HomeMy WebLinkAbout05-93 Paul C Stacy - Stonewall - Backfiler ,k
CUP TRACKING SHEET
(To be completed by Frederick Co. Staff only.)
CUP # 005-93
Owner/Applicant Paul C. Stacy
Application Date March 26, 1993
Fee Paid ® yes initials: GL
Sign Deposit = yes Sign return date:
Submittal Cut -Off Date April 9. 1993
P/C Mtg. date: 5/5/93 BOS Mtg. date: 5/26/93
AGENCY REVIEW COMMENTS
XX VDOT
%X Inspections
XX Fire Marshal
xx Health Dept.
NA Airport Authority
NA City of Winchester
NA Co Sanitation Authority
PLANNING COMMISSION RECOMMENDATIONS OF May 5. 1993
(date)
APPROVAL (WITH CONDITIONS) ✓ yes no
DENIAL Signed
''��'` Secretary
DatejQ,�
BOARD OF SUPERVISORS PUBLIC HEARING ACTION
(date)
APPROVAL
Signed
DENIAL Date
County Adm.
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RECEIPT
N2 023715
FPEDL)<K,n �,v�� _. _ NG AND DEVELOPMENT
P.O. BOX 601, 9 COURT SQUARE
WINCHESTER, VIRGINIA 2L601
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F-1 L E COPY
i COUNTY of FREDERICK
Department of Planning and Development
703 / 665-5651
Fax 703 / 678-0682
MEMORANDUM
TO: Finance Department
FROM: Denice Cather, Clerk Typist kJ---
SUBJECT: Return Of Sign Deposit
DATE: June 1, 1993
The amount of $25.00 was deposited in line item #10-1911-08 for the person named
below as a deposit for a sign. They have now returned the sign and are therefore
entitled to the return of their deposit. Please send a check in the amount of $25.00 to:
Paul C. Stacey
1717 Jordan Spring Road
Stephenson, Virginia 22656
Please contact me if you have any questions.
DRC/gll
9 North Loudoun Street P.O. Box 601
Winchester, VA 22601 Winchester, VA 22604
E
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May 28, 1993
Paul C. Stacy
1717 Jordan Springs Road
Stephenson, Virginia 22656
Dear Mr. Stacy:
COUNTY of FREDERICK
Department of Planning and Development
703 / 665-5651
Fax 703 / 678-0682
This letter is to confirm action taken by the Frederick County Board of Supervisors at their
meeting of May 26, 1993.
Your conditional use permit, #005-93, was approved for a cottage occupation - small engine and
lawn mower repair. This property is located on Route 664 in the Stonewall District, and is
identified as GPIN 56-A-6A.
This use has been approved provided the following conditions are complied with:
1. Any signage must be limited to that allowed for a cottage occupation.
2. Any expansion of existing buildings to accommodate this use will require a new
conditional use permit.
3. If use intensity develops to the point that use of the shared private drive is
impacted, a new conditional use permit will be required and upgrading of the
driveway should be considered.
4. All repair work and storage of parts will be confined inside the structure being
used.
5. All review agency comments will be complied with.
9 North Loudoun Street
Winchester, VA 22601
P.O. Box 601
Winchester, VA 22604
4
Page -2-
P. Stacy Ltr.
May 28, 1993
If you have any questions regarding the conditions placed upon your permit please feel free to
call this office.
Sincerely,
W. Wayne "Her
Zoning Administrator
WWM/slk
cc: Esten O. Rudolph Jr., Commissioner of Revenue
4
0 •
P/C Review Date: 5/05/93
BOS Review Date: 5/26/93
CONDITIONAL USE PERMIT #005-93
PAUL C. STACY
COTTAGE OCCUPATION
SMALL ENGINE & LAWN MOWER REPAIR
LOCATION: On Route 664, 1717 Jordan Springs Road
MAGISTERIAL DISTRICT: Stonewall
PROPERTY ID NUMBER 56-A-6A
PROPERTY ZONING & PRESENT USE: Zoned - RA (Rural Areas)
Use - Residential
ADJOINING PROPERTY ZONING & PRESENT USE: Zoned - RA (Rural Areas)
and RP (Residential Performance,); Use - Ag. and residential
PROPOSED USE: Cottage occupation - small engine and lawn mower
repair.
