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Home My WebLink AboutWPO201600057 Application WPO VSMP 2016-09-26 -, ' Community Development Department .1/4, Albemarle CoL._ ,..y .41, dntire Road Charlottesville.VA 22902-4596 . 1, . ice;(434)2S6-5632 Fax:(4'34)972-4126 Planning Application PARCEL j OWNER INFORMATION TIP 061W0-02-00-00100 Owner(s).. ROSEWOOD VILLAGE.LC Application# . WP0201600057 • ' N PROPERTY INFORMATION • Legal Description ACREAGE ) , Magisterial Dist, Rio • E..: Land Use Primary Residential --Group quarters (incl.fraternities,LI . Current AFD ; Not in A/F District F,71 Current Zoning Primary; Cl Commercial El ...„....„.,„.„_ ____„... . ,..„._. „„.„..„.. •........„.. __________.....______ ..., .......„......., [APPLICATION INFORMATION 1 . Street Address SOO.GREENBRIER DR CHARLOTTESVILLE,22901 ,..Entered B' ,...,..—. ...... , . ,nnifer Smith Application Type Water Protection Ordinances - El 1-,:i2Q61-6.----12] Project Rosewood Village at Greenbrier ' . Received Date 09/26/16 Received Date Final Submittal Date Total Fees 145 1 Closing.File Date Submittal Date Final . Total Paid 145 Revision Number • , Comments r , .. : ,_ Legal Ad • • . , • ... SUB APPLICATION(s) . „.. ... . „. Stormwater ManageTlynpeenti-BMP. •Plii ' Erosion and Sediment Control Plan „_ Sub Applicatio 09/26/16 09/26/16 .. „ . „ ,. . „ . . .Corrannt .„ „..., .. " ... .. . . . . . [APPLICANT / CONTACT INFORMATION 1, ContaciType . . . . . Name A , ..,. . . . Address .. , 1-,— Gti'State . .„.Zip, .. ..,Poneh .. ..PhoneCell ROSE VILLAGE LC 500 GREENBRIER DR . !•CHARLOTTESVILL 122901- i . I i TIN MILLER 440 PREMIER COURT.STE 200 CHARLOTTESVILL 22901 434E820121 , • . . . . . • Signature of Contractor or Authorized Agent Date I • . ) . • . . I • . . . . - . . ' . , . , . . . • . • Virginia Stormwater Management Program (VSIYIP) Application for Albemarle County rrr,r,t� • Project Name: f Oc "w0a.) I//WO G /11 Ott E )V8I21 ON - (The name should be the same as it appears an plans) Is this an amendment to an approved plan? Yes 0 No 0 Is this a revision or resubmission for review? Yes 0 No 0 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 amendment;,please indicate which items are being amended. Signatures must he provided fir 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. O600-oz-6'0-00100 AA-wow 1/Ium , liG44/41Ah(0,-- 9 zz-1‘ 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 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information tin•the Owner(s)to receive correspondence: Print Name j3 z51.ati00 ✓/LC,p 6 E, L�......._. _.. _._._. Address Sco Crn/6-67vQJZI T- dofL/1, .. City..G"/Mitt 1-01/IZC8—/ .-.......__._........._...._.__. State 00 Zip ZlgeI_ Daytime Phone(car)..- (11—• 3 S 9 7 E-mail 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of2 • XB. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 0, C5 A C,i 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;$150 C. Registration Statement on the official DEQ form. 6XD. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. • Pr E. Stormwater Management Plan satisfying the requirements of code section 17-403. Ik F. Pollution Prevention Plan satisfying the requirements of code section 17-404. 141 G. Stormwater.Pollution Prevention Plan satisfying the requirements of code section 17-405. •t_ � ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. 0))1 ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and.408. phi ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name T/!7 /f'1/1.10 Address V.7 /(MI fr CUVv-r, ,.ST6 2&d ee�� p/�} City e imittarresv/G'(,e State �/0 Zip Z2!I/1 Daytime Phone(7314 ) b82—oI24 E-mail riA'i ifLI .Q;n MONt.V '.t:'OVt *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLYy� I /� WPO# t Fee Amount$I'-b.OD Date Paidgp tlJ11�By who`? �5 �,( 1�, eipt#1,®4) ( Ck# 1-0 BY7 ..a 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of2 Registration Statement General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10) (Please Type or Print All Information) I. Construction Activity Operator: (General permit coverage will be issued to this operator. The Certification in Item #12 must be signed by the appropriate person associated with this operator.) Name: Not available at this time Contact: Mailing Address: City: State: Zip: Phone: Email address (if available): Indicate if DEQ may transmit general permit correspondence electronically: Yes ® No ❑ 2. Existing General Permit Registration Number(for renewals only): 3. Name and Location of the Construction Activity: Name: Rosewood Village at Greenbrier Address (if available): 500 Greenbrier Drive City: Charlottesville State: VA Zip: 22901 County (if not located within a City): Albemarle Latitude(decimal degrees): 38.06966 Longitude (decimal degrees): -78.48111 Name and Location of all Off-site Support Activities to be covered under the general permit: Name: Not Applicable Address (if available): City: State: Zip: County(if not located within a City): Latitude (decimal degrees): Longitude (decimal degrees): 1. Status of the Construction Activity (check only one): Federal ❑ State ❑ Public n Private El 5. Nature of the Construction Activity (e.g., commercial, industrial, residential, agricultural, oil and gas, etc.): Commercial 6. Name of the Receiving Water(s) and Hydrologic Unit Code (HUC): Name Meadowcreek- Rivanna River Name: HUC: JR14 HUC: 7. If the discharge is through a Municipal Separate Storm Sewer System (MS4),the name of the MS4 operator: 8. Estimated Project Start and Completion Date: Start Date(mm/dd/yyyy): 12/01/2016 Completion Date (mm/dd/yyyy): 06/01/2017 9. Total Land Area of Development(to the nearest one-hundredth acre): 2..07 Acres Estimated Area to be Disturbed (to the nearest one-hundredth acre): 0.xx Acres 10. Is the area to be disturbed part of a larger common plan of development or sale? Yes n No 11. A stormwater pollution prevention plan (SWPPP) must be prepared in accordance with the requirements of the General VPDES Permit for Discharges of Stormwater from Construction Activities prior to submitting this Registration Statement. By signing this Registration Statement the operator is certifying that the SWPPP has been prepared. 12. Certification: "I certify under penalty of law that I have read and understand this Registration Statement and that this document and all attachments were prepared in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on,my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information,'.the.,information submitted is to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant'penalties for submitting false information including the possibility of fine and imprisonment for knowing violations." Printed Name: Title: Signature: Date: (Please sign in INK. This Certificatiori must be'signed by the appropriate person associated with the operator identified in Item #1.) 07/2014 Page 1 of 1