❑ Issued ❑ Certificatir ❑ Repair Per it ❑ Voluntary Upgrade ❑ Denied Q1tbR 5 7 OSE/PE S4 �e: Ct_ W 4 t10�t V e Date: w- - t+ tVn �nl'r nNSft�'r' The form contains personal information subject to disclosure under the Freedom of Information Act. Revised IZVI/14 Heltzel Soil Consulting Page 2 of b VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19H Property Address: TBD Subdivision: WELL 13 Section: Block: Lot: Directions: Comer of Route 250 & Route 151 General Information Well Purpose (select all that apply): E] Domestic Drinking Water Agricultural ❑ Irrigiation ❑ IndustriaVCommerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 600 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit Page 10; of The proposed well site shown herein, Q 1. is located a minimum of 60 feet from all property lines. 0 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. Q i. Written affirmation from the adjacent property- owner(s) that their property is not used for an agricultural operation. 17 1 ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot 0 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Qi. Written permission from the adjacent property owner's) for the well construction. Q ii_ i certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Lines) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm th y property is not used for an Agricultural Operation as defined in § 3.1-22. f e Code fVi inia Signature of Property Tner Date Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC Page `� of 1412 Saumsville Road, Maumnom, VA 22644 -19G LOT 6 ;RES I i1 I T.M.69-19F =VISED LOT 5 4.63 ACRES //�WELL #10 � Sfl5I41 August 12, 2022 DRAWN BY: SNV WELL LOCATION SKETCH APPRQV E TM # 69-19H ALBEMARLE COUNTY, VA REAM BUFFER T.M.69-19H REVISED LOT 7 11.03+/— ACRES 16V OVERH U TI LI LIN T. M REVI 8.92 Heltzel Soil Consulting, LLC PDBmW Woo69btlt VA24 PROPOSED LOT LAYOUT / SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA S7.RT.150 (50'PRF9MlPTINE r MT) i DID TNBaPRCF RDAp NOT TO SCALE T.M..69- LOT//yr, LDCATWN STREAM SN D.B ItB-529MACR ' i / 91FFFR .. :: A5]ybOROU D.8.7415-704.707 PLAT / �.� / p1ETMAD ;, ('Qqq�' g4O�i zs0 um R Y® v Pm PDMO I I OUI T.M LOT��ECAd WT 11 um ..m �g6 1 1 — ne -. OLE D.B.47M-20 e m PUT D.e M 2u� T IMH FODND STATE RUU IF 3U3 I LL� VON(kYPR fAODIL fAFAN ENrMMND 1 —m I u.m •n LDRNER IN 1 IMNOE PDST 1 NDNU�MENT U4 FOUND I I MONUN I � FOUND M T. G 1 I pNU11NENT LOT 1 LOT I. FDND FRANK ODNLET R CARLA p(NLEY Rs s eB PLAT �5R on Nu o+r RCIINFDTrr (--� 55F�R t Mas MTl DRAWN: V v o'1Dy aa� MM MCNUNENT FOUND V1N H, pe•y "'ANSUITABLET-TING N VOID ILILING MAY REND UNSUITABLE AND VOID THIS PERMIT Heltzel Soil Consulting, LL TO sex 954. NboEnbd, VA nlB T.M.e"L LOT MMT TAN& 9 ACK 08.52M 521 D.11N1}7W.M7 PUT TM.0 6m POND R"M LOT 7 E.CACIQERMAN TRUST 0 D.B.473 20 & 21 PUT PUT STATE ROUTE 803 �ENT) (30"CSMPT�NE � U EXISTING LOT LAYOUT! SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA ST.RT.750 (WMUMPTW EAgITENT) OLD TJRNPl E ROAD M60-812 LOT I RANK DONLEY CARLA ENI 13.8.11B0- Is !j4 VDN MONUNENT FOUND AN III F0tW— Ns. ma NOT TO SCALE ... .. ........... ......... .................. PEA Ra. UTUTY U?IE loN' t� MON TA.A IW PENSm LOT 8 Z03 A01U TAM IN �Hm UTUTY UNES VDI "W 40NIA TX6O-m FMI & T.�Iw `�DW5 TIL�lw �we ADIM an./- Aces NUMT EnuNO Al TK VD4 UNUMENT WD=4 ia. ATNe,4 F"D .0T 2 TX AOTE! C� IN �m POST tJ NtfitJWNT YDH m`ND MONU"MENT FD NIVED un 3 �WIJMT �ft AU= a�mo FCCIND H MONVDUMIONT August 21, 2022 MIND n➢AUMTT3v. vxr THE PLATTING,OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED T.W.69-508.REVISED LOT 1,REVISED LOT 2,REVISEO LOT 3. REVISED LOT 4. REVISED LOT S. REVISED LOT G. REVISED LOT 7 S REVISED LOT B IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER (S). PROPRIETORS. AND/OR TRUSTEES, IF ANY. FDR: STOCKTON CREEK. LLC CITY/COUNTY OF Cho-41+" STATE OF THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS' DAY OF F 2022. BY d.:/ .. D,., FOR: STOCKTON CREEK. LLC NOTARY PUBLIC #7t407107 MY COMMISSION EXPIRES ' n�• p`~ �:'% APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING CS 15'40'16' 1964.86 541.9E 272.72 540.27 S63'33'04'E C2 4'44'04' 1090.9 - 90.14 45.10 90.12 S1B'39'29'W C3. 9'59'39' 1095.92. 1 99.42 94.95 189.1B S36'31'21'W C4 14*56'55* 1090.92 284.62 143.1; 283.82 S55'59'54'W C5 1'20'52' 1487.79 35.00 17.50 35.00 S72-22.45-W C6 22'41'29' 1487.79 589.22 298.52 585.38 S60'21'35'W C7 21*31*58' 157.57 62.98 31.86 62.61 N05'35'16'E CB 32'53'50' 94.14 54.05 27.79 53.31 N32'4B'10'E 1:9 8'13'55' 94..14 13.53 6.77 13.51. N53'22'02"E C10 15'57'OB' 184.27 51.30 25.82 51.14 N65'27'33"E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND REVISED LOTS 1, 2, 3, 4, 5, 6, 7 6 8 THE PROPERTIES OF STOCKTON CREEK,LLC LOCATED ON U.S. ROUTE 250(ROCKFISH GAP TURNPIKE), STATE SHOP STATE RROUTE 750OUTE 151((OLD CRITZERS TURNPIKE ROAD)), AND STATE ROUTE 803(GOODLOE LANE) SCALE 1' = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY S ASSOC.,INC. 663 BERKMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM /-3- BRTAN S. RAY Lk. No. OD2281 02/03/2022 750 Q0 OLD ROCKFISH. UURNPIKE GAP ROAD TURNPIKE B03 GOOOLOE :;.:SITE.-:.' LANE 151 637 CRITZERS DICK SHOP WOODS ROAD ROAD CRITZERS SHOP VICINITY MAP 1'-2000'+/- SHEET 1 OF 3 14912A] HIS PLAT IS NOT SHOWN HEREON IS A. T.M.59-190,19C,190.19E & 1% ARE ZONED RA(ENTRANCE CORRIDOR). T.M.69-19F IS ZONED RA. T.M.69-19H. 19J &. 509 ARE ZONED RA (ENTRANCE, CORRIDOR & FLOOD HAZARD OVERLAY). B. T.M.6B-19B(REVISED LOT U RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISEO LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-190(REVISEO LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.59-19E(REVISEO LOT 4)RETAINS TWO BEVEL OPMENT RIGHTS AND MAY BE FURTHER DIVIDED- F. T.M.69-19F(REVISEO LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-196(REVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. 'I. T.M.59-19J(REVISEII LOT IBIS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED, ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FRON THE DECEMBER 1980 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEN DECEMBER 1900 BOUNDARIES. J. REVISED T.IM.59-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE.. L. SETBACK REOUIREMENTS:FRONT- 75',SIDE- 25' 6 REAR— 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA,THESE LDTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA, THESE LOTS ARE NOT LOCATED IN AN AG —FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ,ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS. ADDRESS & LEGAL REFERENCES: T. M. 69-19B. IGO. 190. ISE. 19F. 196. ISM, 19J & 50B STOCKTON CREEK,LLC 455 SECOND STREET,5TH FLOOR,CHARLOTTESVIL�E.VIRGINIA 22902 D.B. 5657-263. 0.8.892-159 PLAT & O.B.683-44 PLAN. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY.. 3 T.BECT TO THE FOLLOWING: A. MEA EASEMENTS ENTSTORGINIA ELECTRIC AND POWER COMPANY(D.B.264-409 & INST4202200001316).. 8. AN EASEMENT TO VIRGINIA PUBLIC SERVICEICOMPA'NY(D.B.232-585). 4. T.M.69-50B I5 SUBJECT TO AN EASEMENT TO THE CryryEESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(O.B.209-261). 5. T.M.B9-190, SSE, 19F, 19G, 19H & 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(0.8.264-404) 6. T. M. 69-19D, ISE. 19F. 19G, 19H & 19J ARE SUBJECT TO,, AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(O.S.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS DF ppEECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EI(BST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR EXITINGUISH DEVELOPMENT RIGHTS- S . NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJECT TO Ar ADDITIONAL CONDITIONS.UTILITIES,EASEMENTS AND COVWNTSI THAT WAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T.M.69—ISS(LOT 1) - 6..51+/— ACRES T,.M.69-19C(LOT 2) - 5.77+/— ACRES T,.M.69-19D (LOT 3) - 5,15+/— ACRES T:W.69-19E(LOT 4) - 5a45+/— ACRES T,M.69-19F(LOT 5) - 6.68+/— ACRES T,,M.69-19G ((CLOT 6) - 5.88+/— ACRES 7.M.59-19J(LOT BOT j = 6.56+/— ACRES T:M.59-508 - 9.35+/— ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY & ASSOC.,INC. 653 BERKNAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE (434) 293-31R5 RAYSURVEYING. COW SHEET 2 OF 3 149f2A LEGEND: IF IRON FOUND IS IRON SET ........ EXISTING LOT LINES HEREBY EXTINGUISHED -� OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(f00 YEAR FL000 PLAIN) ACCORDING TO; THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 51000E 0225D. U a m N S70'00'0011E 35.00' — T. M.59-BL LOT 6 STUART TAYLOR SMACK D.B.5245-521 D.B.3415-704,707 PLAT N05'f0'43'W 155.67'- N05'1043'W 7.09'j. NOS '20'43'W 23.27:.. NO2I'36-21-H 29.23'-- NO2'36'211W- 100.42' N62'36'21'W� 40.00' T.M.69-6M NOB'55'25'W REVISED LOT 7 166.07' E.C.ACKERMAN TRUST D.B.4733-23 D.B.4733-20 6 21 PLAT N04'S4'11' T D.B.4456-44471.02' O.9.3530-234 PLAT NC4'54'11 5.37, NO3'44'OE 154.34' STATE ROUTE 803 (30'PRESSOCROPOEVLANESEMENT) T.M.69-6G LOT 1 FRANK DONLEY 6 CARLA DONLEY D.B.33B0-82, 85 6 86 PLAT GRAPHIC SCALE 1"=200' '--' NO3'34'29'1 224.03' 0 200 400 VON MONUMENT FOUNC N68'17'21 GL 24.79' S70'00'00'E 102.98' ,_ T.M.69-19G REVISED LOT 6 2.63 ACRES (2.55 AC.) T.M.69-19F REVISED LOT 5 4.63 ACRES ( (4.00 AC.) (4.55 AC, T.M.59-19E REVISED LOT 4 ( 4.62 ACRES A I (Or 07 AC..j1 I T.M.69-19D REVISED LOT 3 4.56 ACRES (0.05 (4.51 AC.) 13.33 AC.:) (5.72 AC. (6.56+/- ACRES) IT 1 (2.36 AC.) (3.01 AC.) m tea. m � M.89-198 m EVISED M LOT i N7B, 3<64 I ACRES .r� T. 0.26 AC.) T.M.69-19C REVISED LOT 2 7.70 ACRES e ; REVISED ' T.M.69-508 8. ACRES ♦r 1�' 91 �S71'33'!38'W 181. a1 1x4'll��Y��`,�pp� MFOUNOT 2 DATE:C S PTEMBER 27.2021 •'Ai37g ir'.1111 w REVISED NOVEM�BER 29. 2021 Y v- REVISED: IFEBRUARY 3, 2022 ROGER 6 ASSOINC. 663 GER SERKMAR COURT •Y# 4�'P' LHARLOTTESVILLEI YIF3INIA 22901 SHEET 3 OF 3 VIRGINIA DEPARTMENT OF HEALTH Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19J HD ID: 101-22-0305 Well Class: Class IIIB (Cased and grouted 50' minimum) PERMIT NOTE: Well Number 14 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1 138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-43 10 Fax APPROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class 11113 private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number ofthe OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #1: 69-19J HDID:101-22-0305 Page 2 of 2 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.virgiiiia.pov/eiiviroilmental-health/pmp-2015-01 forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtle Y Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC clo Alan Taylor Mailing Address: 455 2nd Street BE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Directions to Property: Subdivision: Tax Map: Afton, VA 22920 VDH USE ONLY Health Dept. I1Mg0112.6305 Due Date:_ Phone: 512-426.4728 Fax: Phone: Phone: 434-981-3634 Fax: Email: simpson@aUaswmtrucoonmenagemenLwm WELL 14 Section: Block: Lot: 69-19J Other Property Info: Acraaae: 992 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter 0 Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 3 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement 0 Yes Walk -Out Basement? 0 Yes Fixtures in Basement? 0 Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes 0 No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes** 0 No "There is a $50 fee for determination of eligibility. Water Supply Will the water supply be ❑ Public or 0 Private Is the water supply ❑ Existing or 0 Proposed If proposed, is this a replacement well? ❑ Yes 0 No if yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildin s within 50' of the well be termite treated? ❑ Yes 0 No All Applicants Is this a private sector OSElPE application? Yes ❑ No If yes, is the OSE package attached? 0 Yes Is the property intended to serve as your (the owners') principal place of residence? ❑ Yes 0 No El No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a sHe sketch Fmr waMr s, mnGoe w=1 � o'o w upeny ,b iewcnnrenceo anti a she sKeten Is required. I he site sketch should show your property lines, actual and/or proposed buildings, ea'urad location of your well and/or sewage system. When the site evaluation is conducted, thf property lines, building location (PT;10feSQ*1 1 W4 Wellrgn wage shes must be dearly marked and the property sufficiently visible to see the topography. f rmission to the Virgi^M�artmeat of Health to enter onto the property described during normal business hours for the purpose of ng this i RI tioB.ancGto rfoar. quality assurance checks of evaluations and designs certified by a private sector One ie Sniff Evaivaior F r as ne ry until the sewage disposal system and/or private water FttFt supply has been constructed and approved. I. ,.�u 19�u0U1a60 LSD �(22 (22 Date Ml Ifti4YspaiwJr.3,...a16`H.WrbA,dr,tnarirbh,wNw�trMM�wMs.b lSNW 91/AM Fees HDID# FlaaaWNot 0 Faymotn lyprarehed 4 so A _ _ RMCFt tf Page L of G OSEIPE Report For: 0 Construction Permit ❑ Repair ❑ Voluntary Upgrade ❑ Certification ❑ Subdivision Approval Permit Permit Letter Property Location: 911 Address: TBD City, State, Zip: Afibn, VA 22920 Lot: Section: Subdivision: WELL 14 GPIN or Tax Map #: 69-191 Health Dept. ID #: 1- _ g Latitude: Longitude: Owner; Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Chadotbesvilte, VA 22902 Prepared by: OSE Name: Chris Heltzel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22694 PE Name: License # Address - Lome or Keport: 8/22/2022 Date of Revision 91: Date of Revision #2: 1. Cover Sheet of this report: Sketch 6. Existing Lot Sanitary Survey 'ai ulladuvn aWwmenr hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the sewage Handling & Disposal Regulations (12VAC5-610), the Private Wall Regulations (12VAC5-630), the Regulations forAltemative Onsite systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further ertify that I currently posses any professional license required by the laws and regulations of the Commonwealth that have been duty issued y the applicable agency charged with licensure to perform the work contained herein. The potential for both conventional and alternative nsite sewage systems has been discussed with the owner/applicant. The work attach t t is cover page has been conducted under an exemption to the practice of engineering, specifically the ezerrsptiargl f ,i;" Section 54.1-44e.A.11 rr, 1,P I recommend that a: c:onstrucfion P r ❑ Subdivision Approval be: ❑ issued i Certifcatic �PStter Repair Permit El Voluntary Upgrade El Denied j l;1tRH��� 7 J Nn lytt)UUlg60 / _ \ /k� /s`' J� 2 oetre srgnatur . �-, Date: L1° �`�---\\ l V�TrVE ON51'V'S0♦ . The form contains personal intormatJon subject to disclosure under the Freedom of information Act. Revised f 2101114 Heltzel Soil Consulting Page of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: 22 30S Application Information Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-191 Property Address: TBQ Subdivision: WELL 14 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): El Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3B Minimum Casing Depth: 50 ft. Estimated Water Usage: 450 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit / f Page j ofy The proposed well site shown herein, 0 1. Is located a minimum of 50 feet from all property lines. QX 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. FZI ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. Q ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm § 3.1-2 Signature is not used for an Agricultural Operation as defined in of Virginia. Dzke Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my properly line. Signature of Property Owner Date Heltzel Soil Consultinq, LLC 1412 Saumauille Road, Mamertown, VA 22644 REAM BUFFER 11 August 12, 2022 DRAWN BY: SNV WELL LOCATION SKETCH TM # 69-19J ALBEMARLE COUNTY, VA Page �—, � I R 0 7 m 1 iiiiiR O' 100' 200, 300, Heltzel Soil Consulting, LLC PO Boz 3M, Waadebd,, VA1 TM.BB—BM � LOT 7 EC.AM MAM MUV 0.9.6733-13 O.B.4m-10 & 0 MT B.B.w Ge D.B.3530-134 PUT STATE ROUTE 803 PROPOSED LOT LAYOUT i SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA 3R83 WID@J Mq'OPBHBPmmm NOT TO SCALE HeltZel Soil ConsultinEXISTING LOT LAYOUT / SANITARY SURVEY Page-0—of b g, LLC POBarW WooUebd. VA223e9 STOCKTON CREEK SBD, ALBEMARLE CO, VA 20VOF TIOi PRO)OJUO DRA°1PWASARB 6HOWM. 7SST.RT.750 (30'PRESCR�PTW EASEMENT) TURNPIKE ROAD - NOT TO SCALE T.MA9-& LOT 6 SMART TAYIOR SMAM 0.0.5248-521 D.B.3415-7, ,707 PLAT Twfi9 elm POND REUSED LOT 7 E.C.ACKERMAN TRUST D.B.4733-23 D.8.4733-2D R 21 PLAT D.BA45d DA.390-2N MAT STATE ROUTE 803 (SOTT4N OIPOE LANESEMENTJ TM,89-e0 LOT I f GPLA DONI D.B. B5& 38 PU MONUMENT wN MONUMENT FOUND— J MPRO LOCATION;._LOCATION51NFAA1 ZF FOUND / �'....::5 fV OITYao 7 UOALIPAD PO �4n $0 LINE O DH �Mmma FOUND LM.49-iNl 5�y �T 110!!/-MPE4 I AHEAD D LINES I MONUMENT &7J ACRES RENHDLOT5 4A3 ACIIERES m./-LOT B A.R24/- ACIE4 41H O QPd' _ ee - e n O4fIN VON ONUMENT _ FOUND M.eP1BE nEM�Lm 1 wx MONUMENT LOT 4 I" AO LMA!-i9C FWNO 4A2 AO= Ei\ffiD Ibf 2 )•� ACPLs FEND {� POST VpW /\ MONUMENT wN FWNO MONUMENT U O FOUND T.LLe9 IBD fA TJ wN DT RJWNO4 S 1�` Vh O1a1& 1DH MONUMENT M{P•BY AUgust21,2022 e FOUND N rn nni ov. can THE PLATTINGFOR DEDICATION OF THE FO44LOWING DESCRIBED LANDS, REVISED T.N. 69-508. REVISED LOT 1, REVISED LOT 2, REVISED LOT 3, REVISED LOT 4;REVISED LOT 5.REVISED LOT S. REVISED LOT 7 G (REVISED LOT B IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETORS.ANO/OR TRUSTEES. IF ANY. 9�� FOR: STOC�KTON CR EK. LLC CITY/COUNTY OFGGo Aa& STATE OF 942i THE FOREGOING IMS (I)97TT WAS ACKNOWLEDGED BEFORE ME THIS > OAY OF F.. 2022. BY risi,..s D_. . FOR: _STTO✓CCKTTON CREEK�LLCC NOTARY PUBLIC MY COMMISSION EXPIRES APPROVED FOR RECORDATION A . . . 6L NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING Cl 15'48'.16' 1964.88 541.98 272.72 540.27. S63-33-04-E C2 4.44'0 - 090.92'. 00.14- 55.10 90.12510-39.29-N C3 9'59'39" 1085.92 189.42 94.95 189.18 S38'33'21'W C4 34'56-55' 1090.92. 204.62 143.12 283.82 S55'59'54"W C5 1*20'52'--1487.79 35.00 17.50 35.00 972'22'45'W C6- 22*41'29' 14B7.79 5B9.22 298.52 585.38 S60'23'35'W C7 21'31'58' 167.57 52.98 31.06 62.61 N05'35'i6'E CB 32'53'50' 94.14 54.05 27.79 53.31 N32'48'10'E C9 8'13'55' 94.14 13.53 8.77 13.53 N53.-22.02-E CIO 15'57'OB'1 184.27 51. 30 25.02 51.34 N65'27'33'E BOUNDARY LINE REVISED REVISED LOTS SCALE: i' = PLAT 6.7B8 N CREEK, LLC (SH GAP TURNPIKE), SHOP ROAD), )IKE ROAD), )LOE LANE) DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY 6 ASSOC-INC. 663 SERKMAR COURT CNAETLL4495 OSLEPHONE(3)293-31 RAYSURVEYING.COM D1814N 3. 1IAY Lac. No.000281 02/03/2022 750 _ 250 OLD ROCKFISH TURNPIKE - GAP ROAD TURNPIKE S03 GOODLOE LANE /51 637': CRITZERS DICK SHOP '.WOODS ROAD ROAD CRITZERS SHOP VICINITY MAP 1'=2000'+/- SHEET i OF 3 A. T.M.69-19B, ABC. 191. 19E & 19G ARE ZONED RA (ENTRANCE CORRIDOR). T.M.59-19F IS ZONED RA. T.M.69-19H, 19J 6, 508 ARE ZONED RA [ENTRANCE CORRIDOR 6 FLOW HAZARD OVERLAY). B. T.M.69-19B(REVISED LOT !)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19CIREVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-190(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M,69-19E(REVISED LOT O RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. S. T.M.69-19G(REVISEO LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. I H. I. T.M.69-19J(REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVICEO. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-19B AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 19BO BOUNDARIES OF T.M.59-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.69-50B RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY SIS DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A &IILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REOUIREMENTS:FRONT- 75'.SIDE= 25' 6 REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIG DATA.TMESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED, N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA,THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS. ADDRESS 6 LEGAL REFERENCES: T. M.69-198, 19C. 190. 19E, 19F, ASS. 19H. 19J & BOB STOCKTON CREEK,LLC 455 SECOND STREET. 