REVIEW EVALUATIONS:
Virginia Dept. of Transportation: No objection to Conditional
Use Permit for this property. However should use ever expand
in the future, the entrance may need to be upgraded to VDOT
commercial standards.
County Building Official: Building shall comply with the
Virginia Uniform Statewide Building Code and Section 310, Use
Group S (Storage), of the BOCA National Building Code/1990.
Other codes that apply are Title 28 Code of Federal
Regulation, Part 36 Nondiscrimination on the Basis of
Disability by Public Accommodations and in Commercial
Facilities. Permit required shall be a Change of Use on
Building to be used.
Health Department: See attached letter from Jim Webb, E.H.S.,
dated March 25, 1993.
0 0
Page 2
Stacy CUP
County Fire Marshal: I spoke with Mr. Stacy about fire dept.
access. He stated that the trucks would not have problems
with his driveway which is 100 to 150 yards in length. He
also said that if necessary his swimming pool could be
utilized for water. supply. I request that storage of
flammable and combustible liquids for this operation comply
with the Statewide Fire Prevention Code.
Planning Department: Applicant is proposing a business to
repair small engines and lawn mowers in an accessory building
located adjacent to his home. Access to this property is
along a private driveway that is shared with one other
residence. A moderate amount of traffic generated by this use
would probably not be a problem but a high intensity of
traffic to the property may require road improvements.
Allowing this use at a moderate level would have little or no
impact on the neighborhood.
STAFF RECOMMENDATIONS FOR MAY 5 1993 PC MEETING: Approval with
the following conditions:
1. Any signage be limited to that allowed .for a cottage
occupation.
2. Any expansion of existing buildings to accommodate this use
will require a new conditional use permit.
3. If use intensity develops to the point that use of the
shared private drive is impacted, a new conditional use permit
will be required and upgrading of the driveway should be
considered.
4. All repair work and storage of parts will be confined
inside the structure being used.
5. All review agency comments will be complied with.
PLANNING COMMISSION ACTION SUMMARY: One adjoining property owner
appeared and supported the application request. There were no
objections and the applicant agreed with the suggested conditions.
PLANNING COMMISSION RECOMMENDATION OF MAY 5 1993: Unanimous
approval with the following conditions:
1. Any signage will be limited to that allowed for a cottage
occupation.
Page 3
Stacy CUP
2. Any expansion of existing buildings to accommodate this use
will require a new conditional use permit.
3. If use intensity develops to the point that use of the shared
private drive is impacted, a new conditional use permit will
be required and upgrading of the driveway should be
considered.
4. All repair work and storage of parts will be confined inside
the structure being used.
5. All review agency comments will be complied with.
(Mr. Carper was absent from this meeting.)
Lord Fairfax Environmental Health District
800 Smithfield Avenue
P. O. Box 2056
Winchester, Virginia 22601
w (703) 722-3480 FAX (703) 722-3479
Counties of- Clarke, Frederick, Page, Shenandoah, Warren, and City of Winchester
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VXDHOF HEALTHDEPARTMENT
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Submittal Deadline
P/C Meeting
BOS Meeting
APPLICATION FOR CONDITIONAL USE PERMIT
FREDERICK COUNTY, VIRGINIA
1. Applicant (The applicant if the owner,_,_ other)
NAME:
ADDRESS: ►`i l i��ca� Sit �"�c S 1�i STt=i'H�,IS.��A �i1� , 22( ��(
TELEPHONE ') b_ („ (,9 _ ?, P,5
2. Please list all owners, occupants, or parties in interest of
the property:
�i_C VA
3. The property is located at: (please give exact directions)
a 0 ►�.�sa �i'i 2�.Jc.< 1Z� ��. i L (' �� �� r'F ►>>► ��5�, V A �y
� i�t.3.' i= C'i►.� LET=\ Rom' � �-.it`7 C7'F'�i��.�.• �,�to-(
4. The property has a road frontage of 1G'12'Gq feet and a
depth of 17L Ry feet and consists of ,� acres.
