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Home My WebLink AboutSPH96-0117 - SPL Application - 4/5/1996 • i MASON COUNTY DEPARTMENT OF IIEALTH SERVICES POST OFFIC : BOX 1666 SIHEITTON, IVA 9,75,14 (20 ) 427-9670 FAX 427-7798 APPLICATION FOR LAND USE EVALUATION Receipt No: `Y.2f,! Date of Payment: C'�` (,s' INSTRUCTIONS 1. An application is considered complete when the fee is paid and the following elements have been a ressed: • Parts 1 and 2 of the application form must be conpleted. • One properly excavated backhoe pit per proposed parcel gust be ready for inspection. Properly excavated pits are 6 ft deep with a 4 it deep shelf on one end of the pit. The 4 it deep shelf must slope up to the ground surface for easy ingress and egress. • A scaled plot plan oust be attached to the application. The scaled plot plan must show the prec se location of the test holes, dimensions of the property, and location of any existing or proposed wells, r ads, or buildings within 100 ft of the property boundaries. 2. After a completed application is received, staff will inspect the property and provide the applicant with a written report. IMPORTANT: IN ORDER TO AVOID ADDITIONAL COSTS, BE SURE TEST HOLES AND PARCELS ARE ALL FLAGGED AND CL17ARLY DELINEATED AS TO LOT AND TEST HOLE NUMBER. THE IDENTIFIED TEST HOLES MUST MATCH THE LOCATIONS SHOWN ON THE PROPOSED PLAT MAP. PART 1: APPLICANT/PARCEL IDENTIFICATION Large Lot Subdivision Ei Short Plat Subdivision BLA (Off ce Review) $100 + $10/parcel $85 $400 + $20/20t $10 NAME OF APPLICANT G)ILLIAh 9. hLtV9WALL • TELEPHONE G u �6-49 • MAILING ADDRESS T1/J AW`( lq1 At NO 3zortp'-78- f oot 0 is �O p l A 1 ►. stages p Tf1nI O 1 5 0 • ASSESSOR'S PARCEL NUMBER :? 1 0 2 b - • LEGAL PROPERTY DESCRIPTION 51 SW b z0)J 1230 W. I'1 )- •� z:- 00 3-5.00 4 - 51,06 S- . S b-Sao 7- 50ir7¢ • LOT SIZES (ACRES OR SQ FT) y - S-06 IO -S.kS L(-5,00 1;_s,Do 13_sue _5.1b I S-SS7- �1-1— �o Z t—� � o • DIRECTIONS FOR LOCATING SITE U CI Q —e1Our 0 0 )►�T812SStTfav r E. 9MM lJIb82 Loe o. � So. c IAIW - SW1660. o *j 0W w 10. S frS O n/ L PART 2: INTENDED USE OF PARCEL INTENDED USE OF PROPERTY (Check One) : )� Single family residence Multi-family residence El Other, specify: WATER SOURCE FOR PARCELS (Check One) : Individual wells LJ Community well H:\ON-SITE\LNDIISC.w Revise 12/05/91 Lind It n F.va ln.il irn PART 3: HPALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) SOIL LOGS AND SITE CHARACTERISTICS ------------ LOT N LOT M LOT It LOT k Test Pit A Test Pit A Test Pit A Test Pit A Depth of root pen.: Depth of root pen.: Depth of root pen.: Depth of root pen.- Depth of mottling: Depth of mottling: Depth of mttting: Depth of ttling: Depth to rest. layer: Depth to rest. layer: Depth to rest. layer: Depth to rest. Layer: Soft type (USDA): Soft type (USDA): I Soil type (USDA): Soil type (USDA): Test Pit B Test Pit B I Test Pit B Test Pit e Depth of root pen.: Depth of root pen.: Depth of root pen.: Depth of root pen.: Depth of mottling: Depth of mottling: Depth of mottling: Depth of ttling: Depth to rest. layer: _ Depth to rest. layer: _ Depth to rest. layer: _ ( Depth to rest. layer: Soft type (USDA): Soil type (USDA): _ I Soft type (USDA): Soil type (USDA).- Curtain drain needed? Curtain drain needed? Curtain drain needed? Curtain drain needed? jslope (X): j slope (x): j slope CX): j slope (z): Shoreline? OR): Shoreline? (Y/N): Shoreline? (Y/N): Shoreline? (Y/N): Minflmm lot size:A Minfnm lot size:A I Minimum lot sfze:A Minimua tot size:A A Mini" lot size applies to new subdivisions and is defined as the minimus allowable lend area pet residence or residen- tial equivalent (450 gallons per day). COMMENTS n: oN-srrrlLnvv rcr.w ltov'sad I2/0s/44 Macturnal large lot subdivision lot #1 5 . 00 acre (217800 sq. ft. ) 0-48 sandy loam 6k slope lot #2 5 . 00 acre (217800 sq. ft. ) 0-51 sandy loam 2%- slope Lot #3 5 . 00 acre (217800 sq. ft . ) 0-38 sandy loam 5V slope lot #4 5 . 00 acre (217800 sq. ft. ) 0-25 sandy loam 3!k slope lot #5 5 . 15 acre (224334 sq. ft. ) 0-27 sandy loam 4% slope lot #6 5 . 00 acre (217800 sq. ft. ) 0-31 sandy loam 6t slope lot #7 5 . 08 acre (221284 sq. ft . ) 0-36 sandy loam 8% slope Lot #8 6 . 74 acre (293594 sq. ft . ) 0-40 sandy loam 2% slope lot #9 5 . 00 acre (217800 sq. ft . ) 0-33 sandy loam 1% slope lot #10 5 . 05 acre (219978 sq. ft . ) 0-38 sandy loam 4% slope lot #11 5 . 00 acre (217800 sq. ft . ) 0-42 sandy loam 6% slope lot #12 5 . 00 acre (217800 sq. ft. ) 0-46 sandy loam 5t slope lot #13 5 . 68 acre (247420 sq. ft. ) 0-46 sandy loam 7% slope lot #14 5 . 86 acre (255261 sq. ft. ) 0-32 sandy loam 8145 slope lot #15 5 .52 acre (240451 Sq. ft. ) 0-29 sandy loam 3% slope All test holes have till as limiting layer, all soil types Ehown are type 4 . L.mJ 1':. Il.rlc.il � r PART 4: REVIEW SUMMARY (COMMUNITY D14,VI L01'Ml,N'I' IJSF,) ETS HEALTH CODE After examining lot size, proposed water source, and soil type, it is the de- (! ---termination of Mason County Department of Health Services that each proposed parcel can support an on-site sewage disposal system meeting the requirements of state and local regulations. F�9 6=1 DOES NOT MEET HEALTH CODE After examining lot size, proposed water source, and soil type, it is the de- termination of Mason County Department of Health Services that each proposed parcel cannot support an on-site sewage disposal system meeting the require- ments of state and local regulations. This determination is based on consideration of the following factor(s) : �l d HOLD APPROVAL UNTIL FURTHER ACTIONS ARE TAKEN BY APPLICANT After examining lot size, proposed water source, and soil type, it is the de- termination of Mason County Department of Health Services that each proposed parcel cannot support an on-site sewage disposal system meeting the require- ments of state and local regulations until the following conditions are met: r� LJ Condition(s) required prior to approval have been met by the applicant. Health Official Date PART 5: REVIEWER SIGNATURE Q-\A. , dR, Hea tt Official Date N:\ON-SITF.\1'NDUSF,.W RPv'.ced 12105194