5TH FLOOR, CHARLOTTESVILLE. VIRGINIA 22902 0.8.5657-263. 0.0.692-159 PLAT & D.B.663-44 PLAK. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.59-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-409 & INST.0202200001316). B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEICDMPANY(O.B.232-585). A. T.M.69-500 IS SUBJECT TO AN EASEMENT TO TryE CMpAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MA`S APPLY(13.B.209-261). 5. T.M.69-19D, 19E. 19F, 19G, ASH 6 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-404) 6. T.M.59-19D, 19E. 19F. 19G.19H 6 19J ARE SUBJECT TO AN EASEKENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(O.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCE S OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIG TS EXIST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR EXTINGUISH DEVELOPMENT RIGHTS. S. NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN 6Y ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONDITIONS,UTILITIES,EASEMENTS AND/OR CO ANTS THAT KAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATIDN RECORDS: T.M.69-198 LOT 9 - 6.51+/- ACRES T,M.69-19C OT 2) - 5.77+/- ACRES T..M.69-19D(LOT 3) - 5.15+/- ACRES T.M.69-19E(LOT 4) - 5:.45+/- ACRES T. M. 59-19F 0.0T 5) - 6:66+/- ACRES T.M.E9-19G(LOT 6) - S.SS+/- ACRES T.M.69-19H(LOT 7 - 5, 12+/- ACRES T.M.69-19J(LOT B - 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3.2022 ROGER W.RAY 6 ASSOC..INC. 663 BERKMAR COURT CHARLOTTESVILLE, VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM *f(A* SHEET 2 aF 3 f49f2A LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION ;OF AREA WITHIN ZONE A(f00 YEAR FLOOD PLAIN) ACCORDING TO THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMIUNITY PANEL 510006 D225D. T. M.69-6L LOT 6 STUART TAYLOR SMACK O.B.5246-521 D.B.3415-704.707 PLAT N05'10'43'W 155.& N05'10'43"M 7.01 ND5'10'43'N 23.2 NO2'35'21'W 29.23' NO2'36'21'N 100.42' S7O'00'OO'E 35. DO' 970.00,001E 102. 98' T.M.69-196 REVISED LOT 6 2.63 ACRES �. nn (2.55 AC.) (3.33 AC.) VON m VDH - , 6.56+/- ACRES) I 7. ' r "- 1 "'+M MONUMENT �m r ,,,.. FOUND NO2'36'21'W 25.00- - IS V 'i _i�Tn �, `: 40. 00' 1 1 o n"� (2.36 AC.) - ti T.M.69-19F 91954'02'E S6 $.113 a I' I REVISED LOT 5 89.15 IS 2?2, 3 L E~ T M.69-6M NOB'55'25'N -t 1 J0 �i IS REVISED LOT 7 166.07• .1 4(fi o ACRES Q m 4B• `F,o�-E ;m E C.ACKERMAN TRUST o D.B.4733-23 1 1 m O,a v' POLE 0 B 4733-20 6 21 PLAT N04'S4'Sf'N. I' 1 Ng3'11 `34'E IS LOT 5 •N m IF 0'. '� a :. REVISED 0.8.4456-444 71.02' IIF 300:00 UT 4 7d 63 AC-.1 ^' wj 31. - (3. 03 AC..) 0' T.�{ 69-508`�`. D.B.3530-234 PLAT N04'54'11"N� 2� S60'00'00'E.N 4P,02Y•:P' 6.73 ACRES I I 24.72 �00.00� _ 159.67- m'IF 5.37' 00. F IS - e IS (5, 72 0.C.1 P� Yd1 I (4.55 AC.) ;n i T. M.69-198 MONUMENT N0154,34' - m REVISED f5d.34' ti y LOT 1 Is ar FOUND STATE ROUTE B03 I T. M.69-19E = r N� 3, .00' N vox (30' PRESCRIPTIVE EASEMENT) -- 1 1 REVISED LOT 4 S ;1s ;:. 3:.64 }Y. '�' MONUMENT GOODLOE LANE 1 4.62 ACRES (0.26 AC.) ACRES 1"i FOUND N 15.24' M I �I (0.07 AC.1 1�, • T M 69-19C c pb's . •0, N 4 95 O'747"W 483.10'00 E S 1 F t3�:> REVISED LOT 21 -� 7D'�9 CORNER IN N05'50'52'W 1 ( 262.35 ` •.•1 ^'T� p OT 3 V 7.70 ACRES j,.��0, A .VOW SCE POST e33.577 N05�5g952'N _�I 7C 1 �-3-� OS' �.. 116 VOX FOUND 1 _I IT 0, 66• J'.SAA?2. 140NUMEW Is :FOUND 1 N04'26' 19'W ( T. M.69-19D REVISED LOT 3 IF' A e+ 571'33'13B'N 1B1.O1' T M.69-6G 245. zo• (I'' 1) 4.56 ACRES f^' 31A. . 'A ± Sg MONUMENT LOT 1 (0.05 A0.1� A2�0- F��SCALE: FRANK DONLEY G S�'19'28"N IF r-+y 5T1�PM i" = 200' DAB(.3300 6 26.09' (4.51 AC.) ISM $ S1��g M3 g 9 2111 DATE: SEPTEMBER 27, 2021 . 85 G B6 PLAT Nf 90 � 0 W A � <YA� REVISED: IIMOVEMBER 4, 2021 I CT+ VONK M kN�{ s- REVISED: NOVEMBER 29, 2021 MONVUH .. F ANT ov P.e REVISED: IFEBRUARY 3.2022 GRAPHIC SCALE f'-zoo' M03'34'29'N ROGER W. RRAY V. ASSOC.. INC. 224.63' 663 pERKMAR,CDURT 0 200 400 VON MONUMENT FOUND VOfi CHARLOTTESVILLE.YIRGINIA 22901 N60'17'21'N `MONUMENT TELEPHONE: (434) 293-312S RAYSURVEYLNG.COM GL 24.79' p � * SHEET 3 OF 3 149 RGINIA VDHOFIHEALTH NT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19J HD ID: 101 22-0306 Well Class: Class IIIC (Cased and grouted 20' minimum) PERMIT NOTE: Well Number 15 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1 138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-43 10 Pax APPROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class HIC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC'5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19J HDID:101-22-0306 Page 2 of 2 This construction permit is transferrable until expired or deemed null and void. A permit transfer form may be found on the VDH website at htto://www.vdli.virLinia.i ov/environmental-health/,gip-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA [D Water Supply Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street SE, # 201 Charlotteavllle, VA 22902 Agent: Stockton Creek LLC clo Alan Taylor Mailing Address: 455 2nd Street BE, Suite 201 Charlottesville, VA 22902 Site Address: ran Directions to Property: Subdivision: Afton, VA 22920 1s Tax Map: 69-191 Application or: ❑ Sewage System Owner. VDH USE ONLY Health Dept ID# Due Date: Phone: 512-426-4728 Fax: Phone: Phone: 434-981-3634 Fax: Email: elmpaonGatla,nsWctionmanagemenUom Lot: Acreage: 8.92 Type of A Sewage System pproval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage System and to apply or a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter 0 Construction Permit Section: Other Property Info: sod Use: Family Home (Number of Bedrooms) 4 (Describe): Block: ❑ Subdivision Approval ❑ Repair Multifamily Home (Total # of Bedrooms) Basement O Yes Walk -Out Basement? El No ❑ Yes Fixtures in Basement? ❑' Yes ❑ No ❑ No Conditional Permit Desired? El Reduced Water Flow ❑ Yes � No If yes, what type of conditions are desired? ❑ Limited Occupancy [] Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" ❑ No "There IS 8 $50 tea for determination of Water Supply Will the water supply be ❑ Public or 21 Private Is the water supply PP Y ❑ Existing or Q Proposed If proposed, is this a replacement well? ❑ Yes 0 No If yes, will the old well be abandoned? ❑ Yea ❑ No Will an bulldin s within 50' of the well be termite treated? ❑ Yes 23 No Is this a private sector OSE/PE application? O Yes All Applicants ❑ No If yes, is the OSE package attached? Q Yes Is the property intended to serve as your (the owners') principal place of residence? ❑ No ❑ Yes 0 No in order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water supplies, a plat of the property is recommenced and a site sketch is required. The site sketch should show our roe lines, actual and/or proposed bu3%10" ,spired location of your well and/or sewage s y property P posed IIIAk%swage sites must he dearly marked and the property sufficienitly v sible oon is n ee the topograducted, the phyyInes, building bcatign O avr�permission to the Vl aVepanment of Health to enter onto the property described during normal business hours for the purpose of b�ssin�Q _this application alit erform quality assurance checks of evaluations and designs oerlifletl by a private sector Onsite Soil Evaluator Fr'ofesktbY AIMbfe@itrSis n' -ary until the sewage disposal system and/or private water supply has been constructed and approved. HELT7_6L � i' Li No.1y400014G0 I urb,o�Ownerl�ent, rrr.� Date 01'"404aN1 +aLr,s�nWp�tsM..mrlt�ay+yar.rni.wf..rw.aw..rmh r.e»er,. ac+40W WS"I foe$ HDIA# F6t+rcfal# PIY=M typabbink0 MW� _ �- Page of v OSE/PE Report For: 0 construction Permit ❑ Repair ❑ Voluntary Upgrade ❑ Certification Permit Permit Letter 'roperly Location: 11 Address: TBD City, State, Zip: at: Section: Subdivision: WELL 15 ;PIN or Tax Map #: 59 19J Health Dept. ID #: atitude: Longitude: ne: Stockton Creek LLC cfo Alan Tavlor tress: 455 Second Street SE, # 201 Charlottesville, VA 22902 pared by: E Name: Chris Hel&et License # Iress: PO Sox 554, Woodstock, VA 22664 Name: License # of this report: Date of Revision #1: Date of Revision #2: 6. Existing Lot Sanitary Survey ❑ Subdivision Approval I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and alterative ansite sewage systems has been discussed with the owner/applicant O TI'e recommend that a: sisnzture: of Virginia .. ctlMSi'dOP't s. z rtifiCatlh£d.Q�r � Lic No. 1940001460 s AZ been conducted under an exemption to the practice of engineering, specifically the 1-4n2.A.11 Subdivision Approval Permit Voluntary Upgrade Date: be: 0 Issued ❑ Denied `B(-�-2 (2t The form contains personal udormaWn subjects to disclosure under the Freedom of Information Ad. --^^---�—_-- Revised 12/01/14 Heltzel Soil Consulting Page Z of (" SYSTEM SPECIFICATIONS VDH USE ONLY HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426 4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-191 Property Address, TBD Subdivision: WELL 15 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): 0 Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 600 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Units) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal information subject to discWure under the Freedom of Information Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit The proposed well site shown herein, Page 3 of 1_O 1. Is located a minimum of 50 feet from all property lines. QX 2. is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. QX i. Other confirmation that land use is not an agricultural operation. please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): ! affirm thayrqy property is not used for an Agricultural Operation as defined in § 3.1-22. toe CodAof Vir4nia ZJ vl '1 01.=— Dat Proposed Weil Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consultin 1412 SaumsV01e Road, Maurertown, VA 22644 REAM BUFFER ' 1 0 F .—A August 12, 2022 DRAWN BY: sNV LLC WELL LOCATION SKETCH TM # 69-191 ALBEMARLE COUNTY, VA Page \' `0 I 09.11 73 •i Pw-T-of- Heltzel Soil Consulting, I_LC PROPOSED LOT LAYOUT / SANITARY SURVEY ALLANOWN WH.IS A DRADNFffiD;GESMIi@1 STOCKTON CREEK SBD, ALBEMARLE CO, VA PDemtlilss� VA23NPI 20p OTlHe PROPr19N DIWNPmLD4N@SH01Vlt. ST.RT.750 (30'PR6pUIPPW EASDIENT) DID TURNPNE NOAD_ _ _ _ _ NOT TO SCALE w:z. — vDH............... _.w .....�.— `J^.''":i�i:5ic:iijc:�}2.__... / �r-::-::nd:ee.APPItONMATEE T.M.69-eL /.1.`_ii':iiiii:'ii:i :r: i5i7` i.::: .:::OCAZON 51 EAN _�iip.'. / UOT8 ........................ ... ......... r 51UANT.5246- SMACK....... BUFFER L :...::. :. ;': Rp��-'S(jD DIF TA -5S �i/ Icy V •::.: N 0.Rd4I5-R1/.707 PLAT / � ` / ovwEAe .- URUTY / — q'�e0'o'�?SO — VDK Q%pf / / L/�` �� r�oL `"'•^.:.�'... /fP MONUMENT FOUND I — m�ERNEAD •.. atF — uaun Js uNEs VDIH I I MOT um FOUND st 9 1 1 EC.AgmUST DD.473 20 a V PUT I I a4q DA.We 2 FI.Al 11 Z POUE ONUUMENT l e FOUND STATE ROUT m VON(30PR 303r� EASEMENT)E DQ MONUMENT FOUND CDOOLWEE umQ� I a um CORNEA IN 1 FiNFE POST VON I MONUMENT 1 O UMMae M 1 �FDN I — 1 I VON T ONUMM 1 LOTI;G FOUND FRANK UCM.EY @ WILA DCNLEY ' VON aNNMI9m ;DSV FUT xf MONUIN ROR�y F AlJgLL4S Zi, ZOZZ ".��FOV Fd1N0 N 3r, .a%, BY: —ANY CUTTING OR FILLING MA��N THEDISPOSAL AREA WN MONUMENT FOUND AOI NNfPS UNSUITABLE AND VOID THIS PERMIT" FAO ND DrsaDeld Installer. If you have any question or require mfnor adjustments to this design, contact AOSE at number; at top of this page. Contact Hebei Soil Consulting to schedule PreConeDuctlgn m IStIng (72-hour notice nequNeM Heltzel Soil Consulting, LLC Po B 5" Modstuk. VA 22884 i Lm 6 SMART TAYUDR SMACK D.8.52/8-521 D.S.3415-704,707 PUT PWD SED LOM ] REMSED E.C.q.8'47 N TRUST D.8.4735-36 R 21 PUT D.B. n4 D.D.JS1WnJ4 PUT STATE ROUTE 803 (301P ENT) T.M.E9-AO LOT 1 FRANK DMOXY B: CARU DW 0.9.JJBD-82 85 E BB PUT ODH MONUMENT EXISTING LOT LAYOUT ! SANITARY SURVEY rmB w of b STOCKTON CREEK SBD, ALBEMARLE CO, VA M O� WDRAD�s''ES ST.RT.750 (30'PRESORPTIvE EASEMENT) \ Ow MRNPIKE ROAD NOT TO SCALE APPRONMATE FOUND .i:E LOCAIKN STRENA Sf .. OVFRNFAD q�� .� UIlRE P .. G �ZSp Q MONUMENT T.MA9-i9O FWND RE415ID wr B m A�S� '' :......?.. '. 10 AAd/E{{S gHEAE, .. .. Dw2HFAD a LINE ' uNEs g0 MOUEMENT Tn.eo-lBB FWND BTa ApE:'3 TJI. RFAT MSED AT ! REN4D wi e m b ua ADE$O non./- AfliE.R � ��ro Y a. S _ Y�T .WH MAB-1¢ REN91wT1 MONUMENT wT 4 164 AGES FW ND 4A2 AdES T.M.B9-19O REWSM WT 2 7." ].]0 AOE3 OENNEN IN PENCE POST O WIN ENT MIXMroI D fUUND FOUND TY.69-190 VON �mm wA . goo -ow �FWHDT S�ec6�,E. vQMmm E x\\1 p09\,iOM IMRU FOUND N r.n nv. ten. THE PLATTING 'FOR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T.M.69-50B,REVISED LOT L REVISED LOT 2.REVISED LOT 3. REVISED LOT 4.REVISEO LOT 5.REVISEO LOT S, REVISED LOT 7G REVISED LOT S IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETORS.AND/OR TRUSTEES.IF ANY. FOR: STOCKTON CREEK, LLC CITY/COUNTY OF Cka.L.16fh STATE OF--glmhg THE FOREGOING IMSNMENT WAS ACKNOWLEDGED BEFORE NE THSStIRU"E DAY OF "r9l 2022. BY .Q_/ ', D". . FOR: STOCKTON CREEK.LLC NOTARY PUBLIC0 #.7154fty7 MY COMMISSION EXPIRES : (ie% I(w 2-&7-T APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING C1 1E'49'16' 19S4.86 541.9E 272.72 540.27 S83.33_04'E C2' 4'44'04" SD90.92' 40-f4 45.10 -' 90.12 S1B'39'29'W C3. 9'59'39" f085.92. SB9.42 94.95 189.18 S389i'21'W C4 14'55'55' 1090.92 284.52 143.12 283.82 S55'59'54"W C5 1'20'52' 1487.79 35.00 17.50 35.00 S72'2245'W C6 22.41'29' 1487.751 589.22 298.52 585.38 00'21'35"W C7 21'31-58' 07.57. 22.98 31.06 62.51 N05'35'16"E CS 32'53'50'. 94.14 54.05 27.79 53.31 - M32'48'10'E E91 2 13'55' 94-14 13.53 6.77 13,51. N5322'02'E C1b - SS'57'OB' 04.271 51.301 25.B2 51.14 N65'2733'E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND REVISED LOTS 1.2. 3, 4. 5. 6, 7 6 8 THE PROPERTIES OF STOCKTON CREEK.LLC LOCATED ON U.S. ROUTE 25O(ROCKFISH GAP TURNPIKE), STATE ROUTE 151(CRITZERS SHOP ROAD), STATE ROUTE 75O(OLD TURNPIKE ROAD), AND STATE ROUTE 803(GOODLOE LANE) SCALE: I" = FOR COLLINS ENGINEERING ROGER W.RAY S ASSDC.,INC. 663 BERKMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM 27.2021 4.2021 29.2021 3.2022 A- U BRIAN S. RAY Ile. No. 002281 02/03/2022 750 2-5-01 OLD - ROCKFISH TIURNPIKE GAP ROAD TURNPIKE 803 GODDLOE LANE f51 637 CRITZERS DICK SHOP WOODS ROAD ROAD CRITZERS SHOP VICINITY HAP 1'=2000'+/- A. T.M.fi9-19B, 19C. 190. 19E 9 196 ARE ZONED RA (ENTRANCE CORRIDOR) . T.M.69-19F IS ZONED RA. T.M.59-19H, 19J &SOB ARE ZONED RA(ENTRANCE CORRIDOR G FLOOD HAZARD OVERLAY). B. T.M.69-19B(REVISED LOT U RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. 0. T.M.59-19D(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.59-19E(REVISEO LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISEO LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ;G. T.M.69-196(REVISE13 LOT MIS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. ( H. I. T.M.69-19J(REVISEO LOT % IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT BHT BBEING AOECEB5ACRES 9�VELOPTRIGHTSWEREDERIVEDFRTHE DCEMER1980B0NDARIES OF T.M.66--19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.69-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA.EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REQUIREMENTS: FRONT- 75'. SIDE- 25' 9 FEAR= 35' . M. ACCORDING TO THE COUNTY OF ALBEMARLE GIS OATA.THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA,THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE 618 DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS, ADDRESS 9 LEGAL REFERENCES: T.M.69-190. 19C. ISO. 19E. 19F, 19G, 19H, 19J 9 508 STOCKTON CREEK,LLC 455 SECOND STREET, BIN FLOOR, CHARLOTTESVILLE. VIRGINIA 22902 D.B.5657-263, D.B.892-159 PLAT 9 0.8.693- 4 PLAN. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-508 IS SUBJECT TO THE FULLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(0. S. 284-409 9 INST.#202200001316).. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEICOMPA'NY(0.8.232-585). 4. T.M.69-50B IS SUBJECT TD AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(O.B.209-261). 5. T.M.69-190, ISE, 19F. 19G, 19H 9 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-404) 6, T.M.59-190, ISE. 19F. 196. 19H 9 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EABST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR E)O INGUISH DEVELOPMENT RIGHTS. S. NO TITLE REPORT FURNISHED. ALL EASEMENTS OWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONOITIONS,UTILITIES,EASEMENTS AND/OR COV. ANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE AOJUST�ENT AS PEA TAXATION RECORDS: T,M.69-1980LOT i) - 6..51+/- ACRES T.M.59-19C(LOT 2) - 5.77+/- ACRES T,.M.69-190 (LOT 3) - 5.15+/- ACRES T.M. 59-19EPT 4) - 5_45+/- ACRES T.M.69-19F(LOT 5) - 6.66+/- ACRES T.M.69-19G RE OT 5) - 5.B8+/- ACRES T.M.69-19H(LOT 7) = 5.12+/- ACRES T.M.69-19J(LOT ED = 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27,2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY 9 ASSOC-INC. 663 BERKMAR COURT CHARLOTTESVILLE.VIAGINIA 22904 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 14912A LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES HEREBY EXTINGUISHED _�. OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO,, THE FEMA FLOOD INSRATE MAP. EFFECTIVE DATEE2/4/2005. COMMUNITY PANEL 510006 02250. U a m y T. M. 69-SH .K REVISED LOT 7 E C.ACKERMAN TRUST 0.0.4733-23 D.B 4733 20 & 21 PLAT 0. B.4456-444 D.B.3530-234 PLAT 0 STATE ROUTE 603 (30 PRES6000LOELN VEAEE�ENTT) T. M. 69-6L LOT 6 STUART TAYLOR SMACK O.B.5246-521 D.B.3415-704.707 PLAT N05'10'43'W 155.67' N05'10'43'W 7.09p N05'10'43•W 23.27. NO2.36'21•W 29.23'- NO2'36' 21' W - 100.42' 402 •36' 21'W- 40.00' N04'54'1 5,37' T.M.B9-BG c4u.eu- LOT 1 FRANK DONLEY & S&5.19'28'W--, CARLA DONLEY 26.09, D.B.3380-82, N10'02'00'W-' 85 & 86 PLAT 50 95. VON,,' MONUMENT GRAPHIC SCALE 1"=200' FOUND M03'34' 29`W- 224.53' 0 200 400 VOH MONUMENT FOUNO� GL S7O'00'00'E 102.98' T.M.69-196 REVISED LOT 6 2.63 ACRES MG m- (2.55 AC.) T.M.69-19F REVISED LOT 5 4.63 ACRES (4. 00 AC.) l (4.55 AC.) j T.M.69-19E RVISED LOT 4 t 4.62 ACRES ( (0»07 AC.)q 1 T.M.59-19D REVISED LOT 3 4.56 ACRES (0.05 (4.51 AC.) (3.33 AC.) E 1 OVERHEAD p'{ UTILITY+,.$ LINE ^� b m _ (6. 56+/- (2.35 AC.) IFypf; 11' $ 11 REVISED 3� (3.01 AC.) QT. 69-506 p�?+ F M 7, 8. % ACRES IS 15.72 AC i m T.M.69-19B r REVISED ; H IS AT u a LOT i N7 3,64 0.26 AC.) ? ACRES T. M.69 19C o:: REVISED LOT 2 7.70 ACRES e o � �a A. FE vDH S%Ai. `M D T FOUND x+ y,•A`L' E A& S! , ni 2�il SCALE: F = 200' DATE: SEPTEMBER 27, 2021 4i REVREVISED: NOVEBE2202 MRR95!Ps pAMP.S• 1 REVISED: IFEBRUARY 3.2022 M+"� ROGER W. AY & ASSOC.. INC.+�(S;; 653 p9ERKMAR,COURT 1 CHARLOTTESyILLE• VIRGINIA 22901 I HEALTH NTV/DHOF Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19J HD ID: 101-22-0307 Well Class: Class 1I113 (Cased and grouted 50' minimum) PERMIT NOTE. Well Number 16 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1 138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax APPROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class HIB private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence. and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19J HDID: 101-22-0307 Page 2 of 2 This construction permit is transferrable until expired or deemed null and void. A permit transfer form may be found on the V DH website at http://www.vdh.virginia.gov/environinental-healtli/pmt)-2015-01 - forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System � Water Supply Owner. Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville VA 22902 Site Address: TBD Directions to Property: Subdivision: Tax Map: Afton, VA 22920 Comer of Route 250 6 Route 15f VDH USE ONLY Health Dept. ID#_ Due Date: Phone: 512426.4T28 Fax: Phone: Phone: 434-9813634 Fax: Email: simpsongauasconstructionmanagemend.corn YYCLL 76 Section: Block: 69-ISJ Other Pronertv lnfn- Lot: Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine If the land is suitable for system and to apply for a construction permit (valid for 18 months) only when ready to build. a sewage ❑ Certilication Letter El Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 4 MultifamilyHome (Total # of Bedrooms) Other (Describe): Basement 21 Yes Walk -Out Basement? 