(Please be exact)
5. The property is owned by '�� r_, ��,as
evidenced by deed from �,•, � � V , recorded
(previous owner)
in deed book no. 5M on page 4_1n , registry of the
County of Frederick.
6. 14-Digit Property Identification No.
Magisterial District,(,,-L-
Current Zoning
7. Adjoining Property:
USE ZONING
North�5�7x/T/y!� (_ i
East C'
South
West�c,���c�,� C �p�
page -2-
CUP Application
August, 1990
8. The type of use proposed is (consult with the Planning Dept.
before completing)
M&WE-Viz-
9. It is -proposed that the following buildings will be
constructed:
10. The following are all of the individuals, firms, or
corporations owning property adjacent to both sides and rear
and in front of (across street from) the property sought to be
permitted. (Continue on back if necessary.) These people
will be notified by mail of this application: (PLEASE LIST
COMPLETE 14—DIGIT NUMBER.)
NAME
Address .
S
Property ID#
Oc) C-'- -n-(,l to
-�rsET G
Address
Property ID#
Address
Property ID#
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Address �
Property ID#
Address 6 K
Property ID#
R�gsi��_�=s�c►�'r�.
Address _
Property ID#
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PIN 56—A-6A CUP # 005-9-
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page -4-
CUP Application
August, 1990
12. Additional comments, if any:
I (we), the undersigned, do hereby respectfully make application
and petition the governing body of Frederick County, Virginia to
allow the use described in this application. I understand that the
sign issued to me when this application is submitted must be placed
at the front property line at least seven (7) days prior to the
first public hearing and maintained so as to be visible until after
the Board of Supervisors'
Signature of Applicant
Signature of Owner
Owners' Mailing Address
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Owners' Telephone No. q Q 3- GS 5 t
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REQUEST FOR C.U.P. COMMENTS
Frederick -Winchester Health Department
Attn: Sanitation Engineer
P.O. Box 2056
Winchester, Virginia 22601
(703) 722-3480
The Frederick -Winchester Health Department is located at the
intersection of Smithfield Avenue and Brick Kiln Road, if you
prefer to hand deliver this review form
Applicant's name, address and phone number:
C_
Name of development and/or description of the request:
S Co, %-IC S\NSz> 1 (1ws �
Location: —
):] 1i
Health Department Comments:
Health Signature and Date:
(NOTICE TO HEALTH DEPT. - PLEASE RETURN THIS FORM TO APPLICANT.)
NOTICE TO APPLICANT
It is your responsibility to complete this form as accurately as
possible in order to assist the agency with their review. Also,
please attach a copy of your plans and/or application form.
0
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Submittal Deadline
P/C Meeting Z -S- Y_3
BOS Meeting , �'_ .2(a -9,_3
APPLICATION FOR CONDITIONAL USE PERMIT
FREDERICK COUNTY, VIRGINIA
1. Applicant (The applicant if the owner other)
NAME:
ADDRESS: 1`1 1'1 �.Sni �.� � R� S r�Pt � VA aa(
TELEPHONE
2. Please list all owners, occupants, or parties in interest of
the property:
!` c
3. The property is located at: (please give exact directions)
I—I� � -1 c�R"7Av�tri�1 ,Z��1 �, lZ`� �1�. i L C�F� �'sT��}►��15�� i 'V A �G-.�1.
4. The property has a road frontage of ��,�,� feet and a
depth of q-M,es feet and consists of acres.
(Please be exact)
5. The property is owned by � �L c__ S-rp.,g-I as
evidenced by deed from H kc,k js� -p, Co,��E�L recorded
(previous owner)
in deed book no. S19 on page 43 a registry of the
County of Frederick.
6. 14-Digit Property Identification No .�—,Yc�-A -per _aQr_��
Magisterial District
Current Zoning 'R, A
7. Adjoining
North
East
South
West
ZONING
RA
�A
Ra
page -2-
CUP Application
August, 1990
8. The type of use proposed is (consult with the Planning Dept.
before completing)
CO :T-7A :E C�--ru alT-1 n - Cat ,A-- C ,C
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9. It is -proposed that the following buildings will be
constructed:
10. The following are all of the individuals, firms, or
corporations owning property adjacent to both sides and rear
and in front of (across street from) the property sought to be
permitted. (Continue on back if necessary.) These people
will be notified by mail of this application: (PLEASE LIST
COMPLETE 14-DIGIT NUMBER.)
