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HomeMy WebLinkAboutSUB201800105 Application 2018-06-25 %Orr yCommunity De`relopmentDepartmenti ie Albemarle CoCour. if:,'., L•• 4:1 I fibre Road Charlottesville.V 226902. 59E. It Voice i4 4•295-51332 Fax €434 Si72-3126 Planning Application PARCEL/ OWNER INFORMATION m_ _._..._. _......._...._. _.__.__. __.......__........ _ _ _ . P`IP 11100-00-00-026A0 Owner(s): BOYES, MICHAEL W OR LEIGH B Application# SiU820I 800105 .PROPERTY INFORMATION Legal Description ACREAGE TRACT 1 i t l u.\11 !I.'. Magisterial Dist. Samuel Miller iv. Land Use PrimaryForest . i__.r Current AFD Not in A/F District •vJ Current Zoning Primary Rural Areas . `APPLICATION INFORMATION _._.. v Street=.ddress i I Entered 6y, ��� ; pplication Type Subdivision Nat � Jennifer Smith(.; ..A..« i 6;9.'2018 Project SAGE HOMES, LLC -BLA Received Date 106/05/18 i Receked Date Final 1 I Submittal Datel06/25/18 Total Fees! 2151 Cloning File Date Submittal Date Final i Total Paid 2151 Revision Number w_ ._ ... _ -- _ ._...._. __._.....-,_.._ Comments r Legal.Ad d SUB APPLICATION(s) ______ _. � ______._ j-_.__- Type _..._d Sub 4pipatro;._ Ccn n lent 1 Boundary Line Adjustment 06/25/18 I l 'APPLICANT /CONTACT INFORMATION ContaciTrpe _ Name...__ dressCi* State Zip iPrcr. !'t to it - -= -e"= &OvES MICHAEL',V OR LEIGH & 3033=.IBfP.ENE CHURCH ESttOtiT ..-: 22903 i,--3-, :.= ==: GWEt'l LACY ROGER'A, RAI. 5 ':S-fir.. 663 BER14.1AR CT, CHARLOTTES`:ILL 22901 4342933/95 SAGE HOMES.LLC ^ ar• 3033 ALBERENE CHURCH ESf1OPlT t- 22930 434409515 I 4 Signature of Contractor or Authorized Agent Date "4-4• "14 1)e-t-,Irl t e•-zt,i— p 4,)14.,,, •• ,- Shu A. t ;�?.. . . .IL4-SAit,ia. 'DX.4, ..4 r-.itfra, 0,,,4 11.•. I/1- 9 6 Albemarle County Health Department •Sewage Disposal System& Water Supply Construction Inspection Owner:Carpenter,William and Beverly Owner Phone: (434)248-4047 9 Devonshire Way Health Dept. 1D: 101-02-0997 San Francisco VA 94131 Tax Map Number: 111-824 ' • Subdivision: Section: Lot: Property Address: - ENS: For each item, circle status, date and MI n l�'i j I m t Sewer line: • Satisfactory: - . Pending-Inco ete .' • • • Pending-• needs correction . Comments: ' . Septic Tank: 1�'d4r�AIM R tt ,,, • Roo • • Satisfactory . _ • •• • Pending-incomplete • . . Pending-- needs correction • . • 'Comments: ' • . - • Inlet/Outlet Structure '• . • i Satisfacto • Ye • .. .. . s • • .�'' f' Pending-incomplete • . • �,4 3" • 'Pending•- needs correction • Comments: , Pump System: _• � • ' • • Satisfactory: Yes .. • • ' • Pending-incomplete Pending needs correction • • • • • - Comments: . . • • "' Conveyance Line/force Main ' • 'Satisfactory ' i • Pending-incompiete • ' Pending-• needs correction • . • Comments: • • . Distribution Box/Distribution System • 4k.‘10. D-$ Satisfactory •Pending— incomplete • . Pending•- needs correction . • • Comments: • Header Lines• • Satisfactory Pending-incomplete . Pending-- needs correction' • Comments: • 3 Percolation Lines: • Satisfactory_: • Pending-incomplete . Pending-- needs correction •• Comments: . . - • • Absorption Trenches: • 'Ir, Satisfactory , e °L�� �r �f\J.. lit- . Pending-incomplete Pending-- needs correction , - • -. -Comments:. - ---- - -- --- - .- .--- - -- - - -- • -- -- -____.. Other: ' ' . . • • . , Septic Contractor Name: . • •• • As-built sketch: - • ,, $,o. Completion Statement Received: . •i'4 ' Conditional permit compliance:. . . . bIQ,,.� L'tr'Ia,� . Time spent inspecting: Time in: • , -'Time out:. • . struction Final Approval: U ' 20,f • • Appr ed by Oa a Approved • • • Water Supply Location:. • • • " Satisfactory: Yes • . . . • • • Pending-incomplete • . . • , ' • • ' . • Pending-- needs correction ' • •• . - • -Comments: . . • ' '' Time Spent Inspecting: Time In:�. •Time Out: . .