0 Yes Fixtures in Basement? ❑ Yes No ❑ No ❑ No Conditional Permit Desired? ❑ Yes No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary 1 P ry Use ( yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" El No "There is a $50 fee for determination of eligibility. Water Supply Will the water supply be ❑ Public or Private Is the water supply pp Y ❑ Existing or ❑ Proposed If proposed, is this a replacement well? ❑ Yes No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes 21 No All Applicants Is this a private sector OSEIPE application? El Yes ❑ No If yes, is the OSE package attached? Yes Is the property intended to serve as your (the owners') principal place of residence? ❑ Yes ❑ No No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. Fnr wa+a� <,,,...see , i Ile sae SKetcn should show your property lines, actual and/or proposed buildings AA Qj ocation of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location 9 and t �t�p�Iirl rage sites must be clear) marked and theProperty r �v+- - � y Y sufficiently visible to seethe topography. I�ugj erg sion to the Virgin partment of Health to enter onto the property described during normal business hours for the purpose of &06ssing��gg on ann erform quality assurance checks of evaluations and designs certified by a private sector Onsite Soil Evaluator -9rV*04 � fis neija ary unto the Sewage disposal system and/or private water supply has been constructed and approved. No. 194000146 J � V Signs. tsO�tq Date TaYrRf ar�rHeasi ltly��My.o161+saw+a--�--.M1�t�V1Aw�fi�q�y�alJ. anfw. ffiIr�OH Y.D;J• 1hl !QW% D= Shtervid: 1km Y\R Pe6 S - HDID # Futartt>If3 ao a8 it PRYMM prkii sak ft mw 9 -- _ y -- Pase of 0 Construction Permit ❑ Repair Permit operty Location: 1 Address: TBD Lot: Section: GPIN or Tax Map #: 69-191 OSE/PE Report For: ❑ Voluntary Upgrade ❑ Certification Permit Letter Subdivision: WELL 16 Health Dept. ID #: Longitude: City, State, Zip: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 ❑ Subdivision Approval Prepared by: OSE Name: Chris Heltrel License # 1940.001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: tentslIndex of this report: over Sheet Well Specifrcattons 'ell Location Sketch 2EOS Lot Sanitary Sun ification Statement Date of Revision #1: Date of Revision #2: 6. Existing Lot Sanitary Survey I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations for Alternative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses any professional license required by the laws and regulations of the Commonwealth that have been duly issued by the applicable agency charqed with licensure to perform the work contained herein. The potential for both conventional and attemative Dnsite sewage systems has been discussed with the owner/applicant. 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 64.1-402.A.11 recommend that a: VrtitnN.Permit El Subdivision be: .. Subdivision A ❑ Issued - --- , CNRISTOPHER S. � Lic140.19400W460 ti �r1,a't rON's I TV `'O"z The form contains personal ❑ Repair Permit ❑ Voluntary Upgrade Date: disclosure under Ere Freedom of Information Ad ❑ Denied 1Z2 a2 Revised 12101114 Heltzel Soil Consulting Page of b SYSTEM SPECIFICATIONS VDH USE ONLY HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19J Property Address: TBD Subdivision: WELL 16 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): Domestic Drinking Water Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3B Minimum Casing Depth. 50 ft. Estimated Water Usage: 600 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft_, min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes - This his roan contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit %� The proposed well site shown herein, Page � of w 0 1. is located a minimum of 50 feet from all property lines. QX 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. n i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot 0 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5.2 of the Code of Virginia. (check one below) EJ I. Written permission from the adjacent property owner's) for the well construction. Q it- I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that property's not used for an Agricultural Operation as defined in § 3.1-22.2 of t Code fVf inia. Signa ure of Property O ner Dat Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consultin 1412 saumaville Road, Maurertown, VA 22644 REAM BUFFER ' I #13 #12 9-19H ) D LOT 7 ACRES ) LLC WELL LOCATION SKETCH TM # 69-19J ALBEMARLE COUNTY, VA OVERHEAD POL UTITY LI LINE —'0.0— et I T.M.69-19J awe, 161� WELL RFA ptr- FA REVISED LOT --8 92+/— ACR WELL #16 / August 12, 2022 DRAWN BY: SNV Page l of c R M 7 R r— lQ0.w Heltzel Soil Consulting, LLC PROPOSED LOT LAYOUT! SANITARY SURVEY POBo 6, WooEebck. VA2258C STOCKTON CREEK SBD, ALBEMARLE CO, VA ST,RT.750 (3O'PRESORFVW EASEMENT) % OLD TUfWFIRE ROAD T.M.88-e1 i 1' "�� :- OOAPON SIREAN SMART TIDi5T1.O8R SMACK 0.0.3415-704,70T PLAT / dFFER OVlT81EAD UTUTY UK 1 o OAERNEAO II I I, POND 1 i IV T.MRMl l MMSED LOT ) 1 1 EC .B.4MT3,TAN 0USi 1 DA47W-20 4 21 P1T I I DAH -H4 D.8.1 D-234 Put' I II STATE ROUTE 803 I (coDDpwE w�+EQin I 11 Pap b ALLKNOWN WELLS A DRAMP/61.D STTPS WRF@! MOPTTIEPROPOSED DRAR.=T 11Z 3R0WN. NOT TO SCALE Ulutt uNEs MONUA FOUI x POIE VON ONENT FOUND WN MIANUMENT FOUND FOCECORNEROiN ST WX MIXOUND WN FOUND MONUMENT T.M.8D-6G I I COT FRAM( DONLEY R , mom` NPLA DO:R.EY U.8.3386-SZ 85 R 85 .'lAi MONWHFNi O SIPS �VNOM gw'W \� AUT ON MONUMENT FOUND N�1 N.MTFB' Heltzel Soil Consulting L LC EXISTING LOT LAYOUT / SANITARY SURVEY Pwa Of b Mmx Wwda * VA]2896 STOCKTON CREEK SBD, ALBEMARLE CO, VA aaro PRDros®nw DNTu n sRow . ��RNRKI RO& VE fJSE11RIT) ,,,...... ._ NOT TO SCALE T.M.B9-BL LOT e STUART TAri WM D.RS08.347704,7071 PLAT POND TmA l9P LM.89w REVISED LOT 2 Ap1E5 R"RO tOT 7 ECACK7MANAN TRUST ^ 0.8.4733-29 D.8.47.&20 21 PLAT - D.aasso-xu PLAT STATE ROUTE 803 'PRESCRPTIVE EA9iNEN w IFPEIi UNE MOR ........... Fl "BED MONUI OU TLA9M 6 ADES C 6REVISED two *cne 9.PN N a�4�A Wo WODLOE LANE » LOT • ' 184 ACRES 4Ax AtlES TMAP-10 REN9'D LOT2 7.70 ADSS 0 R VON MONUMENT FOUNDM e MONUMENT O UN LLLPF190 VON T.M.�T IGG REVISED LOTS 4A6 ADRS �Tj1 RDMTRUME T 3 t 5 WR T VON `NIIR a 4%3,3TD MVON �NDT MT0111AONUMENT NPeY _ MANY CUTTING OR FILL WN MONUMENT FOUND,,,,, uMRIMTAnl a Awn e l THE PLATTING FOR DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED T.W.59-508•REVISED LOT L REVISED LOT 2,REVISED LOT 3, REVISED LOT 4. REVISED LOT 5. REVISED LOT S. REVISED LOT 7 S REVISED LOT B IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETORS, AND/OR TRUSTEES.IF ANY. FOR: STOCKTON CREEK, LLC CITY COUNTY OF GGw(ri;wA STATE OF glmbg" THE FOREGOING INB7RUMENT WAS ACKNOWLEDGED BEFORE ME THIS M M DAY OF ll" r .7 2022. BY .4 ,E Dp4. FOR; STOCKTON CREEK,LLC NOTARY PUBLIC 0702f01 0 MY COMMISSION EXPIRES : 42d llr z�L; APPROVED FOR RECORDATION : THE BOARD OF GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING Ci 15'49'16' 1954.86 541.98.. 272.72 540.27 S63-33-04-E C2 4444'04' 1090.92 90.14 45.10 90.12 51B'39'29'W C3. 9759'39'. 10B5.92 189.42 94.95 189.18 S38'31'21'W C4 14'56'55' 1090.92 264.62 143.12 283.82 S55'59'54"W C5 1*20'52- 1487.79 35.00 17.50 35.OD S72'22'45'W C6' 22'41'29' 1487J9 MS.22 228.52 5B5.38 S60'21'35'W C7 21'31'58' 157.57 62.9E 31.86 62.61 N05'35'15"E CB 32'53'50'. 94.14 54.05 27.79 53.31 N32'46'10"E C9 8'13'55" 94.14 13.53 6.77 13.5! N53'22'02"E CSD 15'57'OB" 184.27 51.30 25.B2 5f. 14 N65'27'33°E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-508 LOCATED ON U.S. ROUTE 250(ROCKFISH GAP TURNPIKE), STATE ROUTE 151(CRITZERS SHOP ROAD), STATE ROUTE 750(OLD TURNPIKE ROAD), AND STATE ROUTE 803(GOODLOE LANE) NEAR CRITZERS SHOP WHITE HALL MAGISTERIAL DISTRICT ALBEMARLE COUNTY,VIRGINIA SCALE: 1' = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29. 2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING BRLkN S. RAY LAC. No. 002281 02/03/2022 250 GOOOLOE ;;•;SITE:::: LANE S51 CRITZERS SHOP ROAD VICINITY MAP 1'-2000'+/- ROGER W.RAY 6 ASSOC. INC. 663 BERKMAR COURT CHARLOTTE5VILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 1 OF 3 A. T. M.69-198. 19C. 19D. 19E 6 19G ARE ZONED RA (ENTRANCE CORRIDOR) . T.M.69-19F IS ZONED RA- T.M.89-19H.19J 6.50E ARE ZONED RA(ENTRANCE CORRIDOR S FLOOD HAZARD OVERLAY).. B. T.M.69-198(REVISED LOT 1)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.59-19C(REVISED LOT 2)RETAIMS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-19D(REVISED L07 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.59-19E(REVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-196(FIEVISEO LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. I H. I. T. M. 69-S9J(REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2,36 ACRES FROM T,M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1960 DOL84DARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES- J. REVISED T.IM.59-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIS OATA.EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE.. L. SETBACK REGUIREMENTS:FRGNT= 75'.SIOE- 25' 6 REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA,THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA. THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. O. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS. ADDRESS S LEGAL REFERENCES: 7.M.59-198. 19C. 19D. 19E. 19F. 198, 19H, 19J 6 508 STOCKTON CREEK, LLC 455 SECOND STREET.5TH FLOOR,CHARLOTTESVIL(.E.VIRGINIA 22902 D.S.5657-253. O.B.892-159 PLAT S D.B.683-#4 PLAT. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-500 IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.254-409 6 INST.A202200001316).. S. AN EASEMENT TO VIRGINIA PUBLIC SERVICEI CDMPANY(D.B.232-585). 4. T.M.59-50B IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY, APPLY(D.B.209-261)- 5. T.M.69-19D,19E.19F.196,19H 6 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-404) 6. T.M.69-19D, ISE. 19F. 19G. 19H 6 ISJ ARE SUBJECT TO, AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(O.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF ppECORD REVEAL THAT ADDITIONAL PARCELS ANO/OR DEVELOPMENT RIGHTS EX�IST,THE INTENT OF THIS PLAT IS NOT TO CO SINE THESE PARCELSIOR EXTINGUISH DEVELOPMENT RIGHTS. S. NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ArY ADDITIONAL CONDITIONS.OTILITIES.EASEMENTS AM/OR COV, ANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T.M.69-19B (LOT 1) - 6.51+/- ACRES T,.M.59-19C LOT 2)) = 5.77+/- ACRES T.M.69-19D LOT 3 - 5.15+/- ACRES T,M.69-19E(LOT 4) - 5.45+/- ACRES I.M.69-19F(LOT 5) - 5.68+/- ACRES T.,M.69-19G(LOT 6) - 5.BB+/- ACRES T.M.69-19H(LOT 7) = 5.12+/- ACRES T.M.59-19J(LOT 91 = 6.56+/- ACRES T.M.59-50B . 9.35+/- ACRES DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY G ASSOC..INC. 663 BERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 349 S2A LEGEND: S P IF IRON FOUND IS IRON SET S70'OO'00'E / 35.G0' r ........ EXISTING LOT LINES T.M.59-6L S70'00'00 HEREBY EXTINGUISHED LOT fi E 102. N73'26'0T STUART TAYLOR SMACK 26 _ 0. OVERHEAD O.B.524fi-521 UTILITY LINE D.B.3415-704.707 PLAT 4�p10 (5 04+/ AL) +YS 49 20 E APPROXIMATE LOCATION 4®. 2dfi IS 220 51 r 7 A( OF AREA WITHIN ZONE A(f00 YEAR FLOOD PLAIN) IO.OB AC.) - IS` ""'•••••%0 n( fi ACCORDING T0; THE FEMA W I T.M.69-19G FLOOD INSURANCE RATE MAP. ) :) REVISED LOT 6EFFECTIVE p 42005. COMMUNITY PAINEL 510006 0225D. N05'10'43"W 155.87' }; 2.63 ACRES cum°, N05'!0'43'W 7.09'' " 1 ..00, (2.55 AC.) en'� (3.33 AC_) N05'10'43'W 23.27': NO2-36.21-W 29.23' •• . IS y -.^00'0o'p'$i U m -y "" L0T $•S69i70 " NO2'36'21'W f00.42' 530.00' (2 1 HIS WG5'0D'00'E _-.UO 505400' IS a NO2'36'21'X�j 25.00' IS �.. 40. DO' 11 T. M.69-19F S19'54'021 11 REVISED LOT 5 89.15' I< T. M. 69-5M NDB'56'25'W REVISED LOT 7 166.07" I 1 4.63 ACRES o E.C.ACKERMAN TRUST 1 i (4.00 AC) D.B.4733-23 r D.B.4733-20 6 21 PLAT N04'54'1f'W. •m, I I Wp3'11'34 E IS LOT 5 •zC y p}' 4 t0. 63 AC") °1 D. B.4456-444 71.02' D.B.3530-234 PLAT I IF .300:00' y - 3 6BB VO'00'E p M04'54'11'W 5.37' _ I I, 24.72 �'O0 'D0. 159.07' '. 0'b •' f IS 1 14.55 AC.) m NO3'44'08'W 154 34 T.M.69-19E STATE ROUTE 803 I 1 REVISED 4 (30'PREG000LOEVUNEEASEMENT) _. I. 62 ACRES blv .I NDS'50'52'W 115.24" _. I (0:07 ACJ) ' OVERMA) P(�E UTILITY LINE m - (6.55+/- ACRES) (2.36 AC.) (3.01 AC.) T.M.59-19B REVISED LOT 1 fT 64 0.26 AC.) 0ACRES Isl T.M.69-19C REVISED LOT 2 7.70 ACRES 15,72 N05j54952'W 1e 11, 2n.v, ug57' 'oP -� oI 66 01 .�- 115. I I v+ i _t IG I T.M.69-l90 IF:JAAJ2 S71B1 N04'26'19-W I ) REVISED LOT 3 $�O t 9• 0� T. M.69-6G LOT f 245. zD' ± 4.56 ACRES tD os Ac 1-+.. 31 aa' Sg� �., - MONUMENT FOUND FRANK DONLEY G S85'19'2B'W IF r'^";� So, ¢�p2 D. G 66 PLAT N10'02 00'W 50.95MON (4-51 AC.) g g..w 100 I:N REVISED: DUMENT MON UM FOUND i ff' FOUND P. VMY' REVISED: GRAPHIC SCALE 1"=200' M03'34'29'W ROGER I 224.53' 65: 0 200 400 VON MONMENT FOUND VON CHARLOTTE SL Ni 24.79SL 2q.79' MONUMENT TELEPHI FORA L s Y�9p�TF VON MONUMENT FOUND i5 a REVISED PO '�► t� T. 69-508°'eh0 8. % ACRES MONUMENT IS AT FOUND 1�f.Do' + von g3 336FM .. MONUMENT FOUND '3 43'00'47'W �3 95.17' CORNER IN GN.. von FENCE POST MONUMENT M FOUND ONUMENT FOUND I16'X PTEM$ER 27.2021 INOVEMBER 4.2021 40YE11BER 29. 2021 FEBRUARY 3.2022 PERKMARSCOURTINC. IILLE. YIRGINIA 22901 •YA �M E: (4341 293-3195 {URVEYING.COM SHEET 3 OF 3 149'. VIRGINIA VDHOF HEALTH DEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-50B HD ID: 101-22-0308 Well Class: Class IIIB (Cased and grouted 50' minimum) PERMIT NOTE: Well Number 17 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1 138 Rose Hill Drive Charlottesville, VA 22903 (434)972-6219 Voice (434) 972-43 10 Fax lk NWRON ° This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IUB private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Reltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions where a sewage disposal system is to be located. If modifications or revisions are necessary between now and when you constrict your dwelling, please contact the Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19B H DI D: 101-22-0308 Page 2 of 2 This construction permit is transferrable until expired or deemed null and void. A permit transfer form may be found on the VDH website at htto://www.vdh.virl inia.uov/env_iro_n_mental-health/Linn-2015-01- for ns/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027 Sincerely, J�sih Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for ❑ Sewage System f-41 Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 465 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Afton, VA 22920 Directions to Property: :omer of Route 250 & Route 151 Subdivision: WELL 17 Section: Tax Map: 69-50B Other Property Info: Phone: Fax: Phone: VDH USE ONLY m Health Dept. 10#1 i7 Due Date: 612-426-4728 Phone: 434-9813634 Fax: Emall: slmpeonnaaesconstmceonmenegemeM.com Block: Lot: Acreage: 8.73 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter ❑� Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 4 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement R] Yes Walk -Out Basement? 0 Yes Fixtures in Basement? R1 Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" R1 No "There is a $50 fee for determination of eliqibilitv. Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ Existing or 0 Proposed If proposed, is this a replacement well? ❑ Yes No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes 0 No All Applicants Is this a private sector OSE/PE application? ❑� Yes ❑ No If yes, is the OSE package attached? Yes ❑ No Is the property Intended to serve as your (the owners') principal place of residence? ❑ Yes I] No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. a plat of the property Is recommenced and a site sketch is required. The she sketch should show your property lines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the pro g ge sues must be clearly marked and the property sufficiently visible to see the topography. Uh �i 1 give sion to the VirginiiYLt rtment of Health to enter onto the property described during normal business hours for the purpose of pro ,fig this application end to) rrn quality assurance checks of evaluations and designs certified by a private sector Onsite Soil Evaluator or P fasionCet$ decesFe until the sewage disposal system and/or private water supply has been constructed and approved. R it£1.,�1tl Ltct3u. 040001abit Sianatu oNwiter/Agent Date 7Y.rn...wr.pswir.�.rrV.tl riYwx.ii,rrlS..dw/t,Ao�etls ASL aMW7rU9019 VDH Use only oste Emwed:... . _ _.. Doe D= fees HDW# FLB*Wwacol0 Faymant ryppk�xPtlr BtNf! --- # Page of -6— Fil Construction Permit ❑ Repair Permit OSE/PE Report For: ❑ Voluntary Upgrade Permit ❑ Certification Letter ❑ Subdivision Approval Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 17 GPIN or Tax Map #: 69-50B Health Dept. ID #: Latitude: Longitude: Owner: Name: Stockton Creek LLC cto Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltzel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: 8/22/2022 Date of Revision #1: Date of Revision #2: Contentsfindex of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Specifications 4. Well Location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations for Alternative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that i currently posses any professional license required by the laws and regulations of the Commonwealth that have been duly issued by the applicable agency charged with ticensure to perform the work contained herein. The potential for both conventional and alternative onsite sewage systems has been discussed with the ownerlapplicant. k%bltephf his cover page has been conducted under an exemption to the practice of engineering, specifically the �ftt'pfion in Cody inta Section 54.1-402.A.11 I reeomme �61: a: ia Co Oucti rmtt ❑ Subdivision Approval be: ❑ Issued H P�tt1111 n L r ❑ Repair it L] Voluntary Upgrade ❑ Denied r r10 19A� 5V OSFJPE Sig (' �7� �� Date: The form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12/01/14 Heltzel Soil Consulting Page -t of" VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-50B Property Address: TBD Subdivision: WELL 17 Section: Block: Lot: Directions. Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): Q Domestic Drinking Water ❑ Agricultural ❑ Irrigation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3B Minimum Casing Depth: 50 ft. Estimated Water Usage: 600 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit Page _of b The proposed well site shown herein, Q 1. Is located a minimum of 50 feet from all property lines. QX 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. Written affirmation from the adjacent property owners) that their property is not used for an agricultural operation. QX ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot F7 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) 0 i. Written permission from the adjacent property owner's) for the well construction. Q ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that pny property is not used for an Agricultural Operation as defined in "b kl Dat Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC 1412 Saumsville Road, Maurertown, VA 22644 1, s I I #19 srrasna WELL LOCATION SKETCH TM # 69-50B ALBEMARLE COUNTY, VA OVERHEAD UTILITY LINES REVISED T.M.69-50B 8.73 ACRES WELL #17 � �g0 _241 o. � e�gti 261 r WELL AREA LE foo.w me EL #18 / WELL AREA I � Siff B&1SM 7p.7 / August 12, 2022 DRAWN BY: SNV Page of b I `OLE 1 )LE VDH MONUMENT FOUND O• 80, 160• ^c40' Heltzel Soil Consulting, LLC MB 5 .lKVEf ,VA 22W TAN 8N �SED LOT 7 E.C.ACXERMMI TWO D.6.M7 23 DAL4733-20 k 9 P l ON.N38-N4 D.B.3530-234 RAT STATE ROUTE 803 (3wpj ape w 1) PROPOSED LOT LAYOUT / SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA ST.RT.750 (30PRESDR"w EASEMENT) NOT TO SCALE Heltzel Soil Consulting, LLC PQ a0x 355. Wmlabtl,. VA3269. T.M.69-aL LOT 6 STUART TAYLOR SMACK D.R.5246-521 D.a.3415-TO4.707 PLAT T.M.69-eM POND RENSED LOT ) E.C.ACKERMAN TRUST OIS'4733-23 D.8.4733-20 h 0 PLAT D.d4436-4 0.9.3530-234 PEAT STATE ROUTE 803 CSo PR� M�EEPJIExT) T.M.69-ec LOT 1 FRANK DwN h cwu DONI£Y O.a33e0-ez as � ea wA4 wH MONUMENT EXISTING LOT LAYOUT / SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA -`ST.RT.i50 (3 PRESMPTw EASEMENT) OLD TURNPIKE ROAD r.x.e9-l9c I�/ r RENeED LDr a 293 AtlRS � �� I Y TN.a9-19M) 116M1l�//- ACpES 4 / 1J TMA9-10F i� T.MR9-19d Rto RE s Rn+/- LOT e AES ACRES ^ 8.f2 LOT 4-09 AtliFa REN9FD LOT 9 ).A AOiS O tM.a9-190 REM6D1 LOT 3 TST 456 AaEs RpU�RDND 5INS y i� 1T1 i wx � oe;?o3sT� a MONUMENT FOUND N NOT TO SCALE ONRHEAD _ UTIUTY UNEs PENSED MCN4UUY TLA9-SaB fiTDl e.n Tans 1 m � yn gg8 %3�N V: �ma� r wH WNDT wN EN M(FOUNDD CORNER N FENCE POST wH MON T FODUND THE PLATTING FOR DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED T.M.69-50B.DEVISED LOT 1,REVISED LOT 2.REVISED LOT 3, REVISED LOT 4. REVISED LOT 5. REVISED LOT B. REVISED LOT 7 G REVISED LOT B IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETORS.AND/OR TRUSTEES,IF ANY. FOR: STOCKTON CREEK. LLC CITY/COUNTY OF Lko Gykarh STATE OF u; ...."a THE FOREGOING INSTRUMENT WAS ACKNONLEDGED BEFORE ME THIS`U DAY OF F 2022. BY A.,,( Q,.6, FOR: STO�CKTOONN CREEK. LLC NOTARY PUBLIC a MY COMMISSION EXPIRES :_�iJ, Jjrr .Lo.1,TJjrr .Lp=,I APPROVED FOR RECORDATION : THE: BOARD OF GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC '- TANGENT CHORD CHORD BEARING C1 15.AB'16' 1964.86'. 