NAME
1"�,ta-� ,DSO i�uci«eLJ
Address .►�"c , ►�. �� i -
,
Property ID# r
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COUNTY of FREDERICK
Department of Planning and Development
703 / 665-5651
Fax 703 / 678-0682
May 12, 1993
TO THE APPLICANTS) AND/OR ADJOINING PROPERTY OWNER(S)
The Application of. PAUL C. STACY
CONDITIONAL USE PERMIT #005-93 FOR: a cottage occupation - small engine and
lawn mower repair. This property is located on Route 664, Jordan Springs Road, in the
Stonewall District, and is identified as GPIN 56-A-6A.
This conditional use permit will be considered by the Frederick County Board of Supervisors
at their meeting of May 26, 1993, at 7:15 p.m., in the board room of the old Frederick
County Courthouse, Winchester, Virginia.
Any interested parties having questions or wishing to speak may attend this meeting.
L
W. Wayne iller
Zoning A inistrator
WWM/slk
9 North Loudoun Street P.O. Box 601
Winchester, VA 22601 Winchester, VA 22604
This is to certify th the attached correspondence wa ailed to the following on
May 12, 1993 from a Department of Planning and D1o�ment, Frederick
--- .
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County, Virginia: t°°;
F'RANKI...TNI 18 ,.Jl�z
Paul C., Stacy
1717 Jordan Spring' Road: ?:'s'J't::a' i';J:::i �i:'sJ:7i„ ter•,
Stephenson, Virginia 22656
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Jame P tto
198 M t ew give
Ste enson, Virginia 22656
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William H•. Jenkins
1696 Jordan Spring Road
Stephenson, Virginia 22656
Michael Holt
1695 Jordan Spring Road
Stephenson, Virginia 22656
STATE OF VIRGINIA
COUNTY OF FREDERICK
D. Segabartt
1763 Jordan Spring Road
Stephenson, Virginia 22656
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. Wayne MilleZoning Administrator
Frederick Counr Dept. of Planning
I, Renee' S. Arlotta , a Notary Public in and for the state and
county aforesaid, do hereby certify that W. Wayne Miller,'Zoning Administrator for
the Department of Planning and Development, whose name is signed to the foregoing,
dated May 12, 1993 , has personally appeared before me and
acknowledged the same in my state and county foresaid.
Given under my hand this 12th day of May $ 1993.
My commission expires on August 31, 1995
1G , Cps 0
COUNTY of FREDERICK
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Department of Planning and Development
703 / 665-5651
1738 Fax 703 / 678-0682
April 21, 1993
TO THE APPLICANT(S) AND/OR ADJOINING PROPERTY OWNER(S)
The Application of: PAUL C. STACY
CONDITIONAL USE PERMIT #005-93 FOR: a cottage occupation - small engine and
lawn mower repair. This property is located on Route 664, Jordan Springs Road, in the
Stonewall District, and is identified as GPIN 56-A-6A.
This conditional use permit will be considered by the Frederick County Planning
Commission at their meeting of May 5, 1993, at 7:00 p.m., in the board room of the old
Frederick County Courthouse, Winchester, Virginia.
Any interested parties having questions or wishing to speak may attend this meeting.
Sincerely It
WA
W. Wayne filler
Zoning A ministrator
WWM/slk
9 North Loudoun Street P.O. Box 601
Winchester, VA 22601 Winchester, VA 22604
This is to certify th*he attached correspondence was iled to the following on
April 21, 1993 from e Department of Planning and Avlopment, Frederick
County, Virginia: 56 A
511." 4 2 STA-CY, PIAUI- C. & r.:L-E(.*)NORE C.
CARSON, JANE*T, M RT. i F4OX 14F)
1.900 NORTH BRUNSWICK STE71-1ENSON, VA.
STERI-ING, VA- . 1-11 22656-
221.70-
F4UCKL.E:W, RAyMoND I. 1.
