Attention Owners and Contractors

On January 3, 2007 the Goochland County Board of Supervisors approved a resolution suspending the issuance

of building permits for new residential construction if the sewage disposal system approved by the State Health Department is an Alternative Sewage Disposal System.

Alternative systems are: Fixed-media Filter Systems- Peat-based Textile Filter Fixed Media Attached Growth Treatment Systems “Mound” Systems Aerobic Treatment Units (ATU’s)

Systems utilizing physical, chemical and biological technology to achieve desired results

The purpose of the adopted resolution is to allow the County, in concert with the State Health Department, time to analyze the failures of alternative systems and to recommend policies and regulations for the Board of Supervisors to consider concerning these systems. This resolution is in effect until the Department of Community Development can recommend appropriate policies, procedures and regulations so that public health, safety and fiduciary interests are adequately addressed. The resolution will be in effect for no more than one year but the goal is to be able to rescind the resolution much sooner. Accordingly, building permits for new residential construction supported by approved health permits for alternative systems will be placed on hold. Alternative systems for repairs of existing sewage disposal systems and for commercial construction are not affected by this resolution.

BUILDINGPE~JT APPLIC~nONG()()chlPnd CmfYBuildingllJ$pecti()n D:cpartm~nt

P.O. Box1l9GQQChlatld, VA 23063

(804)556-5305 Fax (804)556-5651 TDD (804)556-5300

C tVALUEOFSTRUCTU~ Exclu "esA.,U Trades PermitsBUILDING

PtRM!TI=EtS~~E~LE: ~lden1IalfAi$basedon the bIJIkt!ngvaloo ottheiOb, $Olo$4000Ofv 00," "Assessed valoo.Add 1 ,75% state.JfJW10~. ,COOiffifJlcl&! ~ 1$I:1a~ontf1e~ldi~~~(jftOO lop. $()10 ~ Of\!~~..,.of 8SseS$OO value, Add 1. 75<>I"s.~e~vy tof~,.

,:~.oo...$W,OO

Above $4000 $4..50 per$1Q09 Of

..Above $4000 $7.50per$1000

I hereby~oknowl~~~e that [h.Y~r.adthl.appilo.tiQ'l ahdknow th.jnfOnnatlMt6betru$ahd~roet61)OfTjplyw~all ~~~lnanc8$ andStat&laws reglilatingbuildlhgCMstructiQ'lahduM...

$lqnaturoofApp.lioant-

LIEN AGENT INfORMATiONPlease check one of the following:0 I do not wish to designate a mechanic's lien agent ~nd that for the purpose of Section 38.88.01 of the Code of Virginia.

this building pe""itshall be a "HONE OESIGNATEO. pe""it.0 I hereby request that the following mechanic's lien agent be .listed as pari of my building permit:

NAME: TelEPHONE:

MAILING ADDRESS:

IN liEU OF AN EROSION AND SEDIMENT CONTROL PLAN FOR A Sn'4GlEFAM.ll V RESIDENCEA STONE DR.lVE-WAV MUST BE INSTAllED BEfORE ANY CONSTRUCTION IS TO BEGIN.

OWNERS AFFIDAVIT

1_- -~..- OF (addre~)~ _AFFIRM THAT I AM THEOWNEROFACERTAIN TRACT OR PARCEL OF LAND LOCATED AT AND THAT I HAVEAPPLIED FOR A BUILDING PERMIT. ..AFFIRM THAT tAM NOTSUBJEC110LtCENSUREA.SACONTRA--croR ORSUBCONTRACTOR AS REQUIRED BY SECTION 54.1..1111 OF THE CODE OF ViRGINIA. _OWNER

IN THE CrTY OR COUNTY

2°- IN THE

SIGNED AND ACKNOWLEDGED BY -

OF ~ VIRGINIA ONTHE.t1A'i/OF

PRESENCE Of TfiE U~DER$IGNED~OTARY" MY COMMISSIONexPIRE~ ...,~

(NOTARY)

I~A~E OF THIS BUILDING PERMIT DOE$ NQTCONSTJTUT~AN ~PPROVAL (JIFSOIL CONDmONSOR SITESUJTA8LITYBY THE COUNTY. THE APPUCANT IS R~$PON$'8LEFOR CONDUCTINGAN'( SOIL TESTS OR ENGINEERINGTE$TSAPPLICANT DEEMS NECESSARY TO1DENTIFY AREASCONTAINI.NGSHRINK-SWEILL SOIL OR GEOLOGICALCONDITIONS..

~

AS THE PROPERTY OWNER(S) ONWHtCH YOUR~ILDJ..NG OR STRUCTURE IS TO BE LOCATED, YOU ARE RESPONS1BLEFOR LOCATING YOUR PROP~TY LINES TO ASSURE THAT THE COUNTY SET.BACK LINES ~'ILL NOT BE VIOLATED. IF YOU ARENOT ABSOlUTELY CERTAIN AS TO THE EXACT LOCATION OF YOUR PROPERTY lINES,n' IS STRONGLY RECOMMENDEDTHAT YOU OBTAIN THE SERVICES OFA SURVEYOR TO DO SO.. If YOU ARE MIST AKEN REGARDING YOURPROPERn LINELOCATIONS AND VIOLATE THE SET-BACK LINE REQUIREMENTS, YOU MAy BE FORCED"ro MOVE YOUR BUILDING AND

STRUCTURE AT YOUR OWN EXPENSE....(WE) HEREBY ACKNOWLEDGE RECEIPT OF THIS NOTICE AN~ASSUME ALLRI5iKS REGARDING PROPERTY LINE

LOCATIONS IN 'tHE EVENT 1 (WEtDECIDE NOT TO OBTAIN A SURVEY OF MY PROPERTY1.INES.

DA TJ::,C;! '!;,;,'C,

DATE__"",~c c ---~

A"~~ C8RTI.FlCATION POa ReNO:V.TlbN OaOeMqUT.oNI CERTIFY THAT THIS STRUCTURE HAS BEEN INSPECTED FOR ASBESTOSANDCOMPLIE:S WITH THE CODE OF VIRGINIA

S~6,,99.7

OWNER, C_-,,-, ,-