541.98 272.72 540.27 S63.33'04"E C2 4.44'04" 10 0.92' .14 45. 10 90.12 SIS-39-29-N C3. 9 5939' fO85.92 189.42 94.95 189_18 S38-31.21-W C4 14'56'55' 1090.92 284.62- 143.12 2B3.82 S55.59'54"W C5 1.20'52" 7487.79' 35.00 17.50 35.00 S72'22'45"N C6' 22'41'29" 1487.79 569.22 298.52 585.38 S50.21'35"W C7 21'91'58' 167.57 62.98 31.B6 62.61 N05.35'16"E C8 32.53'50' 94,14 44.05 77.79 33.31 N32'4B'10"E C9 B•13'55" 94.l4 13.53 6.77 13.51 N53.22.02"E C10 15'57'OB' SB4.27 51.30 25.82 51.14 NBS-27.33°E BOUNDARY LINE REVISED REVISED LOTS THE PROPERTIES LOCATED ON U.S. ROUTE STATE ROUTE 151 SCALE: I" = PLAT B.7se N CREEK,LLC [SH GAP TURNPIKE), SHOP ROAD), 7IKE ROAD). )LOE LANE) DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4. 2021 EVISED: NOVEMBER 29. 2021 REVISED: FEBRUARY 3. 2022 FOR COLLINS ENGINEERING ROGER W. RAY G ASSOC. INC. 663 BERKMAR COURT CHd ELETPHONE:LL(434)R 01 293-3 95 RAYSURVEYING.COM BRIAN S. RAY Lk. Na 002281 02/03/2022 93 GOODLOE LANE VICINITY MAP 1'=2000 SHEET 1 OF 3 THE LAND USE (NOTES SHOWN ON THIS PLAT ARE IMPOSED AT THE REQUEST OF THE DIRECTOR OF PLANNING. BY PLACING HIS/HER SIGNATURE ON THIS PLAT HE/SHE HAS DEEMED THAT THEY ARE CORRECT AND IN ACCORDANCE WIT THE ALBEMARLE COUNTY ZONING ORDINANCE IN EFFECT THIS DATE. THESE NOTES ARE NOT RESTRICTIVE COVENANTS RUNNING WITH THE LAND AND THEIR APPEARANCE ON THIS PLAT IS NOT INTENDED TO IMPOSE THEM AS SUCH. ANY REFERENCE TO FUTURE DEVELOPMENT RIGHTS SHOWN HEREON IS THEORETICAL. A. T.M.69-19B.19C, 190,19E 6 19G ARE ZONED RA(ENTRANCE CORRIDOR). T.M.59-19F IS ZONED RA. T.M.69-19H. 19J G. 50B ARE ZONED RA(ENTRANCE CORRIDOR G FLOOD HAZARD OVERLAY). B. T.M.69-19B(REVISED LOT 1)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISEO LOT 2)PETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-19D(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.59-19EfREVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. 6, T.M.69-19G UIEVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. I. T.M.69-19J(REVISED LOT B)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER i9BO BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.69-500 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIS DATA,EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE- L. SETBACK REGUIREMENTS:FRONT- 75'.SIDE- 25D REAR= 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA.THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA.THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS, ADDRESS G LEGAL REFERENCES: T. M.69-19B, 19C. 190. ISE. 19F, 19G, 19H, 19J 6 SOB STOCKTON CREEK LLC 495 SECOND STRGET,5TH FLOOR.CHARLOTTESVILLE,VIRGINIA 22902 D.B.5657-263, D.B.092-159 PLAT G D.B.683- 4 PLAK. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-SOB IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-409 G INST.l202200001315).. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEICOMPANY(O.B.232-585). 4, T.M.69-50B IS SUBJECT TO AN EASEMENT TO TVE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR A5 IT MAY! APPLY(O.B.209-261). 5. T.M.69-19D. i9E, 19F. 19G, 19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-404) 6. T.M.69-190, ISE. 19F, 196. 19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVIE COMPANY INSOFAR AS IT MAY APPLY(O.S.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF ECORD REVEAL THAT THHIISTPLATLISANOTLTOACOMBINEOR ETHESENPARCELSIOR EXTINGUISHTHE INTENT DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS IMOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES APE SUBJEC TO ANY ADDITIONAL CONOITIONS,UTILITIES,EASEMENTS AND/OR COV WANTS( THAT WAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T.M.59-19B ROT 1 - 6..51+/- ACRES T,,.M.69-190ROT 2 = 5.77+/- ACRES T.M.69-190(LOT 3) - 5.15+/- ACRES T.M.69-19E(LOT 4 - 5..45+/- ACRES T.M. 69-19F(LOT 5) - 6.BB+/- ACRES T.M.59-190(LOT 6) - 5.88+/- ACRES T.M.69-19H(LOT 7) - 5.12+/- ACRES T.M.S9-19J(LOT 8) - 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY G ASSOC., INC. 663 BEPNMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 (434) TELEPHONE: 293-3-3195 RAYSURVEYINEYING. COM SHEET 2 OF 3 1491 LEGEND: ST RT. 750 (30 PRESCRIPTIVE EASEMENT) D 1 OLD TURNPIKE ROAD IF IRON FOUND Arm IS IRON SET 570'00'00"E .�`j' „VDH S$, pp• '��I y.* MONUMENT EXISTING LOT LINES T.M.69-6L S70'00'00 E iYX ! ,LOCAA TIOIIXISTFIEAM FOISND HEREBY EXTINGUISHED LOT 6 102.98 �� N73'26'07'E. -� STUART TAYLOR SMACK - i „�,A• 0 OVERHEAD 0.B.5246-521 2.53' �.. �� ` AN'BUFFER •M1... S UTILITY LINE 0 (5 04+/ AC) 5 I a , D. B.3415-704, 707 PLAT OS = OVERHEAD F ry'�Z� p 'TF rI5 SO4. 49 20 E UTILITY 0 $ke APPROXIMATE LOCATION V�/'LdT IS 220 51 r a LINE ajY h'Ip ^ANp OF AREA WITHIN ZONE J 7 (6.55+/- ACRES) C �+3p A 'TF VON A (100 YEAR FLOOD PLAIN) n( T (0.08 AC.) IS" "'••••• p r�1i LOT 7 m \ f J /M .MONUMENT ACCORDING TO THE FFNA W I T.M.69-196 ? X m L07 6 0 ) m fp0 FOUND FLOOD INSURANCE RATE MAP, (:I REVISED LOT 6 a• '� m''y S 519'30'59'E EFFECTIVE DATE 2/4/2005, om 1 COMMUNITY PANEL 510006 02250. N05'10 43'W 155.67' }; - 2.63 ACRES �^ ✓�Q 'r v POLE 33.99' ND5'f0'43'W 7.09' 1 .00 f2.55 AC.) cn (3.33 AC.) T iA'y. J � v IS N05'10'43'W 23.27.' o m -1 i 0f NO2'35'21'W 29.23' IS " N 9 L v OVERHEAD �•. a MBg •00'UOfN 0T B ' C,pg� m IF Cn, UTILITY •ry m NO2'36'21'M L07 $9••"f2 66 AC.) L07 8 'W. S LINES �,i��`1' 100'42' I IIS NB5'00 `00'E 535,00' bP. pO �x LOi •' ' R m MONUMENT b 85(00.,' IS F m1m- 1 ....Q m ..FOUND NO2.36'21'W 26,00' fmn 40.00' 1 1 T. M.69-19F 519.54.02 ES SS o'nm (2.36 AC.) ti t REVISED LOT 5 Bs 15' 19 JIbN I 4p1,V .� REVISEDLOT7 NOB6fi 075 W '�1 0' Io I9 0, "w 4.63 ACRES SS• F m S E C ACKERMAN TRUST 1 1 (4.00 AC) c !p •�k D 8.4733-23 N04'54'f!"N N63 IS LOT_5 •N yg �'pf. m.:', REVISED POLE DYFM' s D.B.4733-20 d 21 PLAT I'1 SS•3'� E m IF o 9 D.B.4455-444 71.02' IIF 300:00 p7 470 83 AC.: 1O w 3j, (3.01 AC.) 'v T. Mi.69-508 ti"+ • z D.B.3530-234 PLAT 3$e, 588.00'0D'E.N 9c?d��:..' .QC¢ N04'54'1!'W'-�1 1 2b.72• QO•� 159.BT in t., E, IF .� 8. 73 ACRES y 5.37' pp, •F IS m IS (5.72 ACM • m m I (q.55 0.C.) m^ I T. M.69-198 m POLE MONUMENT N0154.34' REVISED IS AT FOUND 154.3a• 1 T.M.69-19E �+ LOT 1 1 00' (305PfiE5CRIPTATE �TI(YE EATE SEMENT) 1 t REVISED LOT 4 1F' - •IS T ,: , 3:.64 N7..g����34 36• -' MONUENT GOODLOE LANE `I 4.62 ACRES O - 10.26 AC.) P .ACRES Is. h '31' FOUND NOS'50'52'N1 1 T.M.69-19C ✓ 1 43'00'47'W 1 t5. 24' yf ( (0.07 AC.)�1 T a p 4, o:d AO 'G� 95.17' 1 H03.1D'Qo'E s Ik 4 3 REVISED LOT 2 �cm oy6� CORNER IN N05'50 52'W - 1 k 262• . TT 7.70 ACRES T� �'',. ti10 M -VDH FENCE POST 104.98 8.3. '; S62.00'091 IS + •� Y MONUMENT 1 M `2q,01 133. 57•' N05'54952•N ( I �9C L i;% 66 US 336 q0 - MONUMENT7.FOUND 1 T. M.69-19D 'Q7 l7 IF'.SAA 8 • I5 S71'33'j38oXD N04'26'19'W I I REVI5E0 LOT 3 bFj$, : Ag9• A''a' von 1e1.o1' T. M.69-6G 245.2D • 4. 56 ACRES cD. D5 Ac.l-'>\. 33 ati`�1•� E MONUMENT U LOT 1 FRANK DONLEY d S6549'2B"W IF T"'? 5Ti• 4�' 4'OP A SCALE: I" = 200• CARLDONLEY 26.09' (451 AC.) zS A3 BS d 86 PLAT N5'W $Tpy�K� 6 ,111 DATE: SE TEM ER 27.2021 0.95, REVISED: NOVER 4. 2021 VDH REVISED: OVEER 29.2021 MONUMENT , Ff' MONUMENT REVISED: iFEBRUARY 3, 2022 GRAPHIC SCALE 1"=200, FOUND i� FOUND H ' 1403 W ROGER PAY d A6C.,ING. 224.63' 4.63' 663 COURT W"41' 0 200 400 VDH MONUMENT FOUND- VON CHARLOTTESVILLE,VIRGINIA 22901 NBB'17'21'W MONUMENT TELEPHONE: (434) 223-3195 GL 24.79• RAYSURVEY2NG.COM SHEET 3 OF 3 14912A RGINIA VDHOF IHEALTH NT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, 4201 Charlottesville, VA 22902 Tax Map Number: 69-50B HD ID: 101-22-0309 Well Class: Class IIIC (Cased and grouted 20' minimum) PERMIT NOTE: Well Number 18 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434)972-6219 Voice (434) 972-43 10 Fax This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IHC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone numberof the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19B HDID:101-22-0309 Page 2 of 2 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.vd1i.vir)ii� ia.Lov/environmental-health/gmp-2015-01- fonns/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System 0 Water Supply Owner: Stockton Creak LLC c/o Alan Taylor Mailing Address: 465 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creak LLC c/o Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TEID Afton, VA 22920 Directions to Property: Come oofRoute 250 & Rout® 7is1 Subdivision: WELL 18 Section: Tax Map: 69.508 Other Property info: VDH USE ONLY Health Dept ID# Due Date: Phone: 512-426-4728 Fax: Phone: Phone: 434.981.3634 Fax: Email: simpaon&naswnswuoonmanagementwm Block: Lot: Acreage: 8.73 Sewage System Of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land Is suitable for a sewage 'n and to apply for a construction permit (valid for 18 months) only when ready to build. Certification Letter E Construction Permit Use: ❑ Subdivison Approval ❑ Repair Single Family Home (Number of Bedrooms) 6 Multifamily Home (Total # of Bedrooms) Daher (Describe): Basement 2 Yes Walk -Out Basement? ❑ No ❑ Yes Fixtures in Basement? 2) Yes El No ❑ No :onditional Permit Desired? ❑ Yes [A No If es, what El Reduced Water Flow Y type of conditions are desired. ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. ma)imum) )o you wish to apply for a betterment loan eligibility letter? ❑ Yes" 0 No 'There is a $50 fee for determina8nn s Water Supply Will the water supply he El Public Public or ❑ Is the water, supply ❑ Existing or ❑ Proposed If Proposed, is this a replacement well? ❑ Yes 0 No If yes, will the old well be abandoned? Will an buildin s within S7 of the well be termite treated? ❑ Yes Q No El Yes ❑ No Is this a private sector OSE/PE appliptlon? , All Applicants ❑ Yes ❑ No if yes, is the OSE package attached? Q Yes Is the property intended to serve as your (the owners') principal place of residence? ❑ No in order for VDH of process your application for a sewage system, ❑ Yes [] No plat of the roe 0 you must attach a pia! of the property and a site sketch. For water supplies, a p property e is recommenced and a site sketch is required- The site sketch should show your property lines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is Conducted, the property lines, building location and the proposed well and sewage sites must be dearly marled and the property sufficiently visible to see the topography. I give nR-- � c{' Lkootj!P I Department of Heaith to enter onto the property described during normal business hours for the purpose of proses gills pp scat ah�7 ertcrn kju&liry assurance checks of evaluations and designs certified or Pr nal Enginaer as n ry until the sewage disposal system and/or g by a private sector OnsBe Soil Evaluator private water supply has been constructed and approved. I L� CHItISTOPtlE1t S• y\ �� 7 J IIELTZEL 2 t 40 U.\'SITESOv Yf/tt.LNe rSnly Dab )�xafrad7 OarO Opp° _ FroS HDIU A l�mdat saes # fsymw wpott*d Sal Ili._ , Date Page of 0 Construction Permit ❑ Repair Permit 1 Address: or Tax Map #: OSEIPE Report For: ❑ Voluntary Upgrade Permit ❑ Certification Letter Section: Subdivision. WELL 18 69-50B Health Dept. ID M Longitude: City, State, Zip: azocxron Greek LLC c% Alan Taylor 455 Second Street SE, # 201 ChadoHesvills, VA 22902 ared by: Name: Chris HeHzel PO Box 554, Woodstock. VA Name: w ncpw.. 1. Cover 2-3. Well 4. Well L this report: Date of Revision #1: Date of Revision #2: 6. Existing Lot Sanitary Survey License # License # ❑ Subdivision Approval VA I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5S610), the Private Weli Regulations (12VAC5 630) Systems, the Regulations forAttemative Onsite (12VACS613J and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses any professional license required by the laws and regulations of the Commonwealth that have been duly issued by tha applicable agency charged with licensure to perform the work contained herein. The potential for both conventional and attemative Dnsite sewage systems has been discussed with the ownerlapplicant. The work attached to this rover page has been conducted under an exemption to the practice of englneering, specifically the exempti of Virginia. Section 54.1-402.A.11 recommend th �permit ❑ Subdivision Approval PP be: ❑ Issued ❑ Certificatio r ❑ Repair Permit ❑ Voluntary Upgrade ❑ Denied C{1RISTOPHERS• L �-\ O )SE/PE Si gA0061460 oO lJ r Lic No Date: ji'' The ksm contains pen wmi inkxmetion subject to disoloauib undefMe Freedom of information Act. - - Revised 12171/74 Heltzel Soil Consulting SYSTEM SPECIFICATIONS Application Information Name: Stockton Creek LLC cd, Phone: 512426-4728 Location Information Tax Map/GPIN #: Subdivision: WELL 18 69-508 Directions: Comer of Route 250 & Route 151 HDIN: Property Address: Section: Page (, of VDH USE ONLY VA 22902 TBQ Block: Lot: General Information Well Purpose (select all that apply); (] Domestic Drinking Water ❑Agricultural ❑ Irigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal Information subject to disclosure under the Freedom of Information Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit The proposed well site shown herein, Page of Q I. Is located a minimum of 50 feet from all property lines. I A 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. Q i. Written affirmation from the adjacent property owner($) that their property is not used for an agricultural operation. Q ii. Other confirmation that land use is not an agricultural operation, please describe: Posed Residential Subdlvison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia, (check one below) Written permission from the adjacent property owner's) for the well construction. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): Mperty is not used for an Agricultural Operation as defined in Codq fVl inia.operty O er Da le Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulti 1412 88umsville Road, Maurertown, v 222644 LLC WELL LOCATION SKETCH TM # 69-50B ALBEMARLE COUNTY, VA OVERHEAD UTILITY _ LINES I I REVISED T.M.69-50B srrEsr 8.73 ACRES 241' I 1 100.00, #19 VMSA-, I rE®' �17'@7M1 1 August 12, 2022 DRAWN BY: SNV Inca WML AREA Page _4,_of W OLE OLE VDH MONUMENT FOUND Heltzel Soil ConsultinPROPOSED LOT LAYOUT! SANITARY SURVEY Pop_of b g, LLC STOCKTON CREEK SBD, ALBEMARLE CO, VA AILAMOM WRb6RAURADRMDSITERW F Mx6 Woven VAx266a EIIY OP 1Ti6PROPo5EU DRAL1'FRiiDs ARE $ROgiJ. ST.RT.750 (301`RESCFYIW EASEMENT) NOT TO SCALE T.M.69-6L LOT 6 SMART TAMOR SMACM O.E.521 -521 0.8.W1 70A.707 R T II II POMo I � 1, T.M.AN 1 4 r RE LOT 7 E.c. R47WTµY1305i 11 DA473 20 k Z PLAT I 1 o9.M5 O.E.353o-2mx3a PUT I 1 11 1 II STATE ROUTE 803 EASEMFN (304RESCR�TIYE TJ 1 C000LOE LANE 1 1� �� I $6 II I Ili T.M.69-60 I I LOT 1 ERAMM OON 6: CARLA OCNLEY D. PRAT 65 & 8 86 PLAT WN rouNo' 0u� 15� sCos11�uW IV/ TT� (VP 98y103 t10� MM MONUMENT FWNO WM Hqs P.O' ry. q�,,USRo. OYME161TL17Y � . ^�`L.:j;?y,I i::.. m 34^7a VA ALBEMARLE CO, STOCKTON CREEK SBD, of 6 Heltzel Soil Consulting, LLC EXISTING LOT LAYOUT / SANITARY SURVEY ^� HE "OPOSED IIeawRrrsPage b"nFm Po eaz 550, LM1'aoYaNMt. VA19Ya 200'OF THE PROPOSED DILAINEI©DSARRSAOWN. ST.RT.750 7 NRN ( R SMIPTIVE EASEMENT) NOT TO SCALE T.M.39-SL LOT S STUART TAYLOR SMAM O.S.52{5-521 0.e.0415 704707 PLAT T.M.39-am REMSm LOT ] E.GACNETOIAN TRUST D.B.{]3YZT D.9.4]5Y20 2I PPUTD.e.4/5B - D.easm-2D4 PLAT STATE ROUTE 803 (DD'PR ��PVJEOE � ENT) 1.M.39-UG LOT T FRANK DONLEY k CARLA DOMLEY D.xSTSO-Sz IN @ SS PLAT MONUMENT POUND VON MONUMENT FOUND— ._ 4 Pa4 oVEWITY N UTILITYae>//,,, N O UNE c�� 75 p — Z MON NA9 I9CFt RZMM LOT 10 ALRLS 'C}4 TA.BFiMI W •: %i:i': ::3ii.:. 1""'i L° i OVERHEAD Uruly UNFS R MONUL TY.�� FOUR — x» Aaas RENPiD LOTS I" AM IIJIMSEDWO 6=+/w+/- ATAE$ 3 tlh p8tl Y haw A vDH r _ _ dU1NMD T 3 e .M.e6-18E ..N-toe RETt9FDLOTI VON MONUMENT ALOT4 T.Y.e�iM: AM FOUND IE}1gD LDE S e T.M AM CORNER IN EENCE POST 4DH O Q MONUMENT VON FOUND MONUMENT FIXMD r.xe9-tm VON ] RIN � T GLO AD� WND R M $Lo RE0�9 Y ZttT / kv MON MU EN August 214 2022 — FOUND N,gi..9 rn T r r. non THE PLATTING AR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T.M.69-508,REVISED LOT L REVISED LOT 2,REVISED LOT 3, REVISED LOT 4.REVISED LOT 5.REVISED LOT 6.REVISED LOT 7 G REVISED LOT B IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER M), PROPRIETORS, AND/OR TRUSTEES, IF ANY. FOR: STOCKTON CREEK• LLC CITY/COUNTY OF Gi'hIIW STATE OF Wi-JA"- THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE NE THIS -'T DAY OF Z5 " 2022. BY A a. Dom,., FOR: STOCKTON CREEK. LLC NOTARY PUBLIC i%1G7107 MY COMMISSION EXPIRES ' n,4. Y 2-07-I APPROVED FOR RECORDATION : NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING Cl 15-48'16" 1954.66 541.96 272.72 540.27 963'33'04'E C2 4'44'04" 1090. 92 90. 14 45, 1D 90.12 SIB 99'29•N C3, 9'59'39' SOB5.92. 189.42 94.95 S89.1B S38'31'21'W C4 14'56'55' 1090.92 284.62 143.12 283.82 S55'59'54'W C5 1'20'52" 1487.79 35.00 17.50 35.00 S72'22'45'W C6 22'41'29' 1497.79 5B9.22 299.52 585.38 S60'21'35'W C7 21'31'58' 167.57 62.98 31.86 62.51 N05-35.16-F CS 32'53'50" 94.14 54.05 27.79 53.31 N32'48'10"E C9 8113455" 94..14 13.53 8.71 13.51 N53'22'02"E CS 15'S7.O8° 184.27 51,30 25.82 51.14 N65-27.33-E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND IEVISED LOTS 1, 2. 3. 4, 5, 6, 7 B 8 PROPERTIES OF STOCKTON CREEK,LLC U.S. ROUTE 250(ROCKFISH GAP TURNPIKE), fE ROUTE 151(CRITZERS SHOP ROAD). TE ROUTE 75O(OLO TURNPIKE ROAD), D STATE ROUTE 803(GOODLOE LANE) SCALE 1" = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY G ASSDC.,INC. 663 BERKMAR COURT CM ELEPHONE:LLR(434)293-3195 RAYSURVEYING.COM BRUIN S. RAY Ek No. 002281 02/03/2022 B03 GOOOLOE •::SIE::�:. LANE 15f ••• CRITZERS SHOP ROAD VICINITY RAP 1'-2000' A. T.M.69-198.19C.19D.19E 6 196 ARE ZONED RA(ENTRANCE CORRIDOR). 7.M.B9-19F IS ZONED RA. T.M.69-19H. 19J & 50B ARE ZONED RA(ENTRANCE CORRIDOR 6 FLOOD HAZARD OVERLAY).. S. T.M.69-19B(REVISED LOT i)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-SBC(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-190(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.59-19E(REVISEO LOT 4)RETAINS TOO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-19G(REVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND KAY NOT BE FURTHER DIVIDED. H. T.M.69-19H(REVISEO LOT 7)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. I. T. M. 59-19J (REVISED LOT 8)I5 ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.35 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1980 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.IN.69-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIS DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE.. L. SETBACK REOUIREMENTS:FRONT= 75'.SIDE= 25' 6 REAR= 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ,ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS. ADDRESS 6 LEGAL REFERENCES: T. M.69-19B. 19C, ISO. IRE. 19F, 196, 19H, 19J 6 500 STOCKTON CREEK,LLC A55 SECOND STREET. 