D. Segebartt RT. i DOX ij,"?
1763 Jordan Spring Road 1z STET-HENSON, VA 22656
Stephenson, Virginia 22656
56
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YOUNG, MICHAL. A. E
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t STET"FIFENSON, v^
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JE L TAM'. R. &
William H.
Jenkins RT� :j kV4
.HE.N 'rIN
EST -HENSON, A.
1696 Jordan Spring Road 22656-.-
Stephenson, Virginia 22656
FEATHE:RS, FRANKL.IN 8 JR
1.30 FEAI'HERSTONE COURT- ---
Michael Holt STF=T*HENf30N, VA
1695 Jordan Spring Road 2.2656....
Stephenson, Virqinia 22656
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74� ' _, [ W. Wayne Mi ler, 'Zoning Administrator
22 156- Frederick O unty Dept. of Planning
STATE OF VIRGINIA
COUNTY OF FREDERICK
1, Renee' S. Arlotta , a Notary Public in and for the state and
county aforesaid, do hereby certify that W. Wayne Miller, Zoning Administrator for
the Department of Planning and Development, whose name is signed to the foregoing,
dated April 21, 1993 , has personally appeared before me and
acknowledged the same in my state and county foresaid.
Given under my hand this 21st day of April -, 1993
My commission expires on August 31, 1995
anw
NOTARY PUBLIC
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LILLIS, REBECCA JO
M45 JORDAN SPRINGS RD
STEPHENSON, VA.
22656--
Dennis T. Cole
Route 7, Box 81
Winchester, VA 22601
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REQUEST FOR C.U.P. COMMENTS
Frederick County Inspections Department
Attn: Building Official
P.O. Box 601
Winchester, Virginia 22601
(703) 665-5650
The Frederick County Inspections Department is located at 9 North
Loudoun St., 2nd Floor of the Hammon Building in Winchester, if you
prefer to hand deliver this review.
Applicant's name, address and phone number:
eta `Doa
Name of development and/or description of the request:
C CpC`, c c .
Location: -
Inspection Department Comments:
Building shall comply with the Virginia Uniform Statewide Building Code and
Section 310. Use Group S (Storage) of the BOCA National Building Code/1990.
Other colas that applyaYe title 28 Onde of Federal R-�Ilatinn, Part 36
Nondiscrimination on the Basis of Disability by Public Accomodations and in
C,0=eri rral Fari l i i-i ac _ Permit required shall hp a Chan= of Use on Building
to be used. 11 _
Code Administrator Signature & Date:_ �1!� �,�
(NOTICE TO INSPECTIONS DEPT. *PLEASE RUURN THIS FORM TO APP . ANT:
NOTICE TO APPLICANT
It is your responsibility to complete this form as accurately as
possible in order to assist the agency with their review. Also,
please attach a copy of your plans and/or application form.
0 0
Eoi� r
REQUEST FOR C.U.P. COMMENTS �lC3°
FEB
Virginia Department of Transportatio 1�'1993
Attn: Resident Engineer r
c ``gP.O. Box 278 � K^ UK00Edinburg, Virginia 22824-0278F'
(703) 984-4133
The local office of the Transportation Department is located at
1550 Commerce St. in Winchester if you prefer to hand deliver this
form.
Applicant's name, address and phone number:
C_ • S T t� c- -a
Name of development and/or description of the request:
Location:
\_1 \ —1 J c1 �:� E�i .� Sit A� �\ L _L R� . � c�T.��i-iP�] ��• :y A -� � l �� L
Va. Dept. of Transportation Comments:
No objection to a conditional use permit for this property. Existing entrance
appears adequate for proposed use. However, should use ever expand in the future,
the entrance may need to be upgraded to VDOT commercial standards.
DOT Signature and Date: ) Ac_ dl 9A 3
(NOTICE TO RESIDENT ENGINEER*PLEASE RETURN THIS FORM TO APPLICA14T.J
NOTICE TO APPLICANT
It is your responsibility to complete this form as accurately as
possible in order to assist the agency with their review. Also,
please attach three copies of your plans and/or application form.
