HomeMy WebLinkAboutWPO201900016 Application WPO VSMP 2019-03-07 " • CommunityDevelopment Department
�%.,IAlbemarle Cour..�-.
401I '" eRoad Chrlottesvil e,VA2290&4596
""`" :(434)296-5832 Fax:(434)972-4126
,1 tpianning Application
PARCEL/ OWNER INFORMATION
TMP 01700'00-.00-.02 00 Owner(s): BAILEY,,MELLSSA LYNN
Application# WP02 01 900016 ,
PROPERTY INFORMATION
Legal Description lACREAGE , , it
Magisterial Dist,IWhtte,Hall j Land Use Primary Residential -Single-family (incl. modular homes LTj
Current AFD Not in A/F District 1.711 Current Zoning Primary Rural Areas p f.i
APPLICATION INFORMATION
Street Address 4S39 FREE UNION RD FREE UNION, 22940 Entered By
t y Jennifer PritcF''.y_,;'I
ApplicationType Water,Protection.Ordinances CTJ 3/7/2019.
Project 4389 Free Union Road'Erosion Control Plan-VESCP
Received Date 03/05/19 . Received Date Final Submittal Date , Total Fees 300
Closing File Date Submittal Date Final • Total Paid 300
Revision Number "
Comments ;: ...• ,„ ,..
Legal Ad 1. • ", • !(^:
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SUB APPLICATION(s)
Stormwater Management/BMP Plan 1 03/05/19
Erosion and Sediment Control Plan 03/05/19 i``:. ,1.* • >»' s� a
APPLICANT /CONTACT INFORMATION
n;ContactType :•,`. Name, _ •...,.Address: '!'7 .. ,..r.-CityState: . "n _gip ,; 5 Phone.._. !'PhoneCell,.
drea AppLart BAILEY`MELISSA LYNN , +14841 FREE:UNION ROAD FREESUNIONVA 122944r :4344698586
_,.,...__.ns...»_.�..__ E _.__::..: �...... .._..... __._ UT_.-_ DR.—... ........<.............:5.__....... ......._....:a_..._....._`___...::.1............._..._.,:_.:�._....__....._
Prbnary CmotaK ]EREMV L FOX 172 50 UTH PANTO PS OR,STE CHARLOTTE5v1LL 122911 43 49 7 9 8 121
w ,1 • 4 T t
Signature of Contractor or Authorized Agent Date
Virginia Erosion and Sediment Control Program (VESCP) rot„
Application for Albemarle County fty
'moo(This application is only to be used for projects exempt from the Virginia
Stormwater Management Program,VSMP,and-the DEQ General Permit)
Project Name: 4389 FREE UNION ROAD EROSION CONTROL PLAN
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes ❑ No 0
Is this a revision or resubmission for review? Yes ❑ No M
County File Number: (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.
111 M 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 evelo went on the subject
property. I hereby grant the County of Albemarle the right to enter upon the pro e as re Inked to ensure
compliance with the approved plans and permits. �`� `�I�
17-021 „Irlpp kcjui..wth'isn Tax Map&Parcel Print Name of wner Signature of 0 '/ Date
Tax Map&Parcel Print Name of Owner Signature of Owner t� Date
Tax Map&Parcel Print Name of Owner Signature of Owner Date
Tax Map&Parcel Print Name of Owner Signature of Owner Date
Contact Information for the Owner(s)to receive correspondence:
Print Name MATTHEW HOVEY
Address
City State Zip
Daytime Phone(434) 989-8586 E-mail mxhovey90@yahoo.com
7/1/14,Revised:7/10/14, 1/7/15, 10/17/18 Page 1 of2
• B. All Fees [Code section 17-207]
Total acres proposed to be disturbed 3.86
Acres to be disturbed Total Fee
Less than 1 $150 per review
More than 1 $300 per review
For amendments to an approved plan;$200 per review
Variances;$150(per request)
Exceptions;$240
Mitigation Plan;$150
Construction Record Drawing;$300
® C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
❑ D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ E. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
/It ❑ F. Construction Record Drawings (as-builts)for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)
Print Name JEREMY L. FOX
Address 172 SOUTH PANTOPS DR. STE. A
City CHARLOTTESVILLE State VA Zip 22911
Daytime Phone(434) 979-8121 E-mail JFOX@ROUDABUSH.COM
*When applications and plans are reviewed,but not approved,and a response to comments is not received
within 6 months from the date of county comments,the application will be deemed withdrawn. Applications
without valid owner's signatures will not be considered valid.
•
FOR OFFICE USE ONLY WPO#�(2-01�A-,xl`�o'/ ��Y t`10llbi , 1
Fee Amount$ Date Paid �ll�l By who? I �f{41441 V !L*it Receipt# I l- +®a Ck# 44 By: VP
solea
7/1/14, Revised: 7/10/14, 1/7/15, 10/17/18 Page 2 of2
Fee Receive.
. .
Re ved DtG
RECEIVED
COMMUNITY Reopiveq By
DEVELOPIORNT
PPHON (434)977-0205
Eo, FAX(434)296-5220
FAX
ROUIDABUSH, GALE &ASSOCIATE,,-INC.
LAND SURVEYING A PROFESSIONAL CORPORATION
ENGINEERING Serving Virginia Since 1956
LAND PLANNING 914 MONTICELLO ROAD
CHARLOTTESVILLE,VIRGINIA
WILLIAM J.LEDBETTER,L.S. 22902 DAVID A.JORDAN,L.S.
DAVID M.ROBINSON,P.E. BRIAN D.JAMISON,L.S.
AMMY M.GEORGE,L.A. KRISTOPHER C.WINTERS,L.S.
TO: Albemarle County Engineering DATE: 5 March 2019
JOB#: 19.0320
X Attached
under separate cover via the following items:
#of Copies Date Job# Description
2 03-05-19 19.0320 4839 Free Union VSMP Plan
2 03-05-19 19.0320 4839 Free Union SWM PPP
These are transmitted as checked below:
For Approval/Signature _For your use _Please return _As requested
Resubmitted w/revisions x Review/Comment For Bids due
Other
REMARKS:
SIGNED: COPY TO:
LogamP-.O'Day
If enclosures are not as noted, kindly notify us at once.