2. Is this the only lot transferred to the grantee from this parent parcel?
3. Is the lot created at least one acre minimum of buildable land in area?
4. Has the lot being created been certified by Albemarle Regional Health Services (ARHS) as capable
of accommodating the wastewater?
5. Access to lot being created: If no go to next question. If yes go to #6
a. Does the lot front a street? If no go to next question. If yes go to #6
b. Does the lot have an access way of at least 45’ in width not serving two additional lots?
If no go to next question. If yes go to #6
c. Does lot have an access easement recorded prior to January 1, 2006?
d. How is the lot being accessed?
6. Does the lot created from original parent tract meet the district minimum lot size required?
7. Do you understand that Failure to record a transfer plat in the Camden County Register of Deeds is a
on of the law and will interfere with the ability to obtain a building permit to build a
structure on the lot?
8. Do you understand Failure to record the transfer plat in accordance with Section 2.2.17, Expiration,
shall render the transfer plat null and void?
9. Does the subdivision comply with all the applicable standards in Section 3.8.3, Special Flood Hazard
Area Overlay (SFHA) if located in the floodplain or a floodway?
each of the following submitted with the completed application?(Yes/No/NA)
a. Copy of your Birth Certificates to show immediate family relationship:
b. Copy of Perc Test from Health Department:
c. If Grantor is grandparent (s) a copy of deed showing ownership for last 10 years.:
I, the undersigned, do certify that all of the information presented in this application is accurate to
the best of my knowledge, information, and belief. Further, I hereby authorize county officials to
enter my property during reasonable business hours f
or purposes of determining zoning
compliance. All information submitted and required as part of this application process shall
become public record.
Property Owner(s)/Applicant* Date
*Note: Forms must be signed by the owner(s) of record, contract purchaser(s), or other person(s)
having a recognized property interest. If there are multiple property owners/applicants, a signature
is required for each.