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_ CO���TY OF FREDERICK, VIRGINIA11�
FIRE MARSHAL'S OFFICE
LAND DEVELOPMENT COMMENTS
Control
No. 021693154
Date Received
021693
Date Reviewed 030193
Applicant
Name Paul
C. Stacy
Address
1717
Jordan Springs
Rd.
Stephenson,
VA
22656
'—
Project
Name Small
Engine &
Lawn Mower
Repair
Phone No. 703-667-3851
Type of
Application
C.U.P.
Current Zoning RA
1st Due
Fire Co. 13
1st
_______
Due Rescue
________
Co. 13
Election
District Stonewall
.-___'--
RECOMMENDATIONS
Automatic Sprinkler System X Residential Sprinkler System
Automatic Fire Alarm System X Other
Emergency Vehicle Access;
Adequate X Inadequate Not Identified
Fire Lanes Required; Yes No X
______
Comments:
Roadway/Aisleway Widths;
Adequate X Inadequate Not Identified
___
Special Hazards Noted; Yes No X
------ -----
Hydrant Locations;
Adequate Inadequate Not Identified X
Siamese Connection Location;
Approved Not Approved Not Identified X
Additional Comments: I spoke with Mr. Stacy about fire dept. access. He
stated that the trucks would not have problems with his driveway which
is 100 to 150 yards in length. He also said that if necessary his
swimming pool could be utilized for water supply. I request that storage
of flammable and combustible liquids for this operation comply with the
Statewide Fire Prevention Code.
Review Time .50 hr
PLANS APPROVED
FIRE MARSHAL, FREDERICK COUNTY
Douglas A. Kiracofe
Fire Marshal
RECORD O&SPECTION-SEWAGE DISPOSAYSTEM
=a Asa
Dateimedw—Case No. 54-9-13
Owner Costello. Michael F. Address P.O-Box 176, Stephenson, Ya. phone 667-3359
(Mailing Address)
Occupant Address Phone
(Mailing Address)
Exact Location of Premises• f Rt. 659 to Rt. 664 Go N. about mile on west side
(Subdivision, Street or Road Name, Section or Lot No.)
WATER SUPPLY INSPECTION
Installed according to Permit Design [` Yes ❑ No. Distance to nearest House Sewer feet. Distance_ to nearest Sewage
Disposal System feet. (Use Form LHS-143 for Detailed Inspection of Water Supply Reference Materials.)
SEWAGE DISPOSAL SYSTEM INSPECTION
(1) LOCATION
Allotted Area adequate Z��Yes ❑ No Distance from
nearest lot lines feet. Trees feet.
Water Supplies feet. Buildings feet.
(2) INSTALLATION AND DESIGN
Installed according to Permit Design ®des ❑ No.
Have additional Household Appliances been added NOT on Permit:
❑ Automatic Washer ❑ Garbage Disposal
❑ Othe,
(Describe)
(3) SOIL CONDITION
Are there soil conditions now evident which indicate system may be unsatisfac-
tory as designed: ❑ Yes o. If Yes, show adjustments
required under "Remarks" below.
(4) HOUSE SEWER LINE .
Installed Yes ❑ No. Type of material C14- V
Size Inches.
(5) SEPTIC TANK Constructed of-- cp cliff
(Kind of Material) y
Inside Dimensions Length feet. Width feet.
Liquid Depth feet. Depth of Air Space Z' Inches.
Inside Fittings comply with requirements Z*i Yes ❑ No.
(6) DISTRIBUTION BOX
Watertight and equal surcharge to each line by Water Test
Yes ❑ No. Distribution Box provided with Z
(Number)
extra outlets for future use.
(7) SUBSURFACE ABSORPTION FIELD
Total Area in bottom of ditches �6 V squpre feet.
Number of ditches SS Length of ditches 166 V feet.
Grade of ditches Minimum Z^ Inches per 100 feet.
Maximum-- y Inches per 100 feet. Has system been
checked by instruments (Level) Ye ❑ No.