• • ' Construction.Finat Approval: • • • . • - • Approved By . Date A • pproved ' i L • •Water Supply and/or Sewage Disposal'System'Construction Permit Page 1 of 4 Commonwealth of Virginia Health Department Department of Health Identification Number: .101r02-0997 ALBEMARLE CO.HEALTH DEPARTMENT • Tax Map Number, I 11-814 General Information HP#:2002-2247 SF Water Sarah!System: NEW Sewage Dissosal System: NEW Based on the application for a sewage disposal system construction permit Ned in accordance with Section 2.13 E.of the Sewage Handling and • Disposal Regulations and/or Section 2.13 of the Private Well Regulations a construction permit is hereby issued to: Owner: WILLIAM AND BEVERLY CARPENTER Telephone 434-245-4047 Address: 9 DEVONSHIRE WAY.SAN FRANCISCO.CA 94131 Fora Type II Sewage Disposal System or Well to be constructed on/at SOUTHSIDE OF ROUTE 701;.1 MILE WEST OF ROUTE 717 LSec/Bk Lot Actual or estimated water use 300 epd- 2 bedrooms _ ..........4DSIGA NOTES: SEWAGE DISPOSAL SYSTEM INSPECTION RESULTS '• Water supply,TO BE INSTALLED I Water supply location:Satisfactory yesno 1 GROUT CAP • To be installed: CLASS:iilC I CASED:20 feet GROUTED:20 feet I EHS DATE Building Sewed/rt 1.D.PVC Schedule 40, 1 Building Sewer Satisfactory yes_no_ or cuuivaient.Slope 1.15"per I0fi(min.) 1 ' Other 1 EHS DATE I�1� Septic Tank:Capacity:750 Gats.(min.) I Pretreatment unit: Satisfactory yes_no_ �/ i ; '771170 (i 41 i I1 1 111 n LI .1.6N i f IgE Other 1 EHS DATE • Inlet-outlet structure:PVC Schedule 40, I Inlet-outlet structure:Satisfactory yes no 4"tees or equivalent. • 1 Other 1 EMS DATE Pump and pump station: I Pump&pump station: Satisfactory yesa_no_ YES describe and show design I If yes: I EHS DATE • Gravity mains: 3"or huger I.D.,min.6" I Conveyance method: Satisfactory yes_no_ fall per 10011..1500 Ib.crush strength 1 or equivalent. Other I EHS DATE • Distribution Box: Precast concrete I Distribution box: Satisfactory yes_no_ with 4 ports. 1 Other I EHS DATE Header lines: Material:4"1.D.1500 lb. I Header lines: Satisfactory yes-_no crush strength Plastic or equivalent Thom 1 , distribution box to 2 A into absorption I trench.Slope 2"min. Other i EHS DATE Percolation lines; Gravity 4"plastic I Percolation lines: Satisfactory yes no i000lb.rcr foot bearing load or equiv. 1 slope 2"-4"(min.max.)per 10011 I Other I EHS DATE Absorption trenches: 1 Absorption trenches: Satisfactory yes no • Sq R.required; 900 depth from 1 around surface to bottom of trench 34": I • aggregate size.5.1.5": I ENS DATE Trench bottom slope 2.4"/100 ft 1 center to center spaacing 9 FT: t Date Approved by: Trench width 36"Depth of aggregate 13": 1 Trench!math 100 ft; 1 Number of trenches 3: 1 Environmental Health Specialists CHS202A L .. _ " .. -- d w PageNtrmber2 . HeatlhDepartment 101-02-0997 • tdentiflcatlon Number Schematic drawing of sewage disposal and/or water supply system and topographic features. snowy a Ines athe Winne see,*watt et meaty Owing gay myo hoses seats wesown en the data aon wag asewage&podmans.a s edges aaspesed gnawsendsewgeesx dspas sawlwasraisX0ted The sehammcdrentgathe wMsneer mai teaks sewage dismal system stag show sixes We,seee radvei,paasada.conveys=spaanandsueeefaossmsanpiarWan.mum maw.S Mee aMadge Mangle* • seats biota eerni ed,shoe el smogs a paean 0 The irtlamation required above has been drawn on the attached copy of the sketch subnadted vat the application. If Gravity System can be Installed • .; Call Health Dept. (434)972-625 ,�,> - - Swale._. ..._ :. Reserveog ii sor44.4*ila-.1 Cal *0----'-,4,,o,,_......,4!,,,:', ,,,,;,,a; it.: x1OQ • �� a 6'his,,,i , . .4k,,,,,s,,,,4,;, NN : - - -\ 100% ��n�l{Rl!1f! rf» i Reserve K ( : o ll� ', 5 D . *. \ "-As.® . ;u.:%E 78' 3unes Existing Existing . 100'Long 34~ *4" r tri Well House 7 Wide Trenches Pink/Black Green IF Centers on Contour Hemlock MN Utility" "To Maintain 100'Setback form - ,ell ZBR Design tion 760 Galion Sepik Tank and PumpChansber tnstsD Center- 01 C Well Piece-of to be Cased and Droutei Mbilmurn 27 Z Driveway in Designated Well Asea Only . to Maintain 6r7Setbackfront Proposed House . _ ._ Penal Not Drawn to Scale This sewage disposal system and/or water supply is to be constructed as specified by this permit. This sewage disposal whim well conrivaien permit is null and void it(al conditions ars charged from those shown on the ' appticatlor tion conditions me changed from those shown on the ccnstnxtlon permit No part of say iltstaltarten shall be awned or used with inspected,corrections mads if necessary,end approved,by the local health depart neat*runless uepiesalyauthorised by the boll health dept Any pmt of any tnata0ation which has been covered prior to .