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FDP201700002 Permit Floodplain Development Permit 2017-02-28
pp P 2-0/71-65'600 1 ,oyA #:4'111111r-74,,'% APPROVED 10', 145, X45 by the Albemarle County ® . Community Development Department . , r ate D ��Rctrn' o )? /? File COUNTY OF ALBEMARLE Department of Community Development 401 McIntire Road Charlottesville,Virginia 22902-4596 Phone(434)296-5832 Fax(434)972-4126 FLOODPLAIN DEVELOPMENT PERMIT This form is intended to aid the Department in documenting and characterizing the nature of development proposed in the floodplain. Development includes buildings or other structures,mining,dredging,filling,grading,paving,excavation or drilling operations or storage of equipment or materials. The form responses will be used to determine whether a floodplain impact plan or special use permit is required. Please check one: New Submittal with no anticipated floodplain impact(no floodplain impact plan) P P ) ❑ New Submittal with an anticipated floodplain impact. Please include a floodplain impact plan. FEE required with submittal: $323(Code 18-35.1g) ❑ FEMA Letter of Map Change(LOMA,LOMR) Please include a complete copy of all material to be submitted to FEMA.Include any computer models(HEC-RASfiles)on a disc. FEE required with submittal: $161 (topographic info only),or$323(floodplain modeling) ❑ New Submittal with a Zoning Special Use Permit.Please include a floodplain impact plan. FEE required with submittal: $323 ❑ Resubmittal (Floodplain Development Permit Number ) Please include your response form from the original submittal. FEE as above required with each resubmittal. A Floodplain Impact Plan,Special Use Permit,or FEMA Map Change will need to follow Zoning Floodplain Overlay District requirements(County Code 18-30.3),found at http://www.albemarle.org/upload/images/Forms Center/Departments/County Attomey/Forms/Albemarle County Code Ch18 Zoning30 Overlay Districts.pdf Section 4 of the Design Standards Manual provides a list of required items to be included in a Floodplain Impact Plan. This can be found at http://www.albemarle.org/department.asp?department=cdd&relpage=4447. CSR e G 0 R"`C \Af Nt,14_ BkovVNI (911) cp 9 Co -o-3 R2. (9 tc07t 9- 0 85 Owner Name(Print) Home Phone Office/Othe'Phofie .73t7 \J eST ) 4oRC3A$ 31- E.1 It' 30.5 Address 1,21fe le.;V. tG 4 . 14 0 4k-rt-t- CA4k_o v-t 144 A 27Q,n I City State Zip Code Tax Map&Parcel Number -Mgx M 4 ��1c:tais-L VZ 0/3 7JJt ck + � Project Name(if applicable) jiriliDC:i� S �.-1 TcR014 "gy�p Building Permit or Project Number(if applicable) 11/1/2015 Please describe the nature of the development activity proposed within the floodplain (e.g. new structure, grading for a playing field,driveway stream crossing,installation of a fence,etc.): A-%1 G k--•E:S — Ntew AD }Tt t714Ar1.. — A _ s-r 1 . t c#'t'0✓�lE N'c S 2 i �Au.�_ Mt1-1►11/1tJ �.tN �c�Ri �.--Et. t : MicNi t..Ar►D DiSToI-2.13ANC.E. %JJ i i t ©LGL.1fZ. GIRT'}ficakri014, SRTw LTt (Please attach any plans or photos to this application) 1. If a structure is proposed,is the structure accessory to a recreational or agricultural use? Yes❑No ® N/A 2. Does the proposed activity involve a stream crossing for a pedestrian trail or driveway serving a single family dwelling? 3. Does any proposed fencing cross a stream channel? Yes®No 0 N/A 4. If any fill is proposed,please approximate the proposed amount of fill in the floodplain Yes 0 No ] N/A Owner/A gnt Si i i - . 1 • r gnature 11 Date 2��v�Zoi7 6 (FOR OFFICE USE ONLY) 4,,roChecked Byr�1' 74741 Date / (for resubmittals) Fee Amount$ O Date Paid ,//L} By Who? Receipt# Check# 11/1/2015