5TH FLOOR, CHARLOTTESVIL�E. VIRGINIA 22902 0.6.5657-263, D.B.892-159 PLAT 6 D.B.683-44 PLAT, 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-506 I5 SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-409 B INST.#202200001316)., B. AN EASEMENT TO VIRGINIA PUBLIC SERVICE,COMPANY(O.5.232-585). 4, T.M.69-50B IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(O.B.209-261). 5. T.M.69-19D. ISE. 19F. 190. 19H 6 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COIPANY(0.B.264-404) 5. T.M.69-19D,19E 19F.19G.19H 6 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EXIST. THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELSIOR EXITINGUISH DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS NOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONDITIONS.UTILITIES,EASEMENTS ANO/OR CO NANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS T.M.69-19B(LOT 1) - 6..51+/- ACRES T.14.69-19C(LOT 2) - 5..77+/- ACRES T .M.69-190 ROT 3 - 5.15+/- ACRES T.M.69-19E(LOT 4) - 5..45+/- ACRES T. M. 69-19F(LOT 5) - 5.6S+/- ACRES T,M.69-19G(LOT 6) - 5.88+/- ACRES T.M.69-19H(LOT 7) - 5.12+/- ACRES T.M.69-19J(LOT B) - 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: MOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY 6 ASSOC.. INC. 663 BERKMAR COURT CHARLOTTESVILLE.VIMGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.CGM SFiEE7 2 OF 3 14912A LEGEND: IF IRON FOUND IS IRON SET ........ EXISTING LOT LINES T.M.69-GL HEREBY EXTINGUISHED LOT 6 STUART TAYLOR SMACK N73 �— OVERHEAD 0.8.5246-521 UTILITY LINE D.B.3415-704, 707 PLAT APPROXIMATE LOCATION OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO,THE FEMA FL000 INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 02250. N05'10'43'M 155.57' N05'1043'W 7.09' NOS'10'43'W 23.27L NO2'36'2i'W 29.23'— U R 100.42' NO2'38'21'K- 40.00' FN1 LOT dY REVISED7 i6 16 E.C.ACKERMAN TRUST D.8.4733-23 0.8.4733-20 G 21 PLAT NO, D.B.4455-444 D.B.3530-234 PLAT p N0 � NO STATE ROUTE 803 (30'PRESCRIPTIVE EASEMENT) GOOOLOE LANE T.M.69-6G "�'•"' LOT 1 FRANK DONLEY 6 SBS'19'2B" CARLA DONLEY 26.09' D.B.3380-82. NIO'02'DO 85 S 86 PLAT GRAPHIC SCALE i"=200' --- NO3'34'29"i 224.63' 0 200 400 VDH MONUMENT FOUNC N68'17'21 GL 24.79' S70'00' 00'E 102.90, . T.M.69-19G REVISED LOT 6 2.63 ACRES m nn• (2.55 AC.) T.M.69-l9F REVISED LOT 5 4.63 ACRES (4.00 AC.) 14,55 AC.) T.M.69-19E REVISED LOT 4 4.62 ACRES (0, 07 AC.)-% 1 T. M.69-190 -V REVISED LOT 3 4.55 ACRES (0.05 (4.51 AC.) .13.33 AC.) 'F (S. 72 AC_ m _ (6.56+/- ACRES) (2.36 AC.) m s REVISED � (3.03 AC.7 a', T.M 69-50B m' F, 8.73 ACRES T.M.69-19B REVISED N LOT 1 N78 w, 364 I ACRES , 0.26 AC.] T.M.69-19C J 7V REVISED LOT 2 '' 7.70 ACRES ;— T, 9% iS71'33'II38'W �,t _ FOUND MONUMENTVDH 181. q!' t1�s"IM SCALE: 1 = 200' StptL@� M F �11 DATE: SEPITEM$ER 27, 2021 REVISEDe gr 41 2021 REVISED:. NOVEMBERR 29. 2021 REVISED: IFEBRUARY 3, 2022 ROGER W. AY G ASSOC., IMC.^ 1w6. 3I ERKMAR, COURT Iy,1 J1 Y� CH TELEPHONE:ILL((4341 293 3192SO01 RAYSURVEYZNG.COM SHEET 3 OF 3 149 VIRGINIA IYDHOFHEALTH DEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville. VA 22902 Tax Map Number: 69-1 v13 HD ID: 101-22-0310 Well Class: Class IIIC (Cased and grouted 20' minimum) PERMIT NOTE: Well Number 19 Dear Alan Taylor: Pagel of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax APPROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class HIC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The pennitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessaryduring construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19B HDID:101-22-0310 Page 2 of 2 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.gov/environmental-health/pmp-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System , ❑ Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street BE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 2nd Street BE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Directions to Property: Subdivision: Tax Map: Afton, VA 22920 VDH USE ONLY Health Dept. ID# Due Date: Phone: 512426.4728 Fax: Phone: Phone: 434-981-3634 Fax: Email: aimpson@ffUasconstructlonmanaaemern.eom Vvt:LL 19 Section: Block: 69-19B Other Property Info: Lot: llnrpanp• I" Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determined the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter ❑, Construction Permit ❑ Subdivlson Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 5 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement 0 Yes Welk -Out Basement? 0 Yes Fixtures in Basement? [±-] Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes E) No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use It yr. maxlmurn) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" El No "There is a $50 fee for dP.teflntnPflnn of piimKira., Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ 6risting or 0 Proposed If proposed, is this a replacement well? ❑ Yes ❑� No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildin s within 50' of the well be termite treated? ❑ Yes 1Z No All Applicants Is this a private sector OSEIPE application? IT Yes ❑ No If yes, is the OSE package attached? ,l Yes Is the property intended to serve as your (the owners') principal place of residence? ❑ No ❑ Yes � No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water suoolies a - - - --- - •---••••••••• •...... ,.. a „� o,.�,u, „ ,ry,,,,G„. , ne, sire snetcn snouia snow your property lines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the proposed w tides must be clearly marked and the property sufficlently visible to see the topography. tip,LT t I OF - I give pennis rt�Eayihe Virginia De processing jLFis piication and to I or Profess"fffnaL noineeras neami Signature y..-I{ELTZEL UcNu.1940001410 0 r, of Health to enter onto the property described during normal business hours for the purpose of silty assurance checks of evaluations and designs certified by a private sector Onsite Soil Evaluator e sewage disposal system and/or private water supply has been constructed and approved. 4L, •«.r,asrsM+1pLr�r�orrWxlUi;Ort�virlpeFw�tlWeeGr �tl. RtrirNRi�i9 VIfHLbs.p„t„ Daftmruuad., D"lol .. Feo S HDIA # Fist" am 0 Fttyt W typsklradc ib MW # — . — Rwdx 8 Date Page( of [] Construction Permit ❑ Repair Permit OSE/PE Report For: ❑ Voluntary Upgrade Permit ❑ Certification Letter ❑ Subdivision Approval Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 19 GPIN or Tax Map #: 69-19B Health Dept. ID #: Latitude: Longitude: Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltzel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: 8/221022 Date of Revision #1: r Date of Revision #2: Contents/index of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Specifications 4. Well Location Sketch 5. Proposed Lot Sanhaiy Survey Certification Statement i hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses any professional license required by the laws and regulations of the Commonwealth that have been duty issued by the applicable agency charged with licensure to perform the work contained herein. The potential for both conventional and alternative onsite sewage systems has been discussed with the owner/applicant. El The work attached to this cover page has been conducted under an exemption to the practice of engineering, specifically the exertptio Ipylid$M mia Section 54.1-4022 A t 1 �" OF I recommend that ��onstructlo{ ❑ Subdivision Approval be: ❑ Issued S i ❑ Certificati00%Let ❑ Repair Permit ❑ Voluntary Upgrade ❑ Denied O apOp1 �r l�� I t OSE/PESign U o•j9 Date: �N9�vt: ota5lt`6So The form contains personal information subject to disclosure under the Freedom of Infomration Act. Revised 12101114 Heltzel Soil Consulting Page 2 of k' VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax MaplGPIN #: 69-19B Property Address: TBD Subdivision: WELL 19 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): 21 Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit Page 3 of The proposed well site shown herein, Q 1. is located a minimum of 50 feet from all property lines. Q 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. Q i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. FRI ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, 1 have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Qi. Written permission from the adjacent property owner's) for the well construction. Q ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that Ty property is not used for an Agricultural Operation as defined in § 3.1-22.29CViminia . a Date Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC Paged Ofb 1412 Saumaville Road, Mauiertown, VA 22W 13N AREA Sifa, 1-1 WELL LOCATION SKETCH TM # 69-19B ALBEMARLE COUNTY, VA 1. IV I. V ..I I V REVISED LOT 8 8.92+/- ACRES WELL #20 103, August 12, 2022 DRAWN BY: SNV SnE SA4 �TTv1.69-1913 REVISED LOT 1 \ 3.64 ACRES 241t- 5 1p 1oo.oa I11 O' 90, ISO, 24o' mommomilla PROPOSED LOT LAYOUT! SANITARY SURVEY ca e - -f b lk.6 54, z, WoeMlotl� VA2ZB8Y l Soil Consulting, L LC STOCKTON CREEK SBD, ALBEMARLE CO, VA ALL IMOWN*UP & DRMtiUMD SITESWINDY PO Bow 2Q0'OPTND PROPo9D DRAMIPDQ.ONAAD SROWN. ST.RT.750 >(JDPRESCRIPRYE EAS NMT) '-_�aD,DRNPMENDAD NOT TO SCALE Pao I I v� T.M.ea-sM `J 11 vm ,•m ,,,m - ,nm REN LOT T I I ^ ECAN TRUST e D.9.4m .B.4ns-as l l 0.8.4751-20 h 21 PIAi I I OP.MSfi-H4 D.e.3s3D-ua Pur I I II �m I II m STATE ROUTE 803D I �•� (3oPNEGGWLM FASOAFNn I "" C00010E LANE a• ,a m 06 T.M oD c 1 LOT FRAM( ODIYET & DONL RS R ALB RATNow,�MaAJMFMFa1ND TT[ ,W.9 .11 W !M.. IN MM POST Heltzel Soil Consulting LLC EXISTING LOT LAYOUT / SANITARY SURVEY ppe of AL:IDiOWN W613@DRA3NPff�D SIPS W[fiBi P08 %55A �VA216&4 STOCKTON CREEK SBp, ALBEMARLE CO, VA :woFTf�PRoroseD nnnlNr�ns ARE 3NOTVN. �`_IXD NBNPM EASEMENT) NOT TO SCALE � T.M.BB-BL LOT 8 SMART TATIOR SMACK D.8.524-521 DE.&F9 M4,7O2 PLAT T.M.89-SM POND REVISED LOT EC.ACMERNAN TRUST D.8.47D3-23 M&4733-2O @ 21 PUT D.B. 4 -444 D-8.353O-234 PUT STATE ROUTE 803 (3oT OLOE L EASEMENT) T.M.BR-8O FRANK Odle @ CARD DONTF.' D.8.S3B0-82. 85 @ SS PUT MONT FFOUND 1NH MONUMENT FWND— SPiPM {yA"TER ................... ..R� DME s .: �\ �J fl 283 MORES LE oMIES umw VD MONLA OU AM FWI T.N.BB- V LN.W-1W 0.n AUES ) &n REVISED ENTT ! 1JU ACRES RFM4D LOT 9 AO 6R2h/- tlE.4 bry A9b 33'h LE A a UI ONT POUND .N.Sttitff RLD1�Lm 1 MONUMENT G yD ENT 4 M04 AM tMAR-1M: FOUND 4.62 AM RMWDIO 2 T.TO ACRE 1.70 FENCE PM 4d� /\ \\\V\\t MONUMENT FOUND T MONUMENFOUND Q I`'-MW! rxeo-teD 4.ss Af11E53 T .,v 15NOpD FOUND ao--^� SS Pimps �'MD y s� tl MONUMENT Fay August 21, 2022 FOUND H THE PLATTING OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T.N. 69-506. REVISED LOT 1, REVISED LOT 2, REVISED LOT 3. REVISED LOT 4,REVISED LOT 5.REVISED LOT 6,REVISED LOT 7 6 REVISED LOT B IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWAER(S). PROPRIETORS. AND/OR TRUSTEES. IF ANY. FOR. STOCKTON CREEX,LLC CITY/COUNTY OF Ckr-41 1641 STATE OF V:w �- THE FOREGOING INSIRUWENT WAS ACKNOWLEDGED BEFORE ME THIS DAY OF FA&y ? - 2022. BY 4 r pl,&, FOR: STOCKTON CREEK,LLC NOTARY PUBLIC 4 ! ,�1 � MY COMMISSION EXPIRES :_42. 2� 3� APPROVED FOR RECORDATION A • . . GL NOTARY SEAL LOCA CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING C1 15'40'i6' 1964.86 541.98 272.72 540.27 S63'33'04'E C2 4'44'04' 1090.92 90.14 45.10 90.12 S1B'39'29'W C3 9'59'39" 1085.92 189.42 94.95 189.iB S38'31'21"W C4 14'56'55" 1090.92 284.62 143.12 293.82 S55'59'54'W C5 1'20'52' 1487.79 35.00 17.50 35.00 S72-22.45-W C6 22'41'29' 14B7.79 5R9.22 298.52 585.38 S60'21'35'W C7 21*31'58' 167.57 62.98 31.86 62.61 N05'35'16"E CS 32'53'50' 94.14 54.05' 27.79 53.31 N32'48'10"E C9 e'13'55' 94.14 13.53 6.77 13.51 N53-22.02"E C10 15:57'OB' 184.27 51.30 25 821 5 T -I4T NFi5'27'33-E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND IEVISED LOTS 1.2.3. 4.5. 6. 7 6 8 WHITE HALL MAGISTERIAL DISTRICT ALBEMARLE COUNTY,VIRGINIA SCALE: I" = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29,2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY S ASSOC..INC. 663 BERKMAR COURT CHARLOTTESVILLE VIRGINIA 22901 TELEPHONE: (134) 293-3195 RAYSURVEYING.COM Aw BBIAN S. BAY Lk. No. 002281 02/03/2022 750 250 OLD ROCKFISH TiURNPIKE GAP ROAD TURNPIKE B03 GOOOLOE :...SITE:::: LANE 15f CRITZERS SHOP WOODS ROAD r ROAD CRITZERS SHOP VICINITY MAP 1.=2000'+/- SHEET 1 OF 3 USE !NOTES SHOWN ON THIS PLAT ARE IMPOSED AT THE REQUEST OF THE DIRECTOR OF PLANNING. IG HIS/HER SIGNATURE ON THIS PLAT HE/SHE HAS DEEMED THAT THEY ARE CORRECT AND IN 'E WITH THE ALBEMARLE COUNTY ,ZONING ORDINANCE IN EFFECT THIS DATE. THESE NOTES IESTRICTIVE COVENANTS RUNNING WITH THE LAND AND THEIR APPEARANCE ON THIS PLAT I5 NOT TO IMPOSE THEM AS SUCH. ANY REFERENCE TO FUTURE DEVELOPMENT RIGHTS SHOWN HEREON IS A. T.M.69-198. 19C, ISO. 19E 9 I% ARE ZONED RA (ENTRANCE CORRIDOR) . T.M.69-19F IS ZONED RA. T. M.69-19H, 19J G. 508 ARE ZONED RA (ENTRANCE CORRIDOR G FLOOD HAZARD OVERLAY). 8. T.M.69-19B(REVISED LOT I)RETAINS TWO DEVELOPMENT RIGHTS MID MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FARTHER DIVIDED. D. T.M.69-19DIREVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E_ T.M.69-19E(REVISEO LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISEO LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-19G(REVISED LOT MIS ASSIGNED ONE DEVELOPMENT RIGHT AMC) MAY NOT BE FURTHER DIVIDED. 91 I. T.M. 69-19J(REVISED LOT MIS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED MITH THE 2.26 ACRES FROM T.M.69-190 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1900 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.69-50B RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIS DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REGUIREMENTS:FRONT= 75',SIOE= 25' 9 REAR- 35'. M. ACCORDING TD THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS LSE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBOMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS. ADDRESS 9 LEGAL REFERENCES: T. M.69-19B, 19C, 19D. 19E, 19F, 19G. 19H. 19J A 50B STOCKTON CREEK.LLC 455 SECOND STREET, STH FLOOR, CHARLOTTESVILI_E. VIRGINIA 22902 D.B.5657-263. D.B.892-159 PLAT 9 D.B.693-44 PLAT. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-5DB IS SUBJECT TD THE FDLLOWIN6: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.254-409 6 INST./202200001316),. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEiCOMPANY(D.B.232-585). 4. T.M.69-50B IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(D.B.209-261). 5. T.M.59-190. ISE, 19F. ISO. IBM 6 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-404) S. T.M.69-19D, ISE. 19F. 196. 19H 9 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(D.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EKIST. THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR EXBIN6UISH DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS KNOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJECT TO ANY ADDITIONAL CDNOITIONS,UTILITIES,EASEMENTS AND/OR COVENANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T_M.69-198(LOT 1) = 6.51+/- ACRES T,.N.69-19C LOT 2) - 5.77+/- ACRES T.M.59-19D (LOT 3) - 5,15+/- ACRES L.M.59-19E (LOT 4) = 5.45+/- ACRES T. M. 69-19F(LOT 5) = 6:68+/- ACRES T,M.59-ISO(LOT 6) 5.88+/- ACRES T.M.69-19H LOT 71 = 5.12+/- ACRES T.M.69-19J (LOT 81 = 6.56+/- ACRES T.M.69-508 - 9.35+/- ACRES DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4,2021 REVISED: NOVEMBER 29,2021 REVISED: FEBRUARY 3, 2022 ROGER N.RAY 9 ASSOC..INC. 663 BERK14AR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 1497PA LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005. COMMUNITY PANEL 510006 02250. GRAPHIC SCALE 0 GL T. M. 69-6L LOT 5 STUART TAYLOR SMACK D.B.5245-521 D.B.3415-704.707 PLAT N05'10'43'W 155.57' N05'10'43'W 7.091 N05'10'43'W 23.27 NO2'36'21•W 29.23'- NO2 96' 21' 40.004 T. M. 69-6N N08'55'25' REVISED LOT 7 166.07' E.C.ACKERMAN TRUST 0.84733-23 0.8.4733-20 G 21 PLAT N04'54'1. D.B.4456-444 71.02' D.B.3530 234 PLAT N04'54'1 5.37' NO3'44'( 154.3, STATE ROUTE B03 (30'PRESCRIPTIVE EASEMENT) -- G000LOE LANE N05'50 104. T. M. 69-6G cqa. cv LOT 1 FRANK DONLEY 6 S185'19'28'1(-� CARLA DONLEY 26.D9' 0.8.3380-82. N30.02'00'W� 85 G 86 PLAT 50.95' VDH NT MONUMENT 1"=200' FOUND ND3'34'29'W-- 224.53' 200 400 VON MONUMENT POUND' N58'17'21'W- 24.79' T.M.69-196 REVISED LOT 6 2.63 ACRES 25L00 (2.55 AC.) T.M.69-i9F REVISED LOT 5 4.53 ACRES (4.00 AC.) (A, 55 AC.) T.M.59-19E REVISED LOT 4 4.62 ACRES tam AC.1� 1 T.M.69-19D REVISED LOT 3 4.56 ACRES (0. 05 (4.51 AC.) (3..33 AC.) m _ (6.56+/- ACRES) c (� Wi 1 vi FW FFMB (2.36 AC.) �2. orwm o its Cy�`_ V.q e m IF o�ot• -' ai REVISED Panv.'"3 3�. (3.01 AC.) e T. 69-50B �Pf; ' BACRES ;_ (5J2 AC ) .IF n gg IS T.M.69-198 i^ VON MONUMENT ;¢ REVISED 1*00, LOT 1 a78. ' ;.. 3u64"38ry( . Vonu9D '�'• MONUMENT 0.26 AC. ) ? 0;.. ACRES Imo. 31 • , FOUND T.M.69-19C REVISED LOT 2 o .0�: l : ' s -eu 19 63 �� 3'00'47'W 17, 7.70 ACRES i j y COR96. IN FENCE POST c,i.AO VOH NUMENT s s71 �M FOUND SCALE: I- - 200' p1 i3t3 gYW)-121It E EV SED:IINOVE►ABER 4,2021 PTEMBER 21 wH D e3 �09 REVISED: NOVEMBER 29, 2021 MONUMENT of e REVISED: iFEBRUARY 3. 2022 ROGER W.RAY G ASSOC..INC. 563 PERKMAR COURT ,dYA r"A/1W.1f CHARLOTTESVILLE.YZRGINIA 22901 TELEPHON : 4341 293-3195 RAY URY YING.COM SHEET 3 OF 3 149 VYDHOF'HEAL .�H= Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19C HD ID: 101-22-0311 Well Class: Class 111C (Cased and grouted 20' minimurn) PERMIT NOTE: Well Number 20 Dear Alan Taylor: Page 1 of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax O-PROWED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class MC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19C HDID:101-22-0311 Page 2 of 2 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:t'/www.vdh.virginia.szov/environmelital-health/pmp-201 5-01 forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shal I be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh )ley"" Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System C] Water Supply Owner: Stockton Creek LLC cfo Alan Taylor Mailing Address: 465 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Melling Address: 455 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Directions to Property: Subdivision: Tax Map: VA 22920 WELL 20 69-19C Section: Other Property Info: VDH USE ONLY Health Dept. ID# Due Date: Phone: 612-4264728 Fax: Phone: Phone: 434-981.3634 Fax: Email: slmpson@maswnstruoonmanagement.com Block: Lot: Acreage: 7.7 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determine it the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter 0 Construction Permit ❑ Subdivison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 5 Multifamily Home (Total # of Bedrooms) Other (Describe): _ Basement Yes Walk -Out Basement? I] Yes Fbdures in Basement? El Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes ED No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. ma)dmum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" D No Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ Existing or 0 Proposed If proposed, is this a replacement well? ❑ Yes No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes 21 No All Applicants Is this a private sector OSE/PE application? [0 Yes ❑ No If yes, Is the OSE package attached? [+] Yes ❑ No Is the property intended to serve as your (the owners/ principal place of residence? ❑ Yes F41 No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. For water supplies, a plat or me property is recommenced and a site sketch is required. The site sketch should show your property lines, actual and/or proposed buildings, and the !red location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the prc�lpi$A 3oee� iWmge sites must be Cleary marked and the property sufficiently, visible to see the topography. I giveDqUinssion to the Vlrginisfrtment of Health to enter onto the property described during normal business hours for the purpose of pr s ia, g application and rm quality assurance checks of evaluations and designs certified by a private sector Onsae Soil Evaluator or o�essi ft" pe ti until the sewage disposal system andfor private water supply has been constructed and approved. LicNo. ­ti M 199000f460 ( Z �. � Z Z . (-';(AfiA� Date 7bbaimeetfiR.slFHr, osyrr i,i4drteWr�,tlrwiw�I as.Aen atAM 7rtb61! VBH tr. ry Rrdc DatE M1„M1. _ Fsa S . _ HDID 4 wst # P+ts q'Fdabear 8 —_- IUD# � Reaetpt if ____ _ -- Page —( of Construction Permit ❑ Repair Permit ` W P il OSEIPE Report For: Y9 ❑ Voluntary Upgrade ❑ Certification ❑ Subdivision Approval Permit Letter Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 20 GPIN or Tax Map #: 69.19C Health Dept. ID #: Latitude: Longitude: Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charloftesville, VA 22902 Prepared by: OSE Name: Chris Heltrel License # 19"01460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: 8/2212022 Date of Revision #1: Date of Revision #2: Contents/Index of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Speciications 4. Well Location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations for Alternative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and aftemative onsite sewage systems has been discussed with the ownerlapplicant. *NN ❑ The Pima 19 ver page has been conducted under an exemption to the practice of engineering, specifically the ex n Code o tr eciion 54.1-402.A.11 o �p 1 recommend t Construction Prspxl ❑ Subdivision Approval be: ❑ Issued 00 H ❑ Repair P nit ❑ Voluntary Upgrade ❑ Denied >� Lic No./940001460 z OSGIPG Sign* tu 'Ft1>1 ,per Date: 44 SRF 50p._ The torte contains personal Information subject to disclosure under the Freedom of Information Act. Revised 12101114 Heltzel Soil Consulting Paget of C' VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19C Property Address: TBD Subdivision: WELL 20 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that appfy): Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: e50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of Information Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit Page � of The proposed well site shown herein, 0 1. Is located a minimum of 50 feet from all property lines. QX 2. Is located within 50 feet of the adjacent property line(s) but 1 have determined that the adjacent property is not used for an agricultural operation. Q i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. QX ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residentiat Subdivison Lot F7 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q I. Written permission from the adjacent property owner's) for the well construction. 