• approval shad be uncovered,it necessary,upon the direction of the Department. Date: 0///4/2003 issued by: .,�,�.._.,_ __G This Construction U tion EnvirotensnW Health specialist . Pettnit valid until Date: Reviewed by: -1141.401,64 • Em►romnenttl Net"Supervirj • e t pr lith tlalle 'tft1101 .........p...................................... ..................................... . • • .• • • Heath Deeddrnart ht i.-0-oil 7 Awe Ciente See es Galendreerens . idertetatial Staten ......- . Gallons Per Cycle:glare . Onewdown In tsches:lhethes Nedl—dg.. Mahan PranpOide Tee:ft.betures343earals . (Gem Rage*es 21 GPM) Type of Peep netsuke&EttinieisIbie MAO Ptarp capabed11\GPI.'ea°Feel 01 Head. v=====•••===== TbsteateStfaanturd be macepdAdapentersjocauteetiesity.stanheare soppiest to gulp based morale,ktvel. .. The ekceite new owned after and mew deptorwra sweet Owl be placed in e snare bead on above grade end mos banters purtp sedan. ' ' . . Each rrnew centre maw shd be provided%vela rnerue awake'meets - . A higlwatealannwilb rennts sensing and demise*Way separate front herr oto"mire mentor she be provided. li nVr-.1).F)),(1,--‘01 1171-11 The atom she be ad:anal:0 and shalt'demi in an alto where I rary be es*snonloo:d. NE [111 1.1 iL'Vi'Q!...1) . na elearteloswactiora theta!be turentrol in Um atectreal etormeaknipeattion bra. Al pipits)and b.dew peesure type wet pressure typeptints est are"Aorta:ay Med. . . . Celiac:or le provide puree stelides and pump ewe data to Heath Demesne Se approval.pieta initaltator' I. ' . • . LittillItti1 % , $ lif trilj • • . • s ' downwen -- . • • . :. es . OYETIA40 "*""`""' . . .. . , • . • ........ . I 1 ' / ti". . • L0P411941"Rope ' \......V......."--- ...........-•••••••, • • : , . • • ' . ,i . . . • 11 . 011illitaltilltiilUlliltlit . . . . . 1 . 14 . 11 :•: ! :ttt '-"N ...-* Ft$ $ $ $ $ I. E i I . • • t ' i CiattOMMOI I MMOOW W I S. 1Cmil.ile , m . : wir SOMIlitbeme . . . . , . C.:100rie —.. ; 1 • 4 , 010114m . . Nat belocatiq IMOraroles• ‘0 Ingided Wilft c i OW* ...---von, 0a0o0m0er. fibm'imusiftm /km*4 . , • ‘, ( *V Piolpfteirt0It El E \ . 1 wittAppereMesi • ( ) 0 \) \ tnr Awacw 'q... ; • —Wow Wit . . 0..varent• • 1.,51! . a i '• R 011 • , 011911M.Eantlift. ep 2' • 0101.01011.0e. To Eosin•Mod* Cipot ha . 0000401W . . / Con$A0101.0* Ptrrp To& • fthennW Climi0Wbfty Millirem swap • Dcamireawk . tiltil $ 11011 , 111SSIllteXttitSilit $ 41 , 1ilit0111111111 , 11 $ 11141111 $ 1g0 , 1111g $ .... • . . • • ) . . i ' ' ' ' •• •• '•'. • •• • .. •••1/4. •'•' •'. ' "' •.•' • . . •'''• .......)... ' . -• .................................::L••.7 ...:.: Ship, `.50` HEALTH DEPT IVO: 101-02-0997 TAX MAP: 111-8Z4 PACE 4 SEWAGE DISPOSAL AND WATER SUPPLY'CONSTRUCTION PERMITS See Page 2 For Design Drawing. Drawing is Not To Scale • Permit is void if the house location interferes with the proposed well or drain Field/resent locations. • Follow all OSHA requirements. • Minimum separation between drain fieldhescrve area(s)and well sites is 100 feet from Class I1IC wells and 30 feet from Class IIID wells. This distance increases by 25 feet for every 5 percent slope for wells down slope of any source of eomamination.