The URL can be used to link to this page

Home My WebLink AboutWPO201800029 Application WPO VSMP 2018-04-24` Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: The Center at Belvedere (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No ❑ Is this a revision or resubmission for review? Yes ❑ No ❑ County File Number: WP0201800029 (to be provided by the County. for new applications) The following are required elements of new applications (from code section 17-401]. For revisions or amendments, please indicate which items are being amended. Signatures must be provided for any submission. ❑ A. Signature of the Owner for each parcel: (Required with every submission or revision, NOT TO BE SIGNED BY AN AGENT OR CONSULTANT) By signing this application as the owner, I hereby certify that all requirements of these plans and permits will be complied with, and I have the authority to authorize the land disturbing activities and development on the subject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance with the approved plans and permits. 61-154 Senior Center Incorporated Tax Map & Parcel Print Name of Owner Signature of Owner Date Tax Map & Parcel Print Name of Owner Tax Map & Parcel Print Name of Owner Tax Map & Parcel Print Name of Owner Contact information for the Owner(s) to receive correspondence: Signature of Owner Signature of Owner Signature of Owner Print Name Senior Center Incorporated attn: Peter Thompson Address 1180 Pepsi PL. City Charlottesville Daytime Phone ( 434) 974-7756 E-mail peter@seniorcenterinc.org Date Date Date VA 7i„ 22901 Revised 07/24/18 Page 1 of 2 ❑ B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 5.76 AC Acres to be disturbed Total Fee Fee Due with this Application Fee with Transfer or modification of permit Less than 1 $290 $145 $20 1 and less than 5 $2,700 $1,350 $200 5 and less than 10 $3,400 $1,700 $250 10 and less than 50 $4,500 $2,250 $300 50 and less than 100 $6,100 $3,050 $450 100 and more $9,600 1 $4,800 $700 For (minor) amendments to an approved plan; $200 per review Variances; $150 Mitigation Plan; $150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence (usually the plan preparer, consultant or agent) Print Name Timmons Group attn: Craig Kotarski Address 608 Preston Ave STE 200 City Charlottesville State VA Zip 22903 Daytime Phone (A34) 327-1688 E-mail craig.kotarski@timmons.com *When applications and plans are reviewed, but not approved, and a response to comments is -not received within 6 months from the date of county comments, the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO # Fee Amount $ Date Paid By who? Receipt # Ck# By: Revised 07/24/18 Page 2 of 2 Albemarle Coity Planning Application Community Development Department :4c1 nti re Road Charl ottesvi Il e. VA 72902-4596 1t0ice: 434} 296-5832 Fax :(434) 972-4125 TMPJ 06100-00-00-15400 Owner(s): SENIOR CENTER INCORPORATED Application # W -i -P62-01800029 I Legal Description BELVEDERE PARCEL I f Magisterial Dist Rio Land Use Primary Open Current AFD !Not in A/F Dtxstrki Current Zoning Primary Neighborhood Model District ►PPLICATION INFORMATION Street Address Entered By Application Type Water Protection Ordinances _ _ + Jennifer Smich Project THE CENTER AT BELVEDERE - VSMP Received Date 04/23/1$ Received Date Final Submittal Date Total Fees 1700 Closing File Date Submittal Date Final Total Paid 1700 Revision Number Comments Legal Ad B Stormwater Management/BMP Plan iO4/23/18 .................. Eration 'and Sediment Control Plan 64/23/18' CONTACT xxactt ype I Name Adare6s I Ci State Zip I Phone I ftoneCell G'w i SENIOR CENTER INCORPORATED ;1160 PEPSI PL i CH aRLOTTESVILL 22901 i ... ......... ................ .................................................................. ,.:.:: Q:. - ............................, ..... ............................................. r1mary t stat : HERB WHITE 3040 AVEMORE S DARE PLACE CH,ARLOTTSVILL :22911 4349842700 .. .................................. ......................:........ Mica nt ! PETER THOMPSON -SENIOR CENTER. INC 491 HILLSDALE DRIVE CHARLOTTESVILL 2290.. ...1 4349747756 _ Signature of Contractor or Authorized Agent Date IM Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: The Center At Belvedere (The name shoidd be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No Is this a revision or resubmission for review? Yes ❑ No M County File Number: (to be provided by the County for new applications) r.; The following are required elements of new applications [from code section 17-401]. For revisions or amendments, please indicate which items are being amended. Signatures must be provided for any submission. ® A. Signature of the Property Owner for each parcel: (Required with every submission or revision, NOT TO BE SIGNED BY AN AGENT OR CONSULTANT) By signing this application as the owner, I hereby certify that all requirements of these plans and permits will be complied with, and I have the authority to authorize the land disturbing activities and development on the subject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance with the approved plans and permits. TMP 61-154 .2— r� i.�,,. > le- Tax e t..�� Tax Map & Parcel Print Name of Property Owner Signature of Owner Date Tax Map & Parcel Print Name of Property Owner Signature of Owner Date Tax Map & Parcel Print Name of Property Owner Signature of Owner Date Tax Map & Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s) to receive correspondence: Print Name Senior Center, Inc., C.O. Peter Thompson, Executive Director Address 1 t8&f%psi-face 4R 1 kk jlks c)4 t p 1! -t; City Charlottesville State VA Zip 22901 Daytime Phone (_A31) C-74-7756 E-mail peter@seniorcenterinc.org 7/1/14, Revised: 7/10/14, I/7t14' Page 1 of ® B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 7.11 Acres to be disturbed Total Fee Fee Due with this Application Fee with Transfer or modification of permit Less than 1 $290 $145 $20 1 and less than 5 $2,700 $,135(0 $200 5 and less than 10 $3,400 1 $1,700 $250 10 and less than 50 $4,500 $2,250 $300 50 and less than 100 $6,100 $3,050 $450 100 and more $9,600 $4,800 $700 For (minor) amendments to an approved plan; $200 per review Variances; $150 (per request) Mitigation Plan; $150 ❑ C. Registration Statement on the official DEQ form. 0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17402. 10 E. Stormwater Management Plan satisfying the requirements of code section 17403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence (usually the plan preparer, consultant or agent) Print Name Herb White Address 3040 Avemore Square Place City Charlottesville State VA Zip 22911 Daytime Phone (A34) 984-2700 E-mail hwhite@wwassociates.net `When applications and plans are reviewed, but not approved, and a response to comments is not received within 6 months from the date of county comments, the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO # Fee Amount $_ Date Pai�y -twlnik Cfkr'R'eceipt # ! t1CkR By:( 15 7/1/14, Revised: 7/10/14, 1/7/14 Page 2 oft