Type aggregate used r_,Oe�
Depth of aggregate under Tile inches
Total depth of aggregate Inches
Depth of backfill over aggregate, inches
(8) SURFACE DRAINAGE
Storm Drains from House and Basement flowing away from Subsurface Drainage
Field: ® Yes ❑ No Was Surface Drainage
required ❑ Yes ® No If Yes, has this been provided
❑ Yes ❑ No. Has area been drained by lowering
Ground Water Table: ❑ Yes [❑ No. e— Not required.
(9) Are follow-up inspections necessary ❑ Yes E]—No:
Septic Tank- tUn �Gw �--�;,,'` �f /
Contractor l Address �� �JJX �' e LW (41—Phone `� � Z (v L
This Sewage Disposal Syste Is 19*04 Approved by � �--f� a� � Health Department
tneviewing Aumonryr
With proper maintenance, approved Sewage Di sr� sal systems may be expected to function satisfactorily, provided no overloading or physical damage occurs to the system.
Remarks: �kJr� kIPS/DeA),ft YJiLC� �G�/� -D ✓s( _fjo��
r�/GsL�/�
)
Virginia Department of Health
LHS-141 Rev. 1176
u
.PER
MIT TO INSTALL g,. REPAJR, E ] REASONS FOR REJECTION �IVATER SUPPLY ❑ SWAEI
GE DISPOSAL SYSTIzM �6
(1) Void aftt3r (11 twelti months. 12j Automatically eaticailea when site conditions are dharfpedlrom those on permit. Z
. t� `''(3)utorngticdlly cancelteil shout facts Eater aecorne krfown that a potenfial haz+irrd.would be lire" t by continuingirist' I
HA/Ve allation.
er .G( Yea No' ! Oate3_Case No.
_IPM �j�
� - •/ .+ ,t , *' 1eWr�3i6..US+i� /�
1 s I iMattt s, ^ Pltone_Gr67?.>.
� i4ddrese
j y: L a .. , t sillne �) One -
oF
JSuAdlvitlon, bYi ' Rosa br N
of �dR� e3i ame, Section w i.ot l ..
r�=A Other Automatic Washing in ~
Actin '�oterftibl; Bdroonts - Y ❑ . No Consumption
�` k nip Garbage Disposal U rt gal. per day
# 4t n y" ,"r� NO
' Additional wastes �[] Actual estimated Water)
WATER St/FjPLY (Existing) Claw . ° t?ther o be inste 'Class "-AFCr:7d
Cased ft. to
.7 ry--- bA grouts {t -
less supported by positive evidence Class III is to be considered as to be installed.)
SOIL STUDY Natural y drained; suitable by sight
• .k .�` Yes ❑ No Technical Classification tLlN
' 'i �fd PefCDlati�nq `�?10 ` ❑ ft Z 26-60 _ [�3' bi Percolation Test. Kn wni
a AUIHtute,,ptlr iri ft
Required [] Yea No Rate
F' ` "'� ►'tc fnehes (Minutes pet inch to nearest 1.0 minutes)
Surface drainage required (eatltiiate over 4 ft.
No OTHER DRAINAGE a t/.•
HOUSE 8E' R LINE Site ncFSes: hype of msterial require dsl
,.. Distance from ~f3Z
Witter Supply _"feet.. .
(4)
DETAII s OF CONSTRUCTION W tertight Septic Tank of Inside Dimensions Length: feet: Width " Material Liquid Capacity �V gallons. i
_ -- _feet Liquid Depth a
SUBSURFACE ABSORPTION FIELD Number of square feet required q p feet. Depth of Air Space feet.
(5)Depth of atggtegate from base of t1%to Bottom of ditches 6 —Type aggregate required
- Toal agg►Ayste minimum deoih irlcheg or m inches. Allowable fall Z to Y inches. c ,• . ore. Depth of drainfield to be �V s.
Distance from well to se tic.tank � Inches from surface of_original ground.
p. fact; distartce.from well to drain ��
Rough Sketch of Premises Qndudiit a feet.
g djacen[propertles Kpertlnent, Showing Location of, Lot Line, Buildings, Water Supplies, Sew Di
=�0e��e Souit3es tN Contamination of water Supplies; bY:lndicating Distances and Si
�/VT Sty ope with regard to one another. sposal Systems, Trees, end Other
/w_IrS
'Loot is e-
20
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