(houtic r�'te,drain;fiekf/reserve:areseetc:} ._. __ — ._ — ---... .. • It is the owner's responsibility to ensure that the well and septic system is on the property and does not interfere • with utilities and easements. • • Health Department's Operation Permit and Well Inspection Report arc required prior to occupancy. • All septic and well contractors must hove a current license with the Virginia Department of Commerce. ' • It is illegal to put either well or septic system into use without final health department approval, rl"t X111 D • Septic and Well Contractors should be provided with a copy of penia before any construction begin© "` ni�i u�_ • Well and all water lines shalt be disinfected prior to water sampling. • Dry holes must be permanently abandoned in accordance with the Private Well Regulations by a certified well driller. • Basement(floor is below surface of ground)? lab NO Walkout : ittil NO • Fixtures in Basement? YES () Litt Pump Required? gialNO • • Is septic tank location in a place of suspected high water table? YES NO If yes,please refer to tank manufacturer's instructions on placing tanks in saturated areas. • Pump is required when the ground surface over the drain field trenches is at a higher elevation than any plumbing • fixture or the sewer line leaving the house. • Do not disturb the drain field or reserve area(s). • • No buried utility service shall be closer than 10 feet to any part of this system. • Do not install drain field systems during periods of wet weather or wet soil. • It is recommended that all trees be removed from the drain field area and all hydrophilic trees within 10 feet of the drain field area MUST be removed. • Place untreated building paper or approved material over the trench gravel. • The maximum soil cover over septic and pump tanks and distribution boxes is IS inches to 24 inches. • A 11 tanks shall be watertight. . • Final grade of drain field shall be crowned to divert surface water and prevent pending. • Roof drains,basement sump discharges(nomscwagc),floor drains,footing drains,discharge from water treatment systems,etc.,being connected to this system is PROIIIBITEDI Divert these away from drain field. • Keep structures and driveways offdrain field/reserve area(s). • tt shalt be the responsibility of the owner or any subsequent owner to maintain,repair or replace(requires a permit)any sewage disposal system that ceases to operate in a sanitary manner. Page 1 COUNTY OF ALBEMARLE APPLICATION FOR BOUNDARY LINE ADJUSTMENT PLAT Boundary Line Adjustment = $215 (Provide 5 copies of plat) Project Name Sage Homes, LLC #14678 zoA Tax map and parcels 111 &8Z8 Zoning RA Physical Street Address(if assigned): Alberene Church Lane Applicant Sage Homes, LLC Street Address 3033 Alberene Church Lane City Esmont State VA Zip Code 22937 Phone Number 434-409-9154 Email sagehomesllc@gmail.com Owner of Record Michael W.& Leigh B. Boyes Street Address 3033 Alberene Church Lane City Esmont State VA Zip Code 22937 Phone Number 434-409-9154 Email sagehomesllc@gmail.com Contact (who should we contact about this project):Gwen Lacy at Roger W. Ray&Assoc., Inc. Street Address 663 Berkmar Court City Charlottesville State VA Zip Code 22901 Phone Number 434-293-3195 Email Gwen@raysurveying.com info@raysurveying.com Brian@raysurveying.com County of Albemarle Department of Community Development 401 McIntire Road Charlottesville,VA 22902 Voice: (434)296-5832 Fax: (434)972-4126 -•: 1/1/2015 4 Page 2 COUNTY OF ALBEMARLE APPLICATION FOR BOUNDARY LINE ADJUSTMENT PLAT Owner/Applicant Must Read and Sign The plat application process includes providing the County with all the information required in Chapter 14 Subdivision of Land of the Albemarle County Code. The foregoing information is complete and correct to the best of my knowledge. I have read and understand the provisions of Chapter 14 Subdivision of Land of the Albemarle County Code. By signing this application I am consenting to written comments, letters and or notifications regarding this application being provided to me or my designated contact via fax and or email. This consent does not preclude such written communicati from also being sent via first class mail. folek\ May 21,2018 ignature of• - • . ' .