0 iL I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that m property is not used for an Agricultural Operation as defined in § 3.1-22.2 o t Co of Virginia. p V 1 14 Signature of Property O ner Date Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Witten Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC 1412 SaLMISO a Road, Maurertown, VA 22644 17' 21 WELL LOCATION SKETCH TM # 69-19C ALBEMARLE COUNTY, VA I I I WELL AREA i T.M.69-19C REVISED LOT 2 7.70 ACRES August 12, 2022 DRAWN BY: SNV a ioo.w 15N AREA Page ` ' REVISED 8.92+/ #20 'j03, me yWELL. \F O' so, ISO, 040' Heltzel Soil Consulting, LLC POWGN,NYodebdc VA� T.M.6Pm BENSiD LOT ECAq umm TRUST 0.9.47 0 O.B.4733-20 4 0 PUT D.B.M0s— O.B.3430-23 PUT STATE ROUTE 803 (30'PR P� L T) PROPOSED LOT LAYOUT / SANITARY SURVEY STOCKTON CREEK SBD, ALBEMARLE CO, VA STRT750 (3o•PNE ,PAW EA9 MT) 2WOPTBBPBOPOSP.O NOT TO SCALE Heltzel Soil Consulting, LLC EXISTING LOT LAYOUT / SANITARY SURVEY POiwP&ammdLVA22881 STOCKTON CREEK SBD, ALBEMARLE CO, VA —� ST.RT.750 (3WPRI=IflPIlVE EASEMENT) OD TURNPIW MIMI NOT TO SCALE VON MONUMENT . ......... APPMOAMATE�y FOUND LO TON ... LOT 6 STUMT TAT SM O.B.52441-521 ...... ...... UxrER Rp`u SR ).9.0415 704.707 PUT UNE ENT tw IN .... W=7 OTILITY UNE!I REWD Tm�m V5M A POND T.M.N-IN TxR lw REVI!IED LOT 0 T.M.69 to JkORES &U+/- mIm; REVISED LOT 7 ON IM EaAm MST D.8.47�n "E"N'D 5 13.8.47Oa.�20 & 21 PUT �W 0.8.35M-n4 PUT STATE ROUTE B03 w (WRiESMIPTAIE EASEMENT) AM ME NOW �OE LANE = 4 104 FOU 4IB2 ACES"m il)T 2 In IN PENCE POST VON O MONUMENT VDIi FOUND MONUMENT F"D WH T.M.6S-U0 RLMEEDII)T3 ONUMENT wr I vt(jp'k� FOUND FMK D� a WU as 80 PUT VCH VON ki O4%rv� D kR MONUMENT M MAi FOUND NOEN DR —ANY CUrnNG OR FILLING MAN WH MONUMENT FOUND I Amnv im%ac ;3' THE PLATTING ;OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T. M. 69-50B,. REVISED LOT i, REVISED LOT 2, REVISED LOT 3, REVISED LOT 4.REVISEO LOT 5.REVISED LOT B. REVISED LOT 7 O REVISED LOT 8 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER (S).. PROPRIETORS. AND/OR TRUSTEES,IF ANT. FOR: STOCKTON CREEK. LLC CITY/COUNTY OF.. C{.w(i ipth STATE OF yr ohfi; THE FOREGOING 111sriFB:NT WAS ACKNOWLEDGED BEFORE ME THIS L.OAY OF rAkig;e 2022. BY A.j~ D&.&,. FOR STOCKTON CREEJK. LLLLCC NOTARY PUBLIO ��"' 505 MY COMMISSION EXPIRES : CM4 9� LOU APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING Cl 15'48'.16" 1964,86 541.98 272.72 540.27 S63'33'04'E C2 4'44'04"-'3090.92 90.14 45.30 90.12 S18'39'29'W Cl _ 9'59'39' 1095.92 iB9.42 94.95 189.18 S38'31'21"W C4 14'56'55' 1090.92 284.62 143.12 283.82 655-59.54'W C5 1'2WW- 4-87.79 35.00 17.50 35.00 S72-22.45-W C6 22'41'29' 1487.79 599.22 298.52 585.38 S60'21'35"W C7 21'31'58' 167,57 62.98 31.86 62.61 N05'35'16"£ CB 32'53'50' 94.14 54.05 27.79 53.31 N32'48'10"E C9 8'13'55' 94.14 13.53 6.77 13.51 N53'22'02"E CS 15'57'00" SB4.27 51,30 25.82 51.14 NG5'27'33'E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.59-50B REVISED LOTS 1, 2. 3, 4, 5, 6, 7 THE PROPERTIES OF STOCKTON CRI LOCATED ON U.S. ROUTE 25O(ROCKFISH C STATE ROUTE 151(CRITZERS SHOP STATE ROUTE 750(OLD TURNPIKE AND STATE ROUTE 803(GOODLOE SCALE: 1' = 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY 6 ASSOC.,INC. 603 5ERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (4341 293-3195 RAYSURVEYING.COM 73-- BRIAN S. RAY Go. No. 002281 02/03/2022 803 GODOLDE LANE VICINITY MAP 1 2000'+/- SHEET 1 OF 3 A. T.M.69-19B, 19C, 190, 19E & 19G ARE ZONED RA (ENTRANCE CORRIDOR). T.M.69-19F IS ZONED RA. T.M.59-19H.19J G. 508 ARE ZONED RA(ENTRANCE CORRIDOR & FLOOD HAZARD OVERLAY), B. T.M.69-19B(REVISED LOT ])RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.89-190(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.69-19E(REVISEO LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISEO LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. S. T.M.69-19001EVISED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. H. II. T.M.69-19J(REVISED LOT 0)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND 14AY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT I5 BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1980 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.59-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REOUIREMENTS:FRONT= 75',SIDE= 25' C REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIB OATA,THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA, THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. D. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF .ALBEMARLE GIB DATA AND SHALL BE MANAGED IN ACCORDANCE KITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: I. OWNERS. ADDRESS & LEGAL REFERENCES: T. M.69-199. 19C, 190. 19F, 19F. ISO. ION. 19J & 508 STOCKTON CREEK,LLC 455 SECOND STREET, 5TH FLOOR, CHARLOTTESVILLE. VIRGINIA 22902 D.B.5657-283, D.B.B92-159 PLAT & D.B.683-44 PLR. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-50B I5 SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POMER COMPANY(O.B.264-409 & INST.l202200001316).. B. AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY(O.S.232-585). 4. T.M.69-508 IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY (I.B.209-261). B. T.M.59-190, ISE. 19F. 19G. 19H & 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.264-404) - 5. T.M.69-19D,19E,19F,19G,19H & 19J ARE SUBJECT Tq' AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MA,Y APPLY 6.8.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF pp€€CORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RI6MMTS E%IIST.THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELSIOR EXITINGUISH DEVELOPMENT RIGHTS. S. NO TITLE REPORT FURNISHED. ALL EASEMENTS MOWN BY HE ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONDITIONS,UTILITIES.EASEMENTS ANO/OR COY NANTS'THAT NAY EXIST. S. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T.M.59-198ROT 1) - 6,.51+/- ACRES T.M.69-19CO.OT 21 - 5..77+/- ACRES T,M.69-19D(LOT 3) - 5;.15+/- ACRES TRSS-19E(LOT 4) - 5:.45+/- ACRES T.M.69-19F(LOT 5) - 6.68+/- ACRES T,.M, 59-190(LOT 61 - 5.80+/- ACRES T.M.69-f9H (LOT 7) - 5.12+/- ACRES T.M.69-19J(LOT B) = 6.56+/- ACRES T:M.69-SOB - 9.35+/- ACRES DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4.2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3. 2022 ROGER W.RAY & ASSOC..INC. 663 BERKMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 14932A LEGEND: IF IRON FOUND IS IRON SET ,....— EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION :OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO, THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 D2250. U N N dV i STATE ROUTE 803 (30 PREGOOOLUE E EASEMENT) 6L S70'00' 00"E 35.00' T.M. 69-SL LDT 6 STUART TAYLOR SMACK 0.8,5246-521 D.B.3415-704,707 PLAT N05'10'43'W 155.67' N05'10'43'M 7.091 N05'10'43'M 23.27;' NO2'36'21"M 29.23', NO2-35.21-K 100.42' NO2'36'21'M, 40.00' T. M. 69-SM NOB'56'25'W REVISED LOT 7 155.07' E C.ACKERMAN TRUST D. B.4733-23 D B 4733-20 S 21 PLAT N04'54'11' 0. B.4456-444 71.02' D. B. 3530-234 PLAT N04'54'11 5.37, T. M.69-BG [40.e0 LOT i FRANK DONLEY G SB5'19'28"W-` CARLA DONLEY 26.09, D.B.3360-82, N10'02'00'W� 85 G 85 PLAT 50 955, VOH NT MONUMENT GRAPHIC SCALE 1"=200' FOUND M03'34'29'W- 224.53' 0 200 400 YDN MONUMENT FOUND— ~(O.OB / T.M.69-196 REVISED LOT 6 2.63 ACRES 25'.00• (2.55 AC.) T.M.69-19F REVISED LOT 5 4.63 ACRES WOO AC.) M.55 AC,) T.M.69-19E REVISED LOT 4 4.52 ACRES A (0,,07 AC ) 1 T.M.69-190 -q REVISED LOT 3 4.56 ACRES (0.05 (4.51 AC.) (3..33 AC.) m _ (5.56+/- ACRES) (2.36 AC.) �IF M°' P' REVISED 2 + (3.01 AC.) ' T. M 69-50B k F °B.76 ACRES IS (5.72 ! T.M.69-198 m m RLOTSIO i DoIS , +� r 0.25 AC.) T.M.59-19C ° b: REVISED LOT 21 7.70 ACRES >ta' FE _ VON SCALE: 1" = 200' REAVISED E�NOVEMBER ER 42021 , 2021 REVISED: NOVEMBER 29.2021 REVISED: IFEBRUARY 3, 2022 ROGER W.RAY GASSOC- INC. 653 ERKMAR,COURT CHARLOTTES901 TEPH& (4334)R 293i 3 95 RAY URVEY2NG.COM .W SHEET 3 OF 3 149. VIRGINIA DEPAR VDHOF HEALTTH NT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19C HD ID: 101-22-0312 Well Class: Class 111C (Cased and grouted 20' minimum) PERMIT NOTE. Well Number 21 Dear Alan Taylor: Page 1 of 2 Albemarle County Health Department 1 138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-43 10 Fax hhl-;ROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IIIC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances. by Chris Heltzel, OSE 1940001460, This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application of conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19C HDID:101-22-0312 Page 2 of 2 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,vdli.virLinia.Lov/environmental-health/amki-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027 Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System Fl Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 465 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Directions to Property: Afton, VA 22920 Comer of Route 250 & Route 151 Subdivision: WELL 21 Section: Tax Map: 69-19C Other Property Info: VDH USE ONLY Health Dept. ID#_ Due Date: Phone: 512-426 4728 Fax: Phone: Phone: 434-9813634 Fax: Email: slmpeon&tlm onstnwUonmenagemen.com Block: Lot: Acreage: 7.7 Sewage System Type of Approval: Applicants for new construction are advised to apply for a certification letter to determined the land is suitable for a sewage system and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter 0 Construction Permit ❑ Subdlvison Approval ❑ Repair Proposed Use: Single Family Home (Number of Bedrooms) 5 Multifamily Home (Total # of Bedrooms) Other (Describe): Basement 0 Yes Walk -Out Basement? ED Yes Fixtures in Basement? LD Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes ❑� No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. ma)imum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" [D No "There is a $50 fee for determination of elicibilb. Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ Existing or i] Proposed If proposed, is this a replacement well? ❑ Yes ❑ No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes 21 No All Applicants Is this a private sector OSEIPE application? Yes ❑ No If yes, is the OSE package attached? Yes ❑ No Is the property intended to serve as your (the owners) principal place of residence? In order for VDH of process vour application for a sewage system. VDU must attach a ❑ Yes 0 No a a plat of the property is recommenced and a she sketch is required. The she sketch should show your property lines, actual and/or proposed buildings, and the desired location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the proposed well and sewage sites must be clearly marked and the property sufficentty visible to see the topography. I giva 1r3mr4gjf lki.tojr %qR,p Ia Department of Health to enter onto the property described during normal business hours for the purpose of procitfg � is appllcatlo�r �n perform qualify assurance checks of evaluations and designs certified by a private sector Onshe Soil Evaluator or o esslonai Engineer asrrte ary until the sewage disposal system and/or private water supply has been constructed and approved. Y 2 CIIRISTOPIALR S. HELTZEt 400014b0 $tore of Oyreer/Agent Date "%. ...mosr+r....+m..y..rfwa..,...rrw, rn.a..rrarr.ee. It xew�rwveore vhNihmask Dow »srda_ _ _ __. _ _ _ DolsDaw Fm 3 HDID # FW=W wok # u PayDt m wxkbak 0 MW0 R4w4Ktl Page L of Construction Permit ❑ Repair Permit p& +ate r•> ,-< .. OSEIPE Report For: ❑ Voluntary Upgrade ❑ Certification ❑ Subdivision Approval Permit Letter Property Location: 911 Address: TBD City, State, Zip: Afton VA 22920 Lot: Section: Subdivision: WELL 21 GPIN or Tax Map #: 69-19C Health Dept. ID #: Latitude: Longitude: Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Hel&el License # 1940-001400 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: lf/22/2022 Date of Revision #1: Date of Revision #2: ContentsMdex of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 24. Well S ecffrcatfons 4. Well Location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC5.613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses any professional license required by the laws and regulations of the Commonwealth that have been duly issued by the applicable agency charged with licensure to perform the work contained herein. The potential for both conventional and alternative onsite sewage systems has been discussed with the ownertapplicant. N"+e+ 121 The wo tOV11 page has been conducted under an exemption to the practice of engineering, specifically the exam `�Jn' ode of Virg, UJn 54.1 402.A.11 a 1 recommend that 0$ Constructi hermit ❑ Subdivision Approval be: Issued ❑L(i#ifi I�#G&L` ttg c Repair Pe 't ❑ Voluntary Upgrade ❑ Denied J ISO.lgatt� \ (22 OSE/PE Signature: i��N v' _ s Date: ,�r1�F OV SftFs The form contains personal information subject to disclosure underfhe Freedom of Information Act Revised 12101114 Heltzel Soil Consulting Page ot of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19C Property Address: TBD Subdivision: WELL 21 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): R1 Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This tbnn contains personal information subject to disclosure under the Freedom of Infotmafion Act. Addendum to AOSE/PE Certification Statement For Private Well Construction Permit r Page � of b The proposed well site shown herein, Q I. Is located a minimum of 50 feet from all property lines. QX 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. i_ Wntten affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. QX ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. Q ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm that m roperty is not used for an Agricultural Operation as defined in § 3.1-22.29 eo¢ode Vf Virginia Da Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consulting, LLC 1412 Sauma lie Road, Maurertown, VA 22644 817E 18-1 171 21 WELL LOCATION SKETCH TM # 69-19C ALBEMARLE COUNTY, VA i I WELL AREA i T.M.69-19C REVISED LOT 2 ..70 ACRES August 12, 2022 DRAWN BY: SNV a 100.0v 13N Page I of KtvistD a.9z+/ #20 I p3, WELL 4 0' Bo' 160' 240• Heltzel Soil Consulting, LLC PROPOSED LOT LAYOUT! SANITARY SURVEY Pf POB 55 WM61mJLVA21 4 STOCKTON CREEK SBD, ALBEMARLE CO, VA zonorTT�vnoPoseonn�mPm�.osnnesHowH. ST.RT.750 (3vPRE Ptw CASEMENT) 55R9EROA5. ___ NOT TO SCALE TAEl5 & LOT 6 MART TAnM SMACK O.8,53/8-5Z C.&1 1y70 M7 PUT II 11 POID I I 11 T.M.59-5M 11 RENSEO LOT 7 t E.c oM . 4s.Tu+-23usr 11 1 O3.473 W & Z PUT ox.4455-M4 O.8.3530-2M PEAT 1 1 II I _ STATE ROUTE 803 1 11� am T.M.S9 w LOT 1 RANK OCNEEY & CARD 0WI O.8.335O-52 B & 86 RAT �. MONUMENT �d\6 q�,LSR ?SO um am I � CORNER M {FNO< POT MONUMENT N➢H fWND 5�p� �, VFjO.re�Y yT�l N p.6 10B lON N'�p0.5' d sF� ,,77�e�Fb gsc'�4' Heltzel Soil Consulting, LLC PO Box 664, VAv3eW., VA }2869 T.M.6Y-6L LOT 6 STUART TAY A OK D.B.5^46-5m DBW5-]O�Tm PUT T.SED POND REMSFD LOT ] N EC.A.8.473 N TRUST 0.8.40 23 & 0 O.B.4]]3-20 k 21 PIAT D.B.4156-ada 0.B.3S7O-234 PUT STATE ROUTE 803 (30'PNESCRI DOE ETI1) T.M.eB-eO LOT I FRANK DONLEY A CARD DOMFY D.D.33E W a R B6 PLAT 'AN MONUMENT EXISTING LOT LAYOUT / SANITARY SURVEY PW ;p of b STOCKTON CREEK SBD, ALBEMARLE CO, VA AUI DM'N WO.ISRDRABiP@1D sr184 RTM@1 ZlM' OT THE PROPo4ED DRAINFBDD$ wRE SAORTI. ST.RT.750 (3DW,rVE EAED.ENT) NOT TO SCALE OLD NMN K ROAD ...... ._ .__. _.................. FOUND APPNOMMATE FOUND AMew ER S DowFm NON V Rwi® un s TALe LIOVIDMEAD Dram �7 4 M4 "M rr.e � raa 0.lJ AQffS TA eNA REN9FD lDT e e �_ REMg9 Im a ld F/T Ae3 AOWSo 6.01�% AtlES p�`96 Y� 1�9�h A _Y , YOH _ ONUMENT FOUND R M.B lw 'qE , MONUMENT C LOT ♦ Fes Mrts FOUND 4.sa ADNR T.M.®-sae qm 3 7.M .m A(TES CL1lIER m FEAOE POS O U MdA MDVT VON TDUHD �MONUMENT EYNIND LLLeO-t9D �1 PFMBm UTE 3 VOL po 1 W UWNT Se 4.ALAFS PD. n Slfl&os MDga B 2311 VDNOo.(VI pB 4%�Dg tN� MONUMENT Pa3" August 21, 2022 FOUND 1 nn •.nr n, c., THE PLATTING OR DEDICATION OF THE FOLLOWING DESCRIBED LANDS, REVISED T. M. 69-5013, REVISED LOT 1, REVISED LOT 2. REEVISED LOT 3, REVISED LOT 4. REVISED LOT 5. REVISED LOT B. REVISED LOT 7 G REVISED LOT 0 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETOR9,AND/GR TRUSTEES, IF ANY. FOR: STOCKTON CREEK.LLC CITY/COUNTY OF U"AwlrI4 STATE OF U;mhg'� THE FOREGOING 2N5rL"NT WAS ACKNOWLEDGED BEFORE ME THIS 3 DAY OF rifik� 2022. BY 4„/ , DoW ,y FOR STOCKTON CREEK..LLCC NOTARY PUBLIC 07101 MY COMMISSION EXPIRES 7'OI APPROVED FOR RECORDATION : SL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD :CHORD BEARING CS 15'40'.1B' 1964.86 541.98 272.72 540.27. S63'33'04'E C2 4'44'04" 1090.92" 90.14 45.10 90.12 SSB'39'29'W C3 9'59'39'. 1OB5.92. 189.42 94.95 1139. SB &3B'31'2i'W C4 14'56'55" 1090.92 2B4.62 $43.12 283.B2 S55'59'54'W C5 1'20'52' f4B7.79 35.00 17.50 35.00 S72-22.45`N C6 22'41'29' 1487.79 589.22 298.52 585.38 SBO'21'35"W C7 21'31'50' 157.57 62.98 31.66 62.61 NOB-35.16"E C8 32'53'50'. 44. 14 54. 05 27.79 53.31 N32-49.10"E C9 B*13*55' 94..14. 13.51 6.77 13.51 N5322'02'E C3r-3r-1 184.271 51.30 25.82 51.14 N65'27'33'E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND IEVISED LOTS 1.2.3. 4.5. 6. 7 6 B KE). SCALE: 1' - 200' DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W. RAY G ASSOC., INC. 663 BERKMAR COURT CHARLDTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM BRTAN S. RAY [ic. No. 002281 02/03/2022 250 B03 GOOOLDE LANE VICINITY MAP 1'=2000'+/- SHEET 1 OF 3 A. T.M.69-198,19C.190.19E G 196 ARE ZONED RA(ENTRANCE CORRIDOR). T.M.69-19F IS ZONED RA. T.M.69-19H,19J &.508 ARE ZONED RA(ENTRANCE CORRIDOR & FLOOD HAZARD OVERLAY). B. T.M.69-19B(REVISED LOT ])RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M. 69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.69-191)(REVISED LOT 3)RETAINS TWO DEVELOPMENT A16HTS AND MAY BE FURTHER DIVIDED. E. T.M.69-19E(REVISEO LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. 