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Home My WebLink AboutWPO201800038 Application WPO VSMP 2018-07-25 aF Virginia Stormwater Management Program (VSMP) 41"17 , Application for Albemarle County '* Project Name: Chapel Hill Stream Restoration (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No 0 Is this a revision or resubmission for review? Yes 0 No 0 County File Number: (to be provided by the County for new applications) The following are required elements of new applications ffrom code section 17-401]. For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. 0 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 e • upon the property as required to ensure compliance with the approved plans and permits. 61Z-03-1A County of Albemarle, VA j 74/j" Tax Map&Parcel Print Name of Owner :ture of O er D to 61Z-04-1A County of Albemarle, VA 713- ,� Tax Map&Parcel Print Name of Owner S'.s. e of 0 er to 61Z-03-8 Countyof Albemarle, VA 3 e /Jig /�%�-- Tax Map&Parcel Print Name of Owner .i-.1 :of Owne D to 61Z-01-4 Under Co.of Albemarle,VA,control for this project. 7//2 //3— Tax Map&Parcel Print Name of Owner Si: a e of wner D e Contact Information for the Owner(s)to receive correspondence: Print Name Jeffrey B. Richardson, County Executive Address 401 McIntire Road Charlottesville VA 22902 City State Zip Daytime Phone(434) 296-5841 E-mail irichardson3Aalbemarle.orq 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 Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application 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 $6,100 $3,050 $450 100 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150 Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Kip Mumaw Address 1739 Allied St., Ste., A City Charlottesville State VA Zip 22902 Daytime Phone(540) 239-1428 E-mail kipna.ecosystemservices. us *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn.Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: Revised 07/24/18 Page 2 of 2 CpwtCOUNTY OF ALBEMARLE ��— Department of Community Development tt `"0 401 McIntire Road yP Charlottesville,Virginia 22902 VSMP Application Completeness Check Project Title: \\S VS u P File Number: 1,u,PO 2010- °Co 3E3 Date: Reviewer: Your application has been checked for completeness per section 17-409 of the County Code. All items must be received and correct for the application to be deemed complete. ❑ This application is complete and plan review has begun ❑ This application is not complete. Please provide the missing items checked below. Received Correct Y N Y N N/A Z ❑ Completed application ❑ ❑ ❑ ❑ Signatures of the Property Owners for each parcel affected ❑ ❑ ❑ ' ❑ N`N Correct Fees Paid ❑ ❑ ❑ ❑ ❑ Registration Statement on the official DEQ form, with correct LDA ❑ ❑ ❑ ❑ ❑ Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ ❑ ❑ ❑ ❑ Stormwater Management Plan satisfying the requirements of code section 17-403. 0 ❑ 0 ❑ ❑ Pollution Prevention Plan satisfying the requirements of code section 17-404. The EPA template should be used. ❑ ❑ ❑ ❑ ❑ Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. The EPA template should be used. ❑ ❑ ❑ ❑ ❑ Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ ❑ ❑ ❑ ❑ Requested Variations or Exceptions as provided in code sections 17-407 and 408, if applicable. (SSF,MMT,etc) 0 ❑ ❑ ❑ ❑ Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. ❑ ❑ ❑ Comments: ■ Albemarle Coin l _ community oeuelopmentDepartmerit M Ch 409 re Road CharlttesviIIe,VA22902-4596 'sad:(434)296-5832 Fax:(434)972-4126 �- . g Planning Application PARCEL/ OWNER INFORMATION IMP O61ZO-O3-OO-O O1 1O Owner(s): CATHOLIC DIOCESE OF RICHMOND; MOST C/O REV.WILLIAM Application# WP0201800038 PROPERTY INFORMATION Legal Description 1 ACREAGE Magisterial Dist.!Rio Land Use Primary Semi—public �+ Current AFD iNot in A/F District gi Current Zoning Primary!Planned Unit Development :+ j APPLICATION INFORMATION Street Address 1465 INCARNATION DR CHARLOTTESVILLE, 22901 Entered By Judy Martin Application Type :Water Protection Ordinances ' 1.5716/2°1s Project Chapel Hills Stream Restoration-VSMP Received Date 05/15/18 Received Date Final Submittal Date Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applcatip Comment I Stormwater Management/BMP Plan 05/15/18 i Eroshan and Sediment Control Pan 05/15/18 • APPLICANT /CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCeal 4 CATHOLIC DIOCESE OF RICIlMOND; IESS HILLSDALE DRIVE , _.CHARLOTTESVILL 22901 r±rla,y C -.tact p WALTER HARRIS 401 MCINTIRE ROAD CHARLOTTESVILL 22901 4348724501 Signature of Contractor or Authorized Agent Date NMI Nary Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: Chapel Hills Stream Restoration (The name should he the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No 0 Is this a revision or resubmission for review? Yes 0 No 0 County File Number: (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-4011. For revisions or amendments,please indicate which items are being amended. Signatures must be provided,for any submission. 0 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. 61Z-03-1A Bishop of The Catholic Dioces of Richmond,VA Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 61Z-04-IA Brachlands Property Owners Association Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 61Z-03-8 Our Lady of Peace Tax Map&Parcel Print Name of Property OwnerSignature of Owner Date 61 Z-01-4 Muhammad I.Khan and Caroline Hsiao-Hua Chou ‘ ‘ a /y2.��A.t.. 5-7- of O I a Tax Map&Parcel Print Name of Property Owner Signature of er Date Contact Information for the Owner(s)to receive correspondence: Print Name �/F�A.t A Q,Q,t5 Address 40r1 Nk jid�hRc City `' q alag V1��C State 4 Zip d 19191 rim Daytime Phone(q-966 7a " SD( - E-mail 1,44 :sPaibeMautoci 7/1/14,Revised:7/10/14,1/7/14 Page 1 oft Nome 'surd O B. All Fees[Code section 17-208] For new or modified plans;Total acres proposed to be disturbed Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than I $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 $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. ❑ 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. O 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 Nathan Staley Address 1402 Grandin Rd SW,Suite 203 City Roanoke State VA Zip 24015 Daytime Phone(540) 795-6180 E-mail nstaley@wetiands.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 S Date Paid By who? Receipt# C k# By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2