- ,Agent Date Gwen Lacy 434 293-3195 Print Name Daytime phone number of Signatory IT 0 ag z z � n m FOR OFFI E USE ONLY SUB#Cyr/8-105 Fee Amount$ oh ^ Date Paid U By who? MtakCtO �J tS Receipt# t t4A3J-- Ck# 61aL00 By: • - -.: 1/1/2015 3 *4b/ *a/# Page COUNTY OF ALBEMARLE BOUNDARY LINE ADJUSTMENT PLAT CHECKLIST Sec. 14-208.1 Boundary line adjustments. The following sections shall apply to each boundary line adjustment, when applicable: A. General: Sections 14-100 through 14-108. B. Administration and procedure: Sections 14-200 through 14-204, 14-209, 14-212.1, 14-231 and 14-231.1. C. Plat requirements and documents to be submitted: Sections 14-300, 14-301, 14-302(A)(1), (2), (3), (4), (5), (6), (7), (9), (10), (11),(14), (15)and(16), 14-302(B)(1), (2), (4),(5), (6), (7), (9) and(10), 14-303(A),(B), (C), (D), (E), (F),(G),(H), (I), (L), (0)and(P), 14-307, 14-307.1, 14-318; if any lot will be less than five(5) acres, the soil evaluation required by section 14-309, 14-310, 14-312 and 14-314. D. On-site improvements and design: Sections 14-400, 14-405, 14-406, 14-416, 14-421, 14-426 through 14- 429, 14-433, 14-438 and 14-441. Sec. 14-300 Persons authorized to prepare plat. Each plat shall be prepared by a professional engineer or a land surveyor, to the limits of his license. Sec. 14-301 Form and style of plats. Each subdivision plat shall comply with the following: A. Standards. Except as otherwise provided in subsection(E), each plat shall meet the standards for plats set forth in 17 VAC 15-60-10 et seq.;provided that each final plat to be submitted for recordation in the office of the clerk of the Albemarle County circuit court shall meet the standards for plats set forth in 17 VAC 15- 60-10 et seq. B. Scale. The plat shall be drawn to a scale of one(1)inch equals fifty(50)feet or to such scale as may be approved by the agent in a particular case. C. Size. The plat shall be prepared on one(1)or more sheets,provided that no sheet shall exceed twenty-four (24)inches by thirty-six(36)inches in size, and further provided that if the plat is prepared on more than one (1)sheet, match lines shall clearly indicate where the several sheets join. D. Approximate North. The top of each sheet shall be approximately north. Sec. 14-302 (A) Contents of preliminary plat. A preliminary plat shall contain the following information: A. A preliminary plat shall contain the following information, which must be included in order for a preliminary plat to be deemed complete under section 14-218: 0 Name of subdivision. The title under which the subdivision is proposed to be recorded. The title shall not duplicate or be a homonym of an existing or reserved subdivision name within the county,the City of Charlottesville, or the Town of Scottsville,except if the subdivision is an extension of an existing subdivision. - - -,: 1/1/2015 (WO 14110 Page 4 COUNTY OF ALBEMARLE BOUNDARY LINE ADJUSTMENT PLAT CHECKLIST E Vicinity map. A map at a scale of one(1)inch equal to two thousand (2,000) feet showing the property and its relationship with adjoining land and streets, its relationship with landmarks in the area and, if the subdivision is a phased subdivision,all other phases of the subdivision for which a final plat has been approved, in detail adequate to describe the location of the property without field review. E 3. Existing or platted streets. The location,width and names of all existing or platted streets and all other rights-of-way. E 4. Private easements. The location and dimensions of all existing and proposed private easements. Existing easements shall be labeled with the deed book and page number and the name of the owner of record. E 5. Public easements. The location and dimensions of all existing and proposed public easements outside of a street right-of-way. Existing easements shall be labeled with the deed book and page number and the name of the public owner of record. Proposed easements shall be labeled as"dedicated to public use." E 6. Alleys and shared driveways. The location and dimensions of all easements for alleys and shared driveways. E 7. Existing and departing lot lines. If the property consists