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County of Loudoun Zoning / Environmental Health <br />Building Clearance Evaluation Request <br />(May be completed by Zoning or Building) <br />Addition Check <br />Pin #:19407991000 LCTM: / 6 4A1 / 3 / / / 12 7 / <br />Property Address or other description: 16 Oak Lane; Sterling, VA 20165 <br />Date Received:03 /21/2011 BOCAApp #: T10133830001 <br />Building Permit #: <br />Applicant Name: Chris. Smith <br />Owner Name: Same as above <br />Please call Applicant to schedule a timed inspection <br />i' .. <br />Applicant Phone: 703 - 380 -4802 <br />Contact Method <br />Description of project: 2nd story addition. Rear addition will be family room and <br />office, exercice room, walk in closet. Front porch <br />(Building Type) <br />CLEARANCE EVALUATION RESULTS (completed by Environmental Health) <br />Water Supply: <br />❑ A well has been drilled and tested in accordance with Chapter 1040 of the Loudoun <br />County Codified Ordinance (Permit #: ). <br />❑ The property is served by public water supply. <br />® The project referenced above has no impact on existing water supplies in the <br />immediate area. <br />❑ Existing supply appears to be satisfactory. <br />Sewage Disposal System: <br />❑ A permit has been issued to construct a sewage disposal system <br />(Permit #: for # of Bedrooms ). <br />❑ The property is served by public sewer. <br />® The project referenced above has no impact on existing sewage disposal systems in <br />the immediate area. <br />❑ Existing systems appear to be satisfactory. <br />Building Zoning Permit Clearance <br />® Granted with conditions stated below <br />❑ Hold - Date: ❑ Off Hold - Date: <br />❑ Denied (Changes of Use Application denied after 60 days if no activity) <br />Conditions / Reasons: Must meet all required setback distances to well and sewage disposal <br />systems. <br />Environmental Health Specialist: Jeff Barr Date: 3/30/2011 <br />pc: Residential Plans Review, Building and Development (if special conditions apply to <br />construction of the structure) <br />