REDACTED UPDATED PERMIT 2022-CR-28S.pdf

IN COOPERATION WITH THE

STATE DEPARTMENT OF HEALTH

August 23rd , 2023

1772 Roanoke Station Road Red Oak, VA 23964

CHARLOTTE COUNTY HEALTH DEPARTMENT

P.O. BOX 695

CHARLOTTE COURT HOUSE, VIRGINIA 23923

Sewage Disposal System Repair Permit

Subject: Health Department ID Number: 22-119-0046 Tax Map Number: 84-A-538; HD File Drawer: 22-493 Site Address: 1772 Roanoke Station Rd, Red Oak, VA 23964

(434) 542-5251

FAX (434) 542-4354

TDD 1·800-828-1120

The attached drawings, specifications, and calculations constitute your permit to install a sewage disposal system on the property referenced above. The attached schematic shows the approved area for the sewage disposal system and well. If modifications or revisions are necessary between now and when you construct your dwelling, please contact the Charlotte County Health Department at (434) 542-5251. No part of any installation shall be covered or used until inspected, and the sewage system may not be placed into operation until you have obtained an Operation Permit from the Charlotte County Health Department.

The following documents will be required to obtain the Operation Permit:

System Inspection by the local Health Department Satisfactory Contractor's Completion Statement

This Construction Permit is null and void if conditions are changed from those shown on your application or if conditions are changed from those shown on the Site and Soil Evaluation Report and the attached construction drawings, specifications, and calculations. VDH may revoke or modify any permit if, at a later date, it finds that the site and soil conditions and/or design do not substantially comply with the Sewage Handling and Disposal Regulations, 12 VAC 5-610-20 et seq., or if the system would threaten public health or the environment. This permit approval has been issued in accordance with applicable regulations based on the information and materials provided at the time of application. There may be other local, state, or federal laws or regulations that apply to the proposed construction of this onsite sewage system or well.

The owner is responsible at all times for complying with all applicable local, state, and federal laws and regulations.

This construction permit is transferable until expired or deemed null and void. A permit transfer form may be found on the VDH website at http://www.vdh.virginia.gov/environmental-health/gmp-2015-01-forms/ .

If you have any questions, please contact me. This authorization to construct a sewage disposal system and well expires: February 23rd , 2025

Issued by:

Alexander Naulty, Environmental Health Specialist, Sr.

''I/DH VIRGINIA

'/ 1 DEPARTMENT

OF HEALTH