of more than one existing lot, then the identification of the existing lots and their outlines, which shall be indicated by dashed lines; and,the location of departing lot lines of abutting lots. E 9. Building sites on proposed lots. The location,area and dimensions of a building site on each proposed lot complying with the requirements of section 18-4.2.The plat shall also contain the following note: "Parcel [letter or number] and the residue of Tax Map/Parcel [numbers] each contain a building site that complies with section 4.2.1 of the Albemarle County Zoning Ordinance." E 10. Right of further division of proposed lots. The number of lots, as assigned by the subdivider, into which each proposed lot may be further divided by right pursuant to section 18-10.3.1, if applicable. The plat shall also contain the following note: "Parcel [letter or number] is assigned [number] development rights and may/may not be further divided and when further divided these rights shall not comprise more than [number] acres. The residue of Tax Map/Parcel [numbers] is retaining [number] development rights and when further divided it shall not consist of more than[number] acres." Development rights need not be assigned to a special lot. E 11. Instrument creating property proposed for subdivision. The deed book and page number of the instrument whereby the property was created, as recorded in the office of the clerk of the circuit court of the county. E 14. Land to be dedicated in fee or reserved. The location, acreage, and current owner of all land intended to be dedicated in fee or reserved for public use, or to be reserved in a deed for the common use of lot owners in the subdivision. E 15. Identification of all owners and certain interest holders. The names and addresses of each owner of record and holders of any easements affecting the property. E 16. Dam break inundation zones. The limits of a dam break inundation zone. ft • -4: 1/1/2015 Page5 COUNTY OF ALBEMARLE BOUNDARY LINE ADJUSTMENT PLAT CHECKLIST Sec. 14-302 (B) Contents of preliminary plat. B. A preliminary plat shall also contain the following information, provided that the preliminary plat shall not be deemed incomplete for purposes of section 14-218 if it does not include this information in the initial plat submittal: O 1. General information. The date of drawing, including the date of the last revision,the number of sheets,the north point, and the scale. If true north is used, the method of determination shall be shown. 0 2. Name of plat preparer. The name of the person who prepared the plat. O 4. Places of burial. The location of any grave, object or structure marking a place of burial located liA/ on the property. O 5. Zoning classification. The zoning classification of the property, including all applicable zoning overlay districts,proffers, special use permits and variances. O 6. Tax map and parcel number. The county tax map and parcel number of the property. O 7. Reservoir watershed; agricultural-forestal district. A notation as to whether the land is within an Albemarle County and/or City of Charlottesville water supply watershed or an agricultural-forestal district. • 9. Flood plain. The location of any part of the property within the flood hazard overlay district, as set forth in section 18-30.3. O 10. Stream buffers. The location of stream buffers required by the water protection ordinance,with "lr'-the following note: "The stream buffer(s) shown hereon shall be managed in accordance with the Albemarle County Water Protection Ordinance." Sec. 14-303 Contents of final plat. In addition to containing all of the information required by section 14 -302, except for the information required by section 14-302(A)(12), a final plat shall contain the following information: O A. Statement of consent to division. A statement that: "The platting or dedication of the following described land [insert a correct description of the land subdivided] is with the free consent and in accordance with the desire