6. T.M.69-196(REVIED LOT 6)IS ASSIGNED ONE DEVELOPMENT RIGHT AID MAY NOT BE FURTHER DIVIDED. H. �I. T.M. 69-igJONE EVELOPMENTSRIGHT IS LOT IS BEING ADDED WNED ITH THE 2.3UR 6EACRESGHTS FROMAND T.M 69-19BFURTHER AND THREEDIVIDED. DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1980 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.M.69-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA. EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REGUIREMENTS: FRONT- 75'. SIUE= 25' 6 REAR= 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA, THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA,THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. D. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY E ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. OWNERS, ADDRESS & LEGAL REFERENCES: T.M.69-198, 19C. 19D. ISE. 19F. 19G. IBM. 19J 6 508 STOCKTON CREEK,LLC 455 SECOND STREET.5TH FLOOR.CHARLOTTESVILIE,VIRGINIA 22902 D.B.5657-253, D.B.892-159 PLAT 6 D.B.60-44 PLAN. 2. THE BOUNDARY DATA SHOWN HEREON I5 BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWEER CCNPANY(D.B.264-409 & INST.02022000013161., B. AN EASEMENT TO VIRGINIA PUBLIC SERVICEICOMPA'NY D.B.232-585). 4. T.M.69-508 IS SUBJECT TO AN EASEMENT TO TVIIE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(D.B.209-261). 5. T. M.59-19D, ISE. ISE. 196. 19H & 19,1 ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(D.B.254-404) 5. T.M.59-190, ISE, ISE. 196, 19H 6 ISO ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY PAPPLY(O.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF RECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGINTS EXIIST. THE INTENT OF THIS PLAT IS NOT TO CO SINE THESE PARDELS OR EXRINGUISH DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS NOMN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONOITIONS,UTILITIES,EASEMENTS AID/OR COV NANTSrTHAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTI.ENT AS PER TAXATION RECORDS: T.M,69-198(LOT 1) - 6.51+/- ACRES T,N.69-19C(LOT 2) - 5.77+/- ACRES T,.M.69-19D(LOT 3) - 5,15+/- ACRES T.M.59-19E(LOT 4) - 5 45r/- ACRES T.M.69-19F ROT 5) - 6:6B+/- ACRES T,M.69-196(LOT 8) - 5.88+/- ACRES T.M.69-19H(LOT 7) - 5.12+/- ACRES T.M.69-19J(LOT 81 = 6.55+/- ACRES T.M.69-508 - 9::35+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29. 2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY & ASSOC-INC. 653 BERKMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM Lf bio- SHEET 2 OF 3 14911 LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES HEREBY EXTINGUISHED OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING T0; THE FENA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005, COMMUNITY PANEL 510006 02250. 6L S70'00.00'E 35.00' T. M. 69-SL LOT 6 STUART TAYLOR SMACK O.B.5246-521 D.8.3415-704,707 PLAT N05'10'43"W 255.67'ND5'10'43'W 7.09 N05'10'43'W 23.27:. NO2.36'21'W 29.23' NO2'36'21'M- 100.42' NO2'36'21'W-. 40.00' T. M. 69-6M N08'55'25'W'- REVISED LOT 7 156.07' E.C.ACKERMAN TRUST D.B.4733-23 0.0 4733-20 S 21 PLAT N04'54'11"W- 0 B.4456-444 71O2' O.B.3530-234 PLAT M04'54'11'W' 5.37' M03'44'08'W 154,34, STATE ROUTE 803 (30' PRESCRIPTIVE 'EASEMENT)_..__. GOOOLOE LANE N05.50'52' 115.24' 370' 1000'00 2.9B''E , t�IS IS S84.4 ld}' 220 (0.08 f T.M.59-196 REVISED LOT 6 2.63 ACRES LSt On - (2.55 AC.) M05'50'52'W� .I 7.49' ) N04.2S'19•W--' T.M.69-6G 245.20' i LOT f FRANK DONLEY 6 S65'f9'28°W� J CARLA DONLEY 26.09, �F 0.8.3380-82, 85 S 86 PLAT N10'021001W�� 50.95' YOH MONUMENT � FOUND GRAPHIC SCALE 1'-200' M03'34'29°W---� 224.S3' 0 200 400 VDH MONUMENT FOUND (3.33 AC.) 66�6n';1'di3;F3""i'o4r 5'sfiy' [a es 0 ' IS f DO' IS T.M.69-19F Sf9.54'02'E REVISED LOT 5 89. f5' I 4.53 ACRES a (4.00 AC.) I e (4.55 AC.) - T.M.69-19E REVISED LOT 4 4.62 ACRES M07 AC,)-% I T.M.69-190LOT 3 $\ REVISED '4bq 4.56 ACRES (0.05 AC. (4.51 AC.) (6.56+/- ACRES) (2.36 AC.) R (3.01 AC.) REVISED T. M. 69-506 8.73 ACRES =Is 15.72 AC.) T.M.69-19B ro REVISED $ IS qT LOT 1 N- 1.:001- 3.64 '3fi 0.26 AC.) S' u - ACRES L.t m -3f• ill T.M.69 1SC REVISED LOT 2 7.70 ACRES mf�o w 5•"' VON o, 66 ��•.., �1. MONUMENT -'S..e,2t•' .Ig.,. FOUND •N i i . `M NOUND T �•A k- F Stpy 6 » SCALE: i" = 200' DATE: SF STEM�E(R 27.2021 ��•a REVISED NOVE�VBER 29.2021 2021 UggN p'e• REVISED: FEBRIIII'ARY 3.2022 ROGER W. PAY & 4SSOC., INC. Go BERKMfIR, COURT CHARLOTTESVILLE•3VIRGINIA 22901 TELEPHONE: 3195 RAYURV(414))6 COM VOH MONUMENT FOUND EET 3 OF 3 149' RGINIA VIDHOFIHEALH DEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19E HD ID: 101-22-0313 Well Class: Class 111E (Cased and grouted 50' minimum) PERMIT NOTE. Well Number 22 Dear Alan Taylor: Page I oft Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434)972-6219 Voice (434) 972-43 10 Fax At PROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class HH3 private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19E HDID:101-22-0313 Page 2 of 2 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.vdli.virLinia.eov/environmental-health/emp-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System (] Water Supply Owner: Stockton Creek LLC c/o Alan Taylor Mailing Address: 466 Second Street SE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC cfo Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville, VA 22902 She Address: TBD Afton, VA 22920 Directions to Property: Comer of Route 250 d Route 151 Subdivision: WELL 22 Section: Tax Map: 69-19E Other Property Info: VDH USE ONLY Health Dept. [DO Due Date: Phone: 512-426-4728 Fax Phone: Phone: 434-981-3634 Fax: Email: almpsonQW"wnstmetlonmanaoemeaL. m Block: Lot: Acreage: 4.62 Sewage System rps of Approval: Applicants for new construction are advised to apply for a certification letter to determine if the land is suitable for a sewage stem and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certification Letter ❑ Construction Permit ❑ Subdivison Approval ❑ Repair ,oposed Use: ngle Family Home (Number of Bedrooms) 5 Mul tfamily Home (Total # of Bedrooms) iher (Describe): Basement ❑ Yes Walk -Out Basement? R Yes Fbdures in Basement? El Yes ❑ No ❑ No i] No Conditional Permit Desired? ❑ Yes i] No if yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment loan eligibility letter? ❑ Yes" F1 No "There is a $50 fee for determination of eligibility. Water Supply Will the water supply be ❑ Public or Private Is the water supply ❑ E)dsdng or 0 Proposed If proposed, is this a replacement well? ❑ Yes 2 No If yes, will the old well be abandoned? ❑ Yes ❑ No Will any buildings within 50' of the well be termite treated? ❑ Yes 21 No All Applicants Is this a private sector OSE/PE application? [] Yes ❑ No If yes, Is the OSE package attached? Ej Yes ❑ No Is the property intended to serve as your (the owners') principal place of residence? ❑ Yes D No In order for VDH of process your application for a sewage system, you must attach a plat of the property, and a site sketch. a plat or me property is recommenced and a sae sketch is required. The site sketch should show your property lines, actual and/or proposed buildings, an t%location of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the li j xe t n ge sites must be clearly marked and the property sutficientty visible to see the topography. I gi RFrmission to the Virginiq— riment of Health to enter onto the property described during normal business hours for the purpose of pr ing this a m%nd 51 orm quality assurance checks of evaluations and designs certified by a private sector Onsile Soil Evaluator or rssipit4t as neces until the sewage disposal system and/or private water supply has been constructed and approved. Ltc�o. tg40001460 h Date n4t`ar�xw�.wlYfnNer+aMwbQwwa iiiormlwK�wKhierYNaK1. a«uM HIQWa m t. Monty Date 1111104d: Dim D= _. Fees K=# FbIlln"dam# Pay=m wpothock# WO ® ReoaiFt r OSEME Report For: ❑� Construction Permit ❑ Repair ❑ Voluntary Upgrade Permit Permit APPROVEb- Page of �o ❑ Certification ❑ Subdivision Approval Letter Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 22 GPIN or Tax Map #: 69-19E Health Dept. ID # Latitude: Longitude: Stockton Creek LLC c/o Alan 455 Second Street SE. # 201 Prepared by: OSE Name: Chris PO Box PE Name: VA 226" Date of Report: 6/22/2022 Date of Revision #1: Date of Revision #2: of this report: 6. Existing Lot Sanitary Survey 14. Well Location Sketch Lot statement License # License # I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5.610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC"13) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses 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 potential for both conventional and alternative unsite sewage systems has been discussed with the owner/applicant. Q The work recommend that 401 Construction Pefrl 5 z ❑ CeVWLettei i C%XXN��j�t \,% 75E/PE Slgnatu 9 S ' Hq�VF ()rS� page has been conducted under an exemption to the practice of engineering, specifically the action 54.1-402.A.11 ❑ Subdivision Approval be: Issued Repair Permit ❑ Voluntary Upgrade t❑ Denied Date: 6J �2 2 12 The form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12/01/14 Heltzel Soil Consulting Paget of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19E Property Address: TBD Subdivision: WELL 22 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): 2) Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class. 3B Minimum Casing Depth: 50 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 50 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 50 ft., min. Distance from Property Line: <50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 50 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit Page �'D of The proposed well site shown herein, Q 1. Is located a minimum of 50 feet from all property lines. 0 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. Q i. Written affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. QX ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivision Lot Q 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. Q ii. 1 certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm tha y property is not used for an Agricultural Operation as defined in § 3.1-22.29 offtCod4fVirg/ria. 1.0 I'L_ Date Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-176.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consu IW2 Saumsvllle Road, Meurertown, VA 22644 snz 17-2 z w LL- LLC WELL LOCATION SKETCH TM # 69-19E ALBEMARLE COUNTY, VA 317817-1 SWELL $ I �A511 160.Od WELL ARM August 12, 2022 DRAWN BY: SNV 21 WELL 'EL 12' M.69-19E EVI SED LOT 4 4.62 ACRES 171 REI \ 8715141\ � S O' 80' 1BO' 1240' Heltzel Soil Consulting, LLC PROPOSED LOT LAYOUT / SANITARY SURVEY POE X.� Woe4nbdo VA2 STOCKTON CREEK SBD, ALBEMARLE CO, VA CT PT 750 T.MXE w REVISED LOT ECACXmm TRUST D.8.4733-23 O.R.4733-20 h r MAT D.E WG-4 D.E.R3 234 PLAT STATE ROUTE 803 (30'PR OES I EASWMT) �LX LAN EASEMENT) ALLKNOWNR&DRADiPIELDSITES 11p' OF iTiB PROMPO S®ORA W Fl®.DS ARE MORRO " N. NOT TO SCALE HeitZel Soil Consulting LLC EXISTING LOT LAYOUT / SANITARY SURVEY P-8. a Pv 1 All 1:NOWN M'EULS a DRAQi IELo91TH9 @t WRE Mo 55e VOaa6mM.VA22694 STOCKTON CREEK SBD, ALBEMARLE CO, VA 29DDFT PRDroSEDDNA[NFP[.DSARE seo". ST.RT.750 (WRfSMPTVE EASEEN» i�.� NOT TO SCALE T.M.49-6L LOT 6 SIUART TAKOR SMACK 0.8.5246-521 DRU15-7U4,707 PLAT TX.69-6M POND REMSED LOT 7 E.C.AaMWAN TRUST D.B.475 23 D.8.475 20 a 21 PUT 0.8.Wb6-444 D.8...5OD-234 PLAT STATE ROUTE 803 (WOPP IPTVE EASEEWENT) �CE LANE T.M.59-66 LOT 1 RCNA DE9aEY D.B.} 95 a 86 PLA wN MONUMENT FWND APPMOMATE .. . FWW Tom" (V MEAD P o 4 LM.69-19E R "�2y� NEM9D LOT 6 263 ACES �' N � •rii:�, �:c.:. . j- �O �Q,. & nTN'""p 63�/ ACRES I OKRHEAD WMuk RTMSm RWI r.M.69-SDa aTa Aaa:s T.LL69-19F _ T.M.99-IN T� m �` R£NSD tAi 3 A81 AGES PETI3ED LOT 6 aB24/- A029 9h ��tl s.•i VDH S m ^ N T N.60-16E 9:9 Lm 4 RENgDLOT 1 sfi" "� w M Mu NO r •62 ACRES TM.69-19c 5%M LOi 2 i.76 AfAEA CIXiNER 6! FENCE POST VCN NONUMENT O O wH FWNO MONUMENT FOUND Lx69-1W 0A' 4A56ACES aOUSEao l OFOUND T / N o.fi Ahoy tMlN / uONUMENT pFey2 I August 21, 2022 FOUND nD A nrwi nv. CXT THE PLATTINGOR DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED T.M,69-50B,REVISED LOT S,REVISED LOT Z REVISED LOT 3, REVISED LOT 4.REVISED LOT 5.REVISEO LOT S.REVISED LOT 7 6 REVISED LOT 8 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S1, PROPRIETORS.ANO/OR TRUSTEES, IF ANY. FOR: STOCKTON CREEK. LLC CITY/COUNTY- OF C"-fiyuao STATE OF VU•rA THE FOREGOING IN6�F1(RIE11T WAS ACKNOWLEDGED BEFORE ME THIS -0AY OF 7fdWur�,r 2022. BY A.,,/w�✓ Da.li+v. FOR STOCKTON CREEK. LLCC NOTARY PUBLIC 71 MY COMMISSION EXPIRES C`JcJ• Tl�� 3-�'1 APPROVED FOR RECORDATION : GL NOTARY SEAL LOCA CURVE DATA LINE DELTA RADIUS ARC - TANGENT CHORD CHORD BEARING C1 15'48'.16' 1964.86 541.98 272.70. 540.27. S63 93'04'E C2 4'44'04" -1090.92- 90.14 45.10 90.12 S18'39'29'W C3, 9'59'39' 1085.92, 169.42 94.95 169.SB S38'31'21'W C4 14'56'55' 1090.92 284.52 143.12 2B3.82, S55'59'54'W C5 ]'20'52' 1487.79 35.00 0.50 35.00 972'22'45'W C6 22041'29' 1487.79 SR9.22 298.52 565.38 SSD'21.'35'W C7 21'31'58' 157.57 62.98 31.B6 62.51 N05'35'167 CB 32'53'50'. 94.14 54.05 27.79 53.31 N32'48'10"E C9 B'13'55" 94.14 13.53 6.77 ]3.5] N53'22'02"E C10 15'S7'OB" 184.27 51.30 25.82 51.14 N65'27'33"E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B AND IEVISED LOTS 1.2.3.4.5. 6. 7 6 8 SCALE: 1' = DATE: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4. 2021 EVISED: NOVEMBER 29. 2021 REVISED: FEBRUARY 3.2022 FOR COLLINS ENGINEERING ROGER W.RAY G ASSOC.,INC. 663 BERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (4341 293-3195 RAYSURVEYING.COM /-3.. V BRIAN S. RAY LAC. No. 002281 02/03/2022 750 250 GOODLOE :':•:SITE:'.': LANE 151 CBITZERS SHOP ROAD VICINITY MAP 1'=2000'*/- SHEET 1 OF 3 A. T. M.59-19B,19C. 190.19E G 19G ARE ZONED RA(EKTRANCE CORRIDOR). T.M.69-19F IS ZONED PA. T.M.59-19H.19J 9.508 ARE ZONED RA(ENTRANCE CORRIDOR G FLOOD HAZARD OVERLAY). B. T.M.59-198(REVISED LOT 1)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19CIREVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. D. T.M.59-190(REVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.69-39E(REVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISED LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-19G(REVISED LOT S)IS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. I. T.M.69-19J(14EVISEO LOT 0)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND KAY BE FURTHER DIVIDED.. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEFBER 1960 BOUNDARIES OF T.M.69-i9J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.iM.69-500 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIB DATA, EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE.. L. SETBACK REQUIREMENTS: FRONT- 75'. SIDE- 25' G REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA, THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIB DATA, THESE LOTS ARE NOT LOCATED IN AN AG -FORESTAL DISTRICT. 0. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF ALBEMARLE GIS DATA AND SHALL. BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: 1. TMME69-19B.119C519D.19EL1. REFERENCES:G, H, M G $08 STOCKTON CREEK,LLC 455 SECOND STREET, 5TH FLOOR, CHARLOTTESVI4E. VIRGINIA 22902 O.S.5857-263, O.B.892-159 PLAT G D.B.683-44 PLAT. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-50B IS SUBJECT TO THE FOLLOWING: A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY (0. B. 264-409 G INST.#202200001316).. 0. AN EASEMENT TO VIRGINIA PUBLIC SERVICEICOMPA'NY(0.8.232-585). 4. T.M.59-508 IS SUBJECT TO AN EASEMENT TO TryE CMEESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS TT MA Y1 APPLY(O.B.209-261). 5. T.M.59-19D, ISE, 19F, 19G, 19H G 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.254-404) B. T.M.59-190, ISE. 19F, 19G. 19H 9 19J ARE SUBJECT TO AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(O.B.232-153). 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF gqECORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGHTS EXIIST,THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR EXTINGUISH DEVELOPMENT RIGHTS. S. NO TITLE REPORT FURNISHED. ALL EASEMENTS MOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUB,EC TO ANY ADDITIONAL CONDITIONS,UTILITIES.EASEMENTS ANO/OR CO NANTS. THAT MAY EXIST. 9. ACREAGES SWORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T.M.69-198 ROT i) - 6,.51+/- ACRES T.M.69-19C ROT 2) - 5.77+/- ACRES T..M.69-190(LOT 31 - 5,.15+/- ACRES T.,M.69-19E (LOT 4) = 5..45+/- ACRES T_M. 69-19F(LOT 5) - 6!6S+/- ACRES T,M.69-19G(LOT 6) = 5.BB+/- ACRES T.M.69-19H(LOT 71 - 5.12+/- ACRES T.M.69-19J(LOT 81 = 6.56+/- ACRES T:M.59-508 - 935+/- ACRES DATE: SEPTEMBER 27.2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29. 2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY G ASSOC..INC. 653 BERKMAR COURT CHARLOTTESVILLE,VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 14932A LEGEND: IF IRON FOUND IS IRON SET ......... EXISTING LOT LINES T M.69-SL HEREBY EXTINGUISHED LOT 6 STUART TAYLOR SMACK N �- OVERHEAD D.B.5245-521 UTILITY LINE 0.8.3415-704.707 PLAT APPROXIMATE LOCATION OF AREA WITHIN ZONE A000 YEAR FLOOD PLAIN) ACCORDING TO THE FEMA FLOOD INSURANCE RATE MAP. EFFECTIVE DATE 2/4/2005. S70'00'00'E 35. 00'- COMMUNITY PANEL 510006 0225D. N05.10'43'W 155.57'N05'10'43'W 7.09k, N05'10'43'W 23.27;� NO2'36'21'W 29.23'-+ n m NO2'36' 21' M 300.42' NO2'36' 21'W- 40.00' T.M.69-GM N08'56'25'W- •M REVISED LOT 7 165.07' E.C.ACKERMAN TRUST D.S.4733-23 0.6.4733-20 s 21 PLAT M04'54'11"W- p D.B.4455-444 71.02' z O.0.3530-234 PLAT e N0454'11'W c 5.37' �^ NO3'44'08'w' 154.34' STATE ROUTE 903 (30'PRESCRIPTIVE EASEMENT) GDOOLOE LANE T. N. 69-BG e4a.ev LOT 1 FRANK DONLEY 6 SB5'19'2B'W� CARLA DONLEY 26.09' D.B.3380-82, N10.05 r- 85 G 86 PLAT 50.95' VOH MONUMENT GRAPHIC SCALE 1"=200' FOUND - NO3'34'29"w- 224.53' 0 200 400 VOH MONUMENT FOUND- 7 Oi 04+/ ACJ I "IS SB220.51* UTILITY �"{ pg A COT .. `$$ LINE - VDH (0 08 AC.1 I5 N'f ,S LOT 7 m T. M.69-19G = "Q'xT y� 1 LOT B f s (B.56+/- ACRES) ..J�• �� MONUMENT FOUND > a Y.0 REVISED LOT 6 $m . B y a sf 3 9'9 9'E 2.63 ACRES cm �jto'v 25'00 (2.55 AC.) v� (3„33 AC.) .AS:. xv I9 .t IS Nf� 00 •4N I1�.'�.j""L4T 6 ' 7 �jL m OYE)alIEAO r� UTILITY - LDT 5 .... E 530.00 AC.).,` r L,oT 8 IF LINES m y VON Ai MONUMENT S NBS• 00'.00• 1 IS f a LOT f,••» •. 'y- 5{ is rw� .'FOUND T.M.69-19F 919-54-02-E p_ o o 89. 15 2y1 ^� (2.36 AC.) a S REVISED LOT 5 Is 4.63 •�'fi�^' Ts 41 $ Is '� ACRES v m 1'E '11'34'E '',y IF 0, MI6'1 REVISED os hA4 IS LOT 5 +' IIF 30000- l5iA101{3 AC. =., "� w*3j, -.. (3.01 AC) T. M, 69-508 �: •,.b�0 'apr„' seeroo'aD•t :N b9• t 8.3 ACRES f, IF 159.87'- w 1. 24.72 d70 _ p�,f- _ Is (5.72 AC 1 QO- ' Vp1 IS l f4.55 AC.) m ,,mn =:T. M.69-19B m MONUMENT m j T.M.69-19E z IZ' REVISED y IS AT FOUND •- LOT i -p78, 1 00• 1. REVISED LOT 4 .IS voH 3464 ,,L 3�4 ask MONUMENT �; Is ®,.31 n*4 4 4.62 ACRES (0,26 AC.) ( T M 69-19C�a'�� (0407 AC.1 1 ACRES c - FOUND 43.007' ]7' ( �!� � R E {17 -+ REVISED LOT 2; _ NE �3+ POST •• 3 7.70 ACRES i FENCE FN83'10'00 SLUT c;=>° :VOH T.M.69-190 REVISED LOT 3 4.56 ACRES (0,05 F (4.51 AC.) VON MONNT FOUND 1•A �A_�r' AS �M WLk T SIN is M OATE:C SEPTEMBER 27, 2021 9 T Z1 REVISED NOVEMMBER 29 2021 1eAN. REVISED: iFEBRUARY 3. 