HomeMy WebLinkAboutWPO201500076 Application Mitigation Plan 2015-09-28 tt Albemarle Couriv men qy Development Departmeit,
401_ifire Road CharlottesYille.VA 22902-4596
See Woe.k434 296.-5832 Fax t434 972-4126
* Planning Application
[PARCEL OWNER INFORMATION
IMP 05900-00-00-001P0 Owner(s): DEEP ACRES LLC
Application# WP0201500076
PROPERTY INFORMATION
Legal Description OLD BALLARD FARM 16
blagsterial tIlst, Samuel Miller [ j Land Use Primar-, Unassigned Li
Current AM Not in A/F District w Current Zoning Primary Rural Areas
1APPLICATION INFORMATION
Street Address Entered Sy
anielle Roth y•
Application Type Water Protection Ordinances
j9!2812015
Prolect Old Ballard Farms Lot 15/16 Driveway - Mitigation Plan
Receyed Date I69/25/15 Received Date Final Frna I Submittal Date I Total Fees 150
Closing File Date [_ Submittal Date Final Total Paid 150
Reision Number I
Comments
zgal Ad
ISUB APPLICATION(s)
Pe Sub a scabo1 Comment
os . • - • • • .
1APPLICANT CONTACT INFORMATION
,,,,,Contactlype 1 Name 1 Address 1 City** ,Z9 Phone PhoneCell
.r DEEP IIIICRES LLC 175E-A WoRTH PARK CHARLOTTESALL 22911
c:ortsct ALN FRANKLIN 427 CRANBERR; LA,NE CROZET VA 22932 4345315544
Signature of Contractor or Authorized Agent Date
4
Virginia Erosion and Sediment Control Program (VESCP) ,_.-A ii-P)1.(713
Application for Albemarle County 190,
(This application is only to be used for projects exempt from the Virginia
Stormwater Management Program,VSMP,and the DEQ General Permit)
Project Name: 79 1 GJI I(Q('i fip,(',•✓\�i4ef,V.4,`0, W I I.V I c a lJ t,..)
7
(The name should be the same as it appears on pl s)
Is this an amendment to an approved plan? Yes No ❑
Is this a revision or resubmission for review? Yes ❑ No ❑
County File Number: W?o 20 l'-- DO DO b (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_,ith the approvedplans and permits.
IF �•0 % ,CSS 04
r --- �.4-k 4 iS fyil ,- , 00/5
Tax Map&Parcel Print Name of Propert�Owner Sign. ur./!.I ,, er 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 Inform4iA !
for the Owner(s6116;
)�t_o receive correspondence:
Print Name T !1z__I(
Address l `I G 121 �,,o JJC A.r 0 n I-n 4 30 1
City O okr I ptke S J , I I6. State VA-- Zip 22,1D
Daytime Phone(43`1) ??g - If$y E-mail /77, 14 Arhntr 419,-,7e 5• t0 ft--
7/1/14 Revicetl• 7/1(1/14 1/7/15 Pacre 1 of 2
+
❑ B. All Fees [Code section 177]
Total acres proposed to be disturbed 0- I
Acres to be disturbed Total Fee �A4
Less than 1 $150 per review rQ"�'
More than 1 $300 per review
For amendments to an approved plan; $200 per review
Variances;$150(per request)
Mitigation Plan; $150
• ion •ecord Drawing;$300
❑ C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
i 'l Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ E. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ F. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer, consultant or agent)
Print Name /Q/, f a 1 su/,n
Address `71z'7 Gia✓J be r7
City e(D z,•Gf" State ),44 Zip 22J3 Z
Daytime Phone(137) 531_55V7 E-mail Q/4,I 6 a �Q.'�/` ^�e .--
*When applications and plans are reviewed, but not approved,and a response to comments is not received
within 6 months from the date of county comments,the application will be deemed withdrawn. Applications
without valid owner's signatures will not be considered valid.
FOR OFFICE USE ONLY WPO#
Fee Amount$I Z-0• q
o Date Paid 47–•15--/S—By who.?A vow\ (2r an I l i✓1Receipt# ' 0 I , ap 3 Ck# 1 3 6 1 By: A5f
7/1/14,Revised: 7/10/14, 1/7/15 Page 2 oft