of the undersigned owners,proprietors and trustees, if any." O B. Section name or number. The name or number of the section if the property is a part of a larger piece of land. O C. Boundary lines. The exterior boundary lines of the property with bearings in degrees, minutes and seconds. Curvilinear data shall include radius, central angle,arc length, and tangent distance. All dimensions shall conform to the standards set forth in this chapter. O D. Acreage of lots. The total acreage of each existing lot and each proposed lot. • -4: 1/1/2015 Page COUNTY OF ALBEMARLE BOUNDARY LINE ADJUSTMENT PLAT CHECKLIST E E. Dimension standards and information on all lots,streets,alleys,easements,and shared driveways. All linear,angular, and curvilinear dimensions of lots, streets, alleys,public easements and private easements and shared driveways shall conform to the requirements set forth in 8 VAC 10-20-370(C), a copy of which shall be on file in the department of community development. Curvilinear data shall include radius,central angle,arc length, and tangent distances and may be shown either directly on the corresponding boundary or surveyed line or in table form. Easements shown for private streets, alleys and shared driveways shall be labeled as"private street easement", "alley easement"or"shared driveway easement."The easement holder(s) shall be identified on the plat. If shared driveways are shown, a note shall be added to the plat stating that maintenance shall be by the owners of the lots affected by the shared driveway easement,not by the Virginia Department of Transportation or the county. E F. Identification of sections, blocks and lots. Sections (phases) shall be identified by numbers; blocks shall be identified by letters; lots shall be identified by numbers, assigned in numerical order. E G. Ownership of common areas.The intended ownership of all common areas. E H. Monuments. The location and material of all permanent reference monuments. Monuments found or installed prior to plat recordation may be referred to if they are permanent and undisturbed. If any monument required by this chapter will be installed after recordation of the final plat,the certification of the professional engineer or land surveyor shall so note. E I. Bearing and distance ties. A definite bearing and distance tie between not less than two(2) permanent monuments on the exterior boundary of the property and further tie to existing street intersection where possible and reasonably convenient. E L. Public utility,drainage and sight distance easements. The location and dimensions of each public utility, drainage and sight distance easement outside of a street right-of-way; for each existing easement, include a note stating the deed book and page number. E O. Signature panels. Signature panels for each owner and for the agent or his designee. The signature panel for the owner shall be located immediately below the statement required by paragraph(A). E P. Notary panels.Notary panels for the notary to acknowledge the signature of the owner. • -4: 1/1/2015 Page 7 COUNTY OF ALBEMARLE BOUNDARY LINE ADJUSTMENT PLAT CHECKLIST Documents and or information to be submitted with Plat, as applicable ❑ Stream crossings. [Sec. 14-307] ❑ Dam break inundation zones. [Sec. 14-307.1] If any lot will be less than five(5) acres, ❑ Soils evaluations. [Sec. 14-309] ❑ Health Director Approval. [Sec. 14-310] ❑ Location of existing buildings. [Sec. 14-312] ❑ Identification of all interests of the County in property. [Sec. 14-314] SEE CODE For Sections 14-400, 14-405, 14-406, 14-416, 14-421, 14-426 through 14-429, 14-433, 14-438 and 14-441. Read and Sign In representing the above referenced firm submitting this plat for preliminary approval, I hereby state that,to the bes of my knowle ,the attached plat contains all information required by this checklist. () ` - May 21, 2018 ignatu e of person comp eting checklist Date Gwen Lacy 434 293-3195 Printed Name Daytime phone number of Signatory •: 1/1/2015