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Home My WebLink AboutWPO201800079 Application WPO VSMP 2018-11-30 a AL, Virginia Stormwater Management Program (VSMP) �' ;gar bl Application for Albemarle County - \rtct��r Project Name: Old Trail Drive Entry Feature ESC &SWM Plan (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No ELI Is this a revision or resubmission for review? Yes ® No 0 County File Number: WPO201800079 (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 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. 55E-01-A3 &A4 11/30/2018 Tax Map& Parcel `Name of P ert y Own a>re of 11 i' P y � _ � r 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 Dave Brockman Address 1005 Heathercroft Cir. Suite 100 City Crozet State VA Zip 22932 Daytime Phone( ) E-mail dave@oldtrailvillage.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of2 WI B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 0.13 Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $290 $145 $20 I 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 $1,100 $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. 1 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 Riki Van-Niekerk Address 172 S. Pantops Dr. Suite A City Charlottesville State VA Zip 22902 Daytime Phone(434) 979-8121 E-mail Riki@Roudabush.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# CL# By, 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of2 x i�bf?CI7c"�rile p[jnf� CommunityDevelopmentDepartment 401 M' ti re Road Charlottesville,VA22902-4596 41 . g Planning Application (434)25832 Fax:(434)972-4126 PARCEL/ OWNER INFORMATION TMP 055E0-0l-ao-000A3 Owner(s): MARCH MOUNTAIN PROPERTIES LLC Application# WP020A800079 PROPERTY INFORMATION Legal Description 1 OL TSL BLOCKS 24,33,B 34 Magisterial Dist.!White Hall Land Use Primary Unassigned Current AFD Nat to A/F DIstrjct Current Zoning Primary Neighborhood Model District V APPLICATION INFORMATION —_ Street Address Entered By Application T ebn OrdinancesL. Judy Martin YP Water Protech lit 23 2tfi8 Project Old Trail Drive,Entry Feature ESC&SWM-VSMP Received Date 10/22/18 I Received Date Final I I Submittal Date Total Fees 145 Closing File Date 1 Submittal Date Final Total Paid 145 Revision Number Comments A Legal Ad SUB APPLICATION(s) Type I Sub Appiicatio I Comment Easement Plat 10/22/18 Stormwater Management/81 +'j , 10/2• 2/16 APPLICANT /CONTACT INFORMATION Cor actType J Name ( Address I MOUNTAINI E'T'A I � J PtPhone ( Phorterrell MARCH MOUNTAIN ► s LLC '1005 HEArHERCRDFr GTR I cRaaETVA ;22332 ortrrury Coitsst DAVE BROCKMAN 1005 HEATHERCROFT QR., ,CROZET,VA. 22932 Pian Fre-parer JEREMY FOX 172 S. PANTOPS DR., STE.A CHARLOTTESYTLL 22902 4349798121 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) eiA44.„.„ Application for Albemarle County ,® . Project Name: Old Trail Drive Entry Feature ESC&SWM Plan (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No 10 Is this a revision or resubmission for review? Yes ❑ No WI County File Number: N/A (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. PI 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. 55E-01-A3&A4 -1, / / Tax Ma &Parcel Name o �o f `�C(�(cte Map perly Owc� � '�-:��re of t!��•r 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 Dave Brockman Address 1005 Heathercroft Cir. Suite 100 City Crozet State VA Zip 22932 Daytime Phone( ) E-mail dave@oldtrailvillage.com RECEIVED OGt 1 9 2018 CpMMUNITY 7/1/14,R0i � �F, age 1 of 2 NOW ® B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 0.J$ Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed pIiration 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 $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 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. O 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 Jeremy Fox Address 172 S. Pantops Dr. Suite A City Charlottesville State VA Zip 22902 Daytime Phone(434) 979-8121 E-mail jfox@roudabush.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# Ck# By 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2