HomeMy WebLinkAboutSUB201600002 Approval - Agencies 2016-03-03COMMONWEALTH of VIRGINIA
In Cooperation with the
State Department of Health
Phone (434) 972-6219
Fax (434)972-4310
2/19/2016
Ellie Carter Ray, Senior Planner
County of Albemarle
401 McIntire Road
Charlottesville, VA 22902
Thomas Jefferson Health District ALBEMARLE -CHARLOTTESVILLE
FLUVANNA COUNTY (PALMYRA)
1138 Rose Hill Drive GREENE COUNTY (STANARDSVILLE)
LOU ISA COUNTY(LOUISA)
P. O. Box 7546 NELSON COUNTY (LOVINGSTON)
Charlottesville, Virginia 22906
RE: Review of Proposed Subdivision Plat as part of Tax Map 85, Parcel 44, located in
Albemarle County, Virginia.
Dear Ms. Ray:
On January 5, 2016, the County of Albemarle requested the Virginia Department of Health (via the Albemarle
County Health Department) review the proposed subdivision plat identified above. This letter is to inform you
that the above referenced subdivision plat is approved for individual Onsite Sewage Systems in
accordance with the provisions of the Code of Virginia, the Sewage Handling and Disposal Regulations,
and local ordinances.
This request for subdivision review was submitted pursuant to the provisions of § 32.1-163.5 of the Code of
Virginia which requires the Health Department to accept private soil evaluations and designs from an
Authorized Onsite Soil Evaluator (AOSE) or a Professional Engineer working in consultation with an AOSE for
residential development. This subdivision was certified as being in compliance with the Board of Health's
Regulations by: Steve Gooch; Onsite Soil Evaluator Number 1940001284. This subdivision approval is
issued in reliance upon that certification.
Pursuant to § 360 of the Regulations this approval is not an assurance that Sewage Disposal System
Construction Permits will be issued for any lot in the subdivision identified above unless that lot is specifically
identified on the above referenced plat as having an approved site for an onsite sewage disposal system, and
unless all conditions and circumstances are present at the time of application for a permit as are present at the
time of this approval. This subdivision may contain lots that to do not have approved sites for onsite sewage
systems.
This subdivision approval does pertain to the requirements of local ordinances.
Stepato
Env amental Heal Specialist, Sr.
Onsite Sewage and , ater Programs
Commonwealth of Virginia VDH Use Only
Health Department ID#
Application for Subdivision Review Due Date
(Page 1 of 2 to be filled out by the Owner or Agent) eil n ,
/MP, ;,..)i`7)
U t1,
Owner Jeanne Ward Phone
Mailing Address 214 21st Street#5D Phone
New York,NY 10011 Fax
Developer/Agent Steve Gooch Phone (434)531-0487
Mailing Address 703 Oliver Creek Road Phone
Troy,VA 22974 Fax
AOSE Steve Gooch Phone (434)531-0487
Mailing Address 703 Oliver Creek Road Phone
Troy,VA 22974 Fax
Directions to Property: From Charlottesville 29 South,right on Plank Road,left on Stillhouse Creek Road to 2285 Stillhouse Creek Road
on left
Name of Proposed Subdivision
Tax Map 85-44 Other Property Identification Dimension/Acreage of Property 10 Ac.
Number of lots proposed 2 Proposed water source(note:new or existing,public or individual) existing,new,individual
General size of lots 2 Ac.+6 Ac. (give range if appropriate)
Additional description of subdivision
Overview of soils and geology(optional but encouraged)
In order for VDH to process a subdivision application you must attach a plat of the property showing the location of the proposed onsite
sewage disposal systems and the reserve absorption areas(if required)and the location of the water supply system on each lot,if applicable.
Each plat or subsection of a subdivision shall be accompanied by specific soil information for each lot(absorption area and reserve area). If
not provided by the local subdivision ordinance,the district or local health department may require the plat to show streets,utilities,storm
drainage,water supplies,easements, lot lines,and original topographic contour lines by detail survey or other information as required.
When the AOSE site evaluations are reviewed,the property lines,building location and the proposed well and sewage system sites must be
clearly marked and the property sufficiently visible to see the topography,otherwise this application will be denied.
I give permission to the Virginia Department of Health(VDH)to enter onto the property described during normal business hours for the
purpose of processing this application and to perform quality assurance checks of evaluations and designs certified by an Authorized Onsite
Soil Evaluator(AOSE)or a Professional Engineer(PE)as necessary until the sewage disposal system has been constructed and approved.
i'leti,C., /2/3/k5
Signa ure of Owner/Agent Date
VDH Use Only
ommonwealth of Virginia Health DepartmentlD#
Application for Subdivision Review Due Date ._
(page 2 of 2 to be filled out by the county official requesting a VDH review)
County Office initiating request
Contact Individual Phone
Local offices of the Virginia Department of Health may review subdivision applications for compliance with state rules and
regulations governing sewage treatment and dispersal and private water supplies,compliance with local ordinance governing
sewage treatment and dispersal and private water supplies and potentially for compliance with other local ordinances. Please
indicate the nature of review you are asking the health department to conduct.
1. Review for conformance with the Sewage Handling and Disposal Regulations
2. Review for conformance with local onsite wastewater ordinances
3. Other(describe below)
Name and title of requestor Date
OSE Form F Revised 7/02/09