HomeMy WebLinkAboutFDP201900009 Permit 2019-05-30COUNTV OF ALBEMARLE
Department of Community Development
401 McIntire Road
Charlottesville, Virginia 22902-4596
APPROVED
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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: X New Submittal with no anticipated floodplain impact (no floodplain impact plan)
❑ New Submittal with an anticipated floodplain impact. Please include a floodplain impact
plan. FEE required with submittal: $323 (Code 1$-35.1g)
❑ FEMA Letter of Map Change (LOMA, LOMR) Please include a complete copy of all
material to be submitted to FEMA. biclude any computer models (HEC-RASfles) 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 floodplaint impact plan.
FEE required with submittal, $323
❑ Resubmittal (Floodplain Development Permit Number _) Please inchide your
response_forin fioin the original.submiltal. 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 1 S-30.3), found at
h!W://www.albomarle,—O,Y./U�loadlimages!'Foriiis Center/Departments/County Attorney/Forms/Albemarle County Code
Ch 1 S 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&reloggf4447.
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Owner Name (Pri t) Home Phone Office / Other Phone
2 auAddress
VA 4 ,-1 s9v
City State Zip Code
Tax Map & Parcel Number 13 1 A
Project Name (if applicable) IJ /A
Building Permit or Project Number (if applicable) AM
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Please describe the nature of the development activity proposed within the floodplain (e.g. new structure, grading for a
playinp field, driveway stream crossing, installation of a fence, etc.
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(Please attach any plans or photos to this application)
1.
2.
3.
4.
If a structure is proposed, is the structure accessory to a recreational or agricultural use?
Does the proposed activity involve a stream crossing for a pedestrian trail or driveway
serving a single family dwelling?
Does any proposed fencing cross a stream channel?
If any fill is proposed, please approximate the proposed amount off fill in the floodplain
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Owner / Agent Signature k kH FY,a pe ai s .. L L�, Date a4!
Ke fiv, W Quc"CK
(FOR OFFICE USE ONLY)
Checked By
(tar resubmittals) Fcc Amount S Dale Paid
Receipt It _
By who'? —
Check k
Dale
Yes ❑ No k.T N/A
Yes ❑ No C9 NIA
Yes ❑ No ER NiA
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