2022� ROGER N. AY G ,ASSOC.. INC. w(y. 663 gpERKMNR. COURT r CHARLOTTESYILLE, yIRGENIA 22901 0}'�'`' TELEPIA)NE: (434) 293-3195 RAYSURVEYING. CON SHEET 3 OF 3 149 VIRGINIA VDHOF HEALTHDEPARTMENT Protecting You and Your Environment OSE Private Well Permit September 15, 2022 Stockton Creek LLC C/O Alan Taylor 455 Second Street SE, #201 Charlottesville, VA 22902 Tax Map Number: 69-19E HD ID: 101-22-0314 Well Class: Class RIC (Cased and grouted 20' minimum) PERMIT NOTE: Well Number 23 Dear Alan Taylor: Page I of 2 Albemarle County Health Department 1138 Rose Hill Drive Charlottesville, VA 22903 (434) 972-6219 Voice (434) 972-4310 Fax APPROVED This letter, in conjunction with the approved plans and specifications, which are attached, constitutes your permit to install a Class IHC private well. The 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 site evaluations and designs from an Onsite Soil Evaluator (OSE) or a Professional Engineer working in consultation with an OSE for residential development. The permitted site was certified as being in compliance with the Board of Health's Private Well Regulations (12VAC5-630-10 ets seq.),and local ordinances if the locality has authorized the local health department to accept private evaluations for compliance with local ordinances, by Chris Heltzel, OSE 1940001460. This letter is issued in reliance upon that certification. The Board of Health hereby recognizes that the site conditions acknowledged by this correspondence, and documented by additional records on file at the local health department, are suitable for the installation of Private Well. The attached plat (or plats) shows the approved areas for the private well. This letter is void if there is any substantial physical change in the soil or site conditions 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 Onsite Soil Evaluator (OSE) or Professional Engineer (PE) who performed the site evaluation and design on which this private well permit is based. The name, address, and phone number of the OSE/PE appears on the certification form attached to this permit. Should revisions be necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or site evaluation and design. This authorization is null and void if conditions are changed from those shown on the application or conditions are changed from those shown on the attached construction drawings, plans and specifications. Tax Map #: 69-19E H DI D: 101-22-0314 Page 2 of 2 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.vdii.virginia.Lov/environmental-health/emp-2015-01- forms/ . No private well shall be used until inspected, corrections made if necessary, and approved by the Albemarle County Health Department or unless expressly authorized by the Albemarle County Health Department. Any part of any installation which has been covered prior to approval shall be uncovered if necessary, upon the direction of the Department. If you have any questions, please contact me. This authorization to construct a private well expires: March 15, 2027. Sincerely, Josh Kirtley Environmental Health Technical Consultant Blue Ridge Health District cc: Chris Heltzel COMMONWEALTH OF VIRGINIA Application for: ❑ Sewage System Q Water Supply Owner: Stockton Creek LLC clo Alan Taylor Mailing Address: 455 Second Street BE, # 201 Charlottesville, VA 22902 Agent: Stockton Creek LLC c/o Alan Taylor Mailing Address: 455 2nd Street SE, Suite 201 Charlottesville, VA 22902 Site Address: TBD Afton, VA 22920 Directions to Property: Subdivision: WELL 23 Section: Tax Map: 69.19E Other Property Into: Vox USE ONLY Health Dept. ID# Due Date: Phone: 5124264728 Fax: Phone: Phone: 434.981.3634 Fax: Email: simpson@aaasconstrucaonmanagemenLcom Block: Lot: Acreage: 4.62 Sewage System rpe of Approval: Applicants for new construction are advised to apply for a certification letter to determine If the land Is suitable for a sewage stem and to apply for a construction permit (valid for 18 months) only when ready to build. ❑ Certfication Letter Construction Permit ❑ Subdivison Approval ❑ Repair oposed Use: ngle Family Home (Number of Bedrooms) 5 Multifamily Home (Total # of Bedrooms) :her (Describe): Basement 21 Yes Walk -Out Basement? ED Yes Fixtures in Basement? 21 Yes ❑ No ❑ No ❑ No Conditional Permit Desired? ❑ Yes No If yes, what type of conditions are desired? ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary Use (1 yr. maximum) Do you wish to apply for a betterment ban eligibility letter? ❑ Yes— ❑' No "There is a $50 fee for determination of eliaihility_ ill the water supply be ❑ Public or 0 Private If proposed, is this a replacement well? ❑ Yes ill any buildings within 50' of the well be termite treated? this a private sector OSE/PE application? 0 Is the water supply ❑ Existing or 21 Proposed No If yes, will the old well be abandoned? ❑ Yes ❑ Yes No All Applicants Yes ❑ No If yes, is the OSE package attached? Is the property intended to serve as your (the owners') principal place of residence? ❑ Yes i] No In order for VDH of process your application for a sewage system, you must attach a plat of the property and a site sketch. ❑ No Yes ❑ No sunulies_ a prat of me property is recommenced and a site sketch is required. The site sketch should show your property lines, actual and/or proposed buildings, and cation of your well and/or sewage system. When the site evaluation is conducted, the property lines, building location and the p _ "*On afters must be dearly marked and the property sufficiently visible to see the topography. I givgj'!B*iss1on to the Virgirde'(Fe ment of Health to enter onto the property described during normal business hours for the purpose of pmc&Ag this appl Z to le rm quality assurance checks of evaluations and designs certified by a private sector Onsite Soil Evaluator of Rf�siojtas`r�rgsE ntll the sewage disposal system and/or private water supply has been constructed and approved. X9� %C. Signatur(� �1$it�` Date •. , .. 111,17 I t,edr..e w.6H[sPaMu�fld�A6O. iuWd'SIda9! 5=1 go QIIX Dam Knstreda � Demo tine: Fans HM4 FhWAW nw48 Fayaiorlt grpdatwcY R t3HIi # � Rexipt 9 _ - Page of (o 2 Construction Permit ❑ Repair Permit OSEIPE Report For: ❑ Voluntary Upgrade Permit ❑ Certification Letter ❑ Subdivision Approval Property Location: 911 Address: TBD City, State, Zip: Afton, VA 22920 Lot: Section: Subdivision: WELL 23 GPIN or Tax Map P 69-19E Health Dept. ID #: Latitude: Longitude: Owner: Name: Stockton Creek LLC c/o Alan Taylor Address: 455 Second Street SE, # 201 Charlottesville, VA 22902 Prepared by: OSE Name: Chris Heltzel License # 1940-001460 Address: PO Box 554, Woodstock, VA 22664 PE Name: License # Address: Date of Report: 8/22/2022 Date of Revision 01: Date of Revision #2 Contents/index of this report: 1. Cover Sheet 6. Existing Lot Sanitary Survey 2-3. Well Specifications 4. Well Location Sketch 5. Proposed Lot Sanitary Survey Certification Statement I hereby certify that the evaluations and/or designs contain herein were conducted in accordance with the applicable provisions of the Sewage Handling & Disposal Regulations (12VAC5-610), the Private Well Regulations (12VAC5-630), the Regulations forAltemative Onsite Systems (12VAC5-613) and all other applicable laws, regulations, and policies implemented by the Virginia Department of Health. I further certify that I currently posses any professional license required by the laws and regulations of the Commonwealth that have been duty Issued by the applicable agency charged with Iicensure to perform the work contained herein. The potential for both conventional and alternative onsite sewage systems has Wf"�yy s5 ed with the owner/applicant. �T�1 or• -V''i+�aa ❑ The k ched to thisge has been conducted under an exemption to the practice of engineering, specifically lh-e exg in Code of Virgin on 54.1-402.A.11 1 recommend that, (] fit Permit., ❑ Subdivision Approval be: ❑ Issued p �r Repair Permit ❑ Voluntary Upgrade ❑ Denied 2 2 Z OSElPE T signature: Yq ' Date: t� rz t The form contains personal intormation subject to disclosure under the Freedom of intormation Act. Revised 12/01/14 Heltzel Soil Consulting Paget of VDH USE ONLY SYSTEM SPECIFICATIONS HDIN: Application Information Name: Stockton Creek LLC c% Alan Taylor Address: 455 Second Street SE, # 201 Phone: 512-426-4728 Charlottesville, VA 22902 Location Information Tax Map/GPIN #: 69-19E Property Address: TBD Subdivision: WELL 23 Section: Block: Lot: Directions: Corner of Route 250 & Route 151 General Information Well Purpose (select all that apply): p Domestic Drinking Water ❑ Agricultural ❑ Irrigiation ❑ Industrial/Commerical ❑ Geothermal Well Class: 3C Minimum Casing Depth: 20 ft. Estimated Water Usage: 750 gpd Minimum Grout Depth: 20 ft. Horizontal Setbacks Distance from Building Sewer: 50 ft., min. Distance from Pretreatment Unit(s) 50 ft., min. Distance Conveyance System: 50 ft., min. Distance to Absoprtion Area: 100 ft., min. Distance from Property Line. e50 ft Distance from Foundations: 50 ft., min. Distance from other source(s) of contamination: 100 ft., min List other sources: NA Notes: This form contains personal information subject to disclosure under the Freedom of information Act. Addendum to AOSEIPE Certification Statement For Private Well Construction Permit Page ez, of — The proposed well site shown herein, Q 1. Is located a minimum of 50 feet from all property lines. FTJ 2. Is located within 50 feet of the adjacent property line(s) but I have determined that the adjacent property is not used for an agricultural operation. L.J i. Witten affirmation from the adjacent property owner(s) that their property is not used for an agricultural operation. QX ii. Other confirmation that land use is not an agricultural operation, please describe: Proposed Residential Subdivison Lot 0 3. Is located within 50 feet of the adjacent property line where the property is used for an agricultural operation. For confirmation, I have attached the appropriate documentation pursuant to § 32.1-176.5:2 of the Code of Virginia. (check one below) Q i. Written permission from the adjacent property owner's) for the well construction. ii. I certify that no other site on the property complies with the Board's Regulations for the construction of a private well. Proposed Well Site is located within 50 feet of an Adjacent Property Line(s) Property is not used for an Agricultural Operation Statement for Adjacent Property Owner(s): I affirm thaAy property is not used for an Agricultural Operation as defined in Property 4a /rZ4 /I a L,7-- Da Proposed Well Site is located within 50 feet of an Adjacent Property Line Property is used for an Agricultural Operation Appropriate documentation to comply with § 32.1-175.5:2 of the Code of Virginia: Written Permission I grant permission for the construction of the proposed private well described herein which is within 50 feet of my property line. Signature of Property Owner Date Heltzel Soil Consultinq, LLC 1412 Saumsvilie Road, Maurertown, VA 22644 SM n-2 17.1 AREA WELL LOCATION SKETCH TM # 69-19E ALBEMARLE COUNTY, VA r w 100.00, , c WELL AREA August 12, 2022 DRAWN BY: SNV '1 #10 sm ral 21 #23 Jr.M.69-19E EVISED LnT 4 4.62 ACRES Page of REI \ 14I \ \ \ � C O' BO' 16O' eAO' HeltZel Soil Consulting, LLC PROPOSED LOT LAYOUT / SANITARY SURVEY Page_7 f b PO Do, 554Woabmtl�. vnxEma STOCKTON CREEK SBD, ALBEMARLE CO, VA A L OOWN WHESk DRA NFIODSRP3VITND , 200'OPTTffi PROPORED DAAWFD:I.DS ARE STNTVN. ST.RT.780 (3D'PRE lPn1E EASEMENT) -;- -__pD uaPnEROADs___ NOT TO SCALE 'LELLOT OBL :,ADAnON STUART TAILOR SMACK i i ..: - Ay DIFFER .....' .::.'r::: 'Sqo 0.E.3DI5� � 04.4T011 PUT ����� ...m 5.n OfEAO "Lmu� OB(fO�230 ` ..:.... 1 � : UNE UnU'^nF� UNEs Main REVISED LOT T EC. 47MAN 33-23 USf D.B.4733-M k 21 PUT DP.4 M-444 DA. 50-2M PUTMR 11 I \J ONUMENT FOUND STATE ROUT' 803 1 "'" ,,, 3orRE VLANE Nn w� MONUMF'OUND T 11 _ CORNER IN 1 ( m F ma POST MONUMENT FOUND I I MONUMENT 1 FOUND id I wx T. LOT , O i 1 FOUND T LOT 1 FOUND FRANK ADM k IU 0. COMET Mai MPPLAT Y 15� UMH MENT MR MONUMENT �L PR�lyl FOUND August FOUND Sl.�F`+ NE�,9 M yHl DRAWN iN D yR� —ANY CUTTING OR FILLING MAY RENE MH MONUMENT FOUND WN �0.9- UNSUITABLE AND VOID THIS PERINf Heltzel Soil Consulting, LLC POe 5 .WttAa VAx T.M.89-a LOT e SMART TAYLOR AIM]( 0O.vfe-ul Oa3fts-7M.707 RAT T.M.NH m PEMSEDME47W LOT 7 EGACfEEppIIAN TMUST O.B.23 D.R.Q33-1A & 0 21 PUT - D.ELM304 0.8.35sO-13f FIAT STATE ROUTE 803 (30PRE arnw EAE T) T.M.6"a LOT 1 FRANK DONUN e CARD DONIEY O.E SSBD- as so WN EXISTING LOT LAYOUT / SANITARY SURVEY PRNe a or b STOCKTON CREEK SBD, ALBEMARLE CO, VA 1INON"°n` &ORAVMELD91" ES"'I' WOFTNEMOPDSFDDRAMF'� SD EPPORM. `.750 (3CPRESCePnW EASCMENT) NOT TO SCALE .. e,�DAiiF WOO lOT a 1N ACES N I xlm T ... ill��� 1GF8 UES OU YOI TYTNFOU an Aaca tRM-lIF T.M.�1a w J� RW A LOT 3 n+/- LOT a e: IF AN ACESO 6RN/- ACE4 N 3=^�1�f (F BEM#4 VON M.MR w RMADLOT T MONUMENT LOT TY.ee-IeC ae1 AQ6 FWNo 'LN AC6 PETl4D lDi x 7.7R A033 CORNEA W FENCE POS TEN MONUMENT OMOFOUND T IpIIO CMER-Iq NDN RMMM LOT 3 ONUMENT ` AN ACNE �gosl'� VL np0, FOUND (VN�0yy00^ MONUMENT yorl August 21, 2022 FOUND Np THE PLATTING DA DEDICATION OF THE FOLLOWING DESCRIBED LANDS. REVISED T.N.69-50B.REVISEO LOT L REVISED LOT 2,REVISEO LOT 3, REVISED LOT 4.REVISEO LOT 5.REVISED LOT 6.REVISE0 LOT 7 G REVISED LOT 8 IS WITH THE FREE CONSENT AND IN ACCORDANCE WITH THE DESIRE OF THE UNDERSIGNED OWNER(S), PROPRIETORS.AND/OR TRUSTEES, IF ANY. FOR: STOCKTON CREEK. LLC CITY/COUNTY OF Ci d1y6lif STATE OF THE FOREGOING I 6 WAS ACKNOWLEDGED BEFORE ME THIS' DAY OF +°<". 2022. BY 4 , Dard.. FOR. STOCKTON CREEK.LLC NOTARY PUSLIC'�!!� %tG�(07 MY COMMISSION EXPIRES C2,4• I" 2CLI APPROVED FOR RECORDATION : GL NOTARY SEAL CURVE DATA LINE DELTA RADIUS ARC TANGENT CHORD CHORD BEARING Cl 15.'48'i6' 1964.86 541.98 272.72 540.27 S63'33'04'E C2 4'44' 10 0.92" 00.14 45.10 90.12 SIS-39-29-W C3. 9'59'39' 1085. 92. 189.42 94. 95 189. SB S38'31' 1'W C4 14 56'55' 1090.92 284.62 143.12 283.82 S55'59.'54"W 05 1-20.52- 1487. 9 35.00 17.50 35.00 S72'22'45'W C6 22'41'29' 1487.79 589.22 296.52 585.38 S60'21'35'W C7 21'31'58' 167.57 62.98 31.86 62.61 N05-35.16.9 CB 32'63'50'. 94.14 54.05 27.79 53.31 N32'48'10'E C9 843'55' 94.14 13.53 6.77 13.51 N53'22'02' C10 15'57'OB' 184,27 51.30 25.92 51.14 N65'27'33'E BOUNDARY LINE ADJUSTMENT PLAT REVISED T.M.69-50B REVISED LOTS 1, 2, 3, 4, 5, 6, 7 6 B THE PROPERTIES OF STOCKTON CREEK,LLC LOCATED ON U.S. ROUTE 250(ROCKFISH GAP TURNPIKE), STATE ROUTE 151(CRITZERS SHOP ROAD), STATE ROUTE 75O(OLD TURNPIKE ROAD), AND STATE ROUTE 803(GOODLOE LANE) NEAR CRITZERS SHOP WHITE HALL MAGISTERIAL DISTRICT ALBEMARLE COUNTY,VIRGINIA SCALE: i' = 200' OATS: SEPTEMBER 27, 2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29, 2021 REVISED: FEBRUARY 3, 2022 FOR COLLINS ENGINEERING ROGER W.RAY S ASSOC., INC. 663 SERKMAR COURT CHARLOTTESVILLE.VIRGINIA 22901 TELEPHONE: (434) 293-3195 RAYSURVEYING.COM WOODS ROAD BRIAN S. RAY Lk- No. OD2281 02/03/2022 250 ROCKFISH GAP TURNPIKE B03 GOODLOE .;SITE LANE A. T.M.69-19B. 19C. 19D. 19E & 19G ARE ZONED AA (ENTRANCE CDRRIDORl. T.M.69-19F IS ZONED RA. T.M.59-19H. 19J &. 50B ARE ZONED RA(ENTRANCE CORRIDOR G FLOOD HAZARD OVERLAY). B. T.M.69-19B(REVISED LOT !)RETAINS TWO DEVELOPMENT RIGHTS AND MAY NOT BE FURTHER DIVIDED IN ITS CURRENT CONFIGURATION. C. T.M.69-19C(REVISED LOT 2)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. 0. T.N.59-190lREVISED LOT 3)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. E. T.M.69-19EIREVISED LOT 4)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. F. T.M.69-19F(REVISEO LOT 5)RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. G. T.M.69-19G(REVISED LOT MIS ASSIGNED ONE DEVELOPMENT RIGHT AND MAY NOT BE FURTHER DIVIDED. T I. T. M. 69-19J (REVISED LOT 8)IS ASSIGNED FOUR DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. ONE DEVELOPMENT RIGHT IS BEING ADDED WITH THE 2.36 ACRES FROM T.M.69-198 AND THREE DEVELOPMENT RIGHTS WERE DERIVED FROM THE DECEMBER 1900 BOUNDARIES OF T.M.69-19J. WHEN USED THEY SHALL BE WITHIN THEIR DECEMBER 1980 BOUNDARIES. J. REVISED T.�M.69-508 RETAINS TWO DEVELOPMENT RIGHTS AND MAY BE FURTHER DIVIDED. K. ACCORDING TO THE ALBEMARLE COUNTY GIS DATA. EACH REVISED LOT SHOWN HEREON CONTAINS A BUILDING SITE THAT COMPLIES WITH SECTION 4.2.1 OF THE ALBEMARLE COUNTY ZONING ORDINANCE. L. SETBACK REOUIREMENTS:FRONT= 75'.SIDE= 25& REAR- 35'. M. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA,THESE LOTS LIE WITHIN A WATER SUPPLY WATERSHED. N. ACCORDING TO THE COUNTY OF ALBEMARLE GIS DATA,THESE LOTS ARE NOT LOCATED IN AN AS -FORESTAL DISTRICT. D. THE APPROXIMATE LOCATION OF THE STREAM AND STREAM BUFFER SHOWN HEREON WAS TAKEN FROM THE COUNTY OF .ALBEMARLE GIS DATA AND SHALL BE MANAGED IN ACCORDANCE WITH THE ALBEMARLE COUNTY WATER PROTECTION ORDINANCE. NOTES: i. OWNERS. ADDRESS & LEGAL REFERENCES: T.M.69-198, 19C, ISO, 19E, 19F. 19G. IBM. 19J S 50B STOCKTON CREEK,LLC 4.95 SECOND STREET.5TH FLOOR.CHARLOTTESVI E.VIRGINIA 22902 D.B.5657-263. D.B.892-159 PLAT & D.B.683- 4 PLAN. 2. THE BOUNDARY DATA SHOWN HEREON IS BASED ON A CURRENT FIELD SURVEY. 3. T.M.69-50B IS SUBJECT TO THE FOLLOWING A. EASEMENTS TO VIRGINIA ELECTRIC AND POWER COMPANY(O.B.264-409 & INST.0202200001316) B. AN EASEMENT TO VIRGINIA PUBLIC SERVICE I COMPANY ED. B. 232-5B5). 4. T.M.59-50B IS SUBJECT TO AN EASEMENT TO THE CHESAPEAKE AND POTOMAC TELEPHONE COMPANY OF VIRGINIA INSOFAR AS IT MAY APPLY(D. B. 209-261). 5. T.M.69-19D, 19E. 19F, 19G. 19H 6 19J ARE SUBJECT TO,, AN EASEMENT TO VIRGINIA ELECTRIC AND POKER COMPANY(O.B.264-404) B. T.M.69-19D, 19E. 19F, 19G. 19H & 19J ARE SUBJECT TO, AN EASEMENT TO VIRGINIA PUBLIC SERVICE COMPANY INSOFAR AS IT MAY APPLY(O.B.232-153)- 7. SHOULD AN OFFICIAL DETERMINATION OF PARCELS OF {CORD REVEAL THAT ADDITIONAL PARCELS AND/OR DEVELOPMENT RIGIETS EXIIST. THE INTENT OF THIS PLAT IS NOT TO COMBINE THESE PARCELS OR EXI ANGUISH DEVELOPMENT RIGHTS. B. NO TITLE REPORT FURNISHED. ALL EASEMENTS NOWN BY ME ARE SHOWN OR NOTED HEREON. THESE PROPERTIES ARE SUBJEC TO ANY ADDITIONAL CONOITIONS.UTILITIES.EASEMENTS AND/OR COV NANTS THAT MAY EXIST. 9. ACREAGES BEFORE THIS BOUNDARY LINE ADJUSTMENT AS PER TAXATION RECORDS: T_14.69-198(LOT 1) - 6.51+/- ACRES T,M.69-19C(LOT 2) = 5.77+/- ACRES T.M.69-190(LDT 3) - 5,15+/- ACRES T;M.69-19E(LOT 4) - 5.45+/- ACRES T,M.69-19F (L.OT 5) - 6.68+/- ACRES T.M.69-198(LOT 6) - 5.88+/- ACRES T.M.69-19H(LOT 71 a 5.12+/- ACRES T.M.B9-19J(LOT 8) - 6.56+/- ACRES T:M.69-50B - 9,:35+/- ACRES DATE: SEPTEMBER 27,2021 REVISED: NOVEMBER 4, 2021 REVISED: NOVEMBER 29.2021 REVISED: FEBRUARY 3, 2022 ROGER W.RAY & ASSOC.,INC. 663 BERKMAR COURT CHARLOTTESVILLE. VIRGINIA 22901 TELEPHONE (434) 293-3195 RAYSURVEYING.COM SHEET 2 OF 3 14912A LEGEND: IF IRON FOUND IS IRON SET ........ EXISTING LOT LINES HEREBY EXTINGUISHED p_ OVERHEAD UTILITY LINE APPROXIMATE LOCATION OF AREA WITHIN ZONE A(100 YEAR FLOOD PLAIN) ACCORDING TO; THE FEMA FLOOD INSURANCE RATE MAP, EFFECTIVE GATE 2/4/2005, COMMUNITY PANEL 510006 02250. S70'00'00'E 35.00'-- T.M. 69-6L LOT 6 STUART TAYLOR SMACK 0.8.5245-521 D.B.3415-704,707 PLAT N05'10'43'W 155.67' N05'10'43'W 7.09%1 NOE•10'43'M 23.271, NO2'36'21'W 29.23.-- NO2'36'21'w� 100.42' NO2'36'21'W- 40.00' T. M.69-6M N08'56 25'W REVISED LOT 7 155. 07' E.C.ACKERMAN TRUST D.B.4733-23 D.B.4733-20 G 21 PLAT N04'54'11' D.B.4456-444 71.02' D.0.3530-234 PLAT R04'54'31 5.37' STATE ROUTE 803 (30'PRESCRIPTIVE EASEMENT) GOOOLOE LANE N04'26' T.M.69-SG 245.2 LOT 1 FRANK CONLEY & S85'191:: CARLA DONLEY 26.09 D.B.338D-82, NSO'02' 85 6 86 PLAT 50.9 GRAPHIC SCALE 1'=200, M03'3 224 0 200 400 VOH MONUMENT S70'00'00'E 102.98' ,: �(O.OB 1 T.M.69-199 REVISED LOT 6 2.63 ACRES 25.00(2.55 AC.) (3.33 AC.:) OVERHEADp6�[ UTILITY LINE (6.56+/- ACRES) -25.00' T.M.69-l9F 9f9.54'02'E otn . (2.36 AG.) c , 4 REVISED LOT 5 89. 15' 2 J u°i m Ar 4.53 ACRES go'Sf'34'E IS LOT 5 ,...N IF o 07. RLVI$ED mm`�f�►' '�'. (F )i 5i i�p 53 A6.. w�f, Y (3.01 AC) a. 3 T. 69-508 fvH' 41 i2"+BbO•.. SBBe�O_.. ;m?Re£. IF;m B.ACRES 'OD IS IS (5.72 0.0 1-m ' U.55 AC.) m .� ' "T.M. 69-19B MONUMENT T.M.69-19E D :x REVISED Is AT FOUND REVISED LOT 4 + g 30 64 N7g g41 if 14A,. MONVOH UMENT 4.62 ACRES I a1FOUND w.26 AC.) ACRES ( T M 69-19C a - h �' 43.00'47'W (0>07 Ac.7 95. REVISED LOT 2 ' a -ems CORNERIIN }( N83 `30' , .35 T ti 7.70 ACRES VOH FENCE POST g{^ G82 W•- 6 �.- ' in MONUMENT ( Z24.01 ' 7� - 3 n7� p1• '? 11 -.�08 vDH FOUND MONUMENT I T.M.69-190$; t IF^S4A. IS FOUND 1 REVISED LOT 3 At.45ae+ s71 33' 3e w 4i7 2• F ,M Y� MONUMENT 181.01' ( 4.56 ACRES 4 31A' I. [ (0. 05 AG.)-4� ►1:' FOUND IF r'-0''sA s7'�� AIM SCALE: I' = 200' (4.51 AC.) 9S Tim M G.211) DATE: SE TEMSER 27.2021 G6 MONUMENT V p 8 T4 REVISED:• EVEN ER 29.2021 FDUNo vole' REVISED: IFEBRUARY 3, 2022 ROGER W.RAY S �ASSOC.. INC. 553 OERKMAR, COURT 'K°°AA11177Y Y• ,,... CHARLOTTESVILLE. YTRGINIA- 22901