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Home My WebLink AboutWPO201900014 Application WPO VSMP 2019-05-01 Virginia Stormwater Management Program (VSMP) 1� Application for Albemarle County •` Project Name: Foothill Farm (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No E Is this a revision or resubmission for review? Yes E No 0 County File Number: WP02019-00014 (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. E 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. r�/� VM 62-71 (mSidS )Q.�g6l C.^ 11�J' __ ' tS/0 Tax Map&Parcel Print Name of Property Ownent f Signature of Owner D6(te 62- 71 4 1 .� 1� a/ l/ Tax Map&Parcel Print a e of Property O y er Si Lure of 0 er ate 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 Tobias&Lynn Dengel Address 540 Park St. City Charlottesville State VA Zip 22902 Daytime Phone(203) 439-1944 E-mail TobiasDengel@gmail.com 7/1/14,Revised:7/10/14,1/7/14 Page 1 of 2 i• ❑B. All Fees[Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 3.79 ac. 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 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 0 C. Registration Statement on the official DEQ form. ▪ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. a 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 Clark Gathright Address 100 10th St NE Suite 200 City Charlottesville State VA Zip 22902 Daytime Phone(434) 971-8848 E-mail cgathright@dgarchs.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 ii Fee Amount S Date Paid By who? Receipt N CkH By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 :<�--�.n""4.'' f---� Community Development Department 'ii+14l '_1 Albemarle COUna 401 M�-i,rrtire Road Charlottesville,YA22902-4596 ' c `i — �m V '(434)29B-5S32 Fax:(434)972-4126 f.,' 1-:.: ?1 Planning Application PARCEL/ OWNER INFORMATION TMP : 06200-00-00-07100 ` Owner(s): DENGEL,TOBIAS A TRUST& LYNN T DENGEL TRUST - " Application# .WP02 01 9 00 01 4 _ ,` PROPERTY INFORMATION Legal Description ACREAGE ' - Ia ll Magisterial Din.IRlvanna - in Land Use Primary1Forest L�_3 Current AFD Not in A/FDistrict tyl Current Zoning Primary Rural Areas , '.It APPLICATION INFORMATION - - Street Address 753 ROCKY HOLLOW RD CHARLOTTESVILLE,22911 Entered By ,. {.n Jennifer Pritct AApplication Type Water Protection.Ordinances • - ' , t.] 3/5/2019 ( Project Foothills Farm VSMP , ', : Received Date 02/28/19 Received Date Final Submittal Date Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments .(A. 1. Legal Ad J . !!VI E SUB APPLICATION(s) • - - .. Stormwater Management/BMP Plan 02/28/19 i ' , Erosion and Sediment Control Plan 1 02/28/19 i • APPLICANT /CONTACT INFORMATION • -.-.. . .. -. _. HContactTyper• .,:t. -; :,. 'r Name•; ` t .. .s; " . .•_.'.Address'.- - :.CityState.. • -Zip- _'r,- :Phone',='')'PhoneCellr. Owna¢GPpflart i DENGEL4TOBLA5,A TRUST&;LYNN T ' j540 PARKST' , ' ' „ . ', I.CHARLOTTESVJLL ,:1229al ''r2024391944 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) � Application for Albemarle County . .,hm Project Name: Foothills Farm (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No El Is this a revision or resubmission for review? Yes ❑ No El 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. RI 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. 62-71 ToyiaC f LliAn 1)Ailqe( 4/ 4t4r,' / 0.211410 Tax Map&Parcel Print Name isof Property OWner Signature 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 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name -T0 1 a S -F L!,l n it Dale( Address s /D Of k 5 r. City �( 1e y(4 - State V,4 Zip ay.fars Daytime Phone(?0)- ({S/— Cf E-mail Ts()IA S. C?'& ir,Ai L( o v h 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 ❑ B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 4.05 ac. ./ 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 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;$150 O C. Registration Statement on the official DEQ form. CI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. RI E. Stormwater Management Plan satisfying the requirements of code section 17-403. El F. Pollution Prevention Plan satisfying the requirements of code section 17-404. G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. O H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. 0 I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Clark Gathright Address 100 10th St NE Suite 200 City Charlottesville State VA Zip 22902 Daytime Phone(434) 971-8848 E-mail egathright@dgarchs.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLYWPO# , -1C� By: (J Fee Amount$ 1 30 Date Paid \5� &)QS By who? Receipt# \ [IOTA ad!! 4 J 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 Fee Received RECEIVEDReceived Date FEB 1 B 7n1n COMMUNITY Received By DEVELOPMENT COUNTY OF ALBEMARLE t� 11 Department of Community Development 401 McIntire Road Charlottesville,Virginia 22902 VSMP Application Completeness Check Project Title: h(/(46 lr-t V`2- P File Number: WPC 2019 - tq Date: 2 92-1.9 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 Y N Correct Y N N/A ❑ Completed application ❑ ❑ ❑ ❑ 0 Signatures of the Property Owners for each parcel affected ❑ ❑ ❑ O.- ❑ 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. ❑ ❑ ❑ ❑ 0 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. ❑ ❑ ❑ ❑ tik 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) ❑ ❑ ❑ ❑ Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. ❑ ❑ p Comments: ■