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HomeMy WebLinkAboutWPO201800091 Other VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY FOR OFFICE USE ONLY GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM ID Number: CONSTRUCTION ACTIVITIES (VAR10) Technical Criteria: IIB ❑ IIC ❑ REGISTRATION STATEMENT 2019 NEW ISSUANCE ® RE-ISSUANCE ❑ MODIFICATION WITH ACREAGE INCREASE ❑ MODIFICATION WITHOUT ACREAGE INCREASE ❑ Existing Permit Coverage Number(if applicable,VAR10####): Section I. Operator/Permittee Information. A. Construction Activity Operator(Permittee). The person or entity that is applying for permit coverage and will have operational control over construction activities to ensure compliance with the general permit. A person with signatory authority for this operator must sign the certification in Section VI. (per Part III. K. of the VAR10 Permit). Construction Activity Operator Name: Contour Construction LLC Contact person: Mark Hutchison Address: 1713 2-B Allied Street City,State,Zip Code: Charlottesville, VA, 22903 Phone Number: 434-981-4988 Primary Email: fk@GG 94Fe/1R tfd-t n7ft /� C)n-�-OUY pi(�'tr MO a-O I c 2 /�I CC Email: C/ B. Billing Information (leave blank if same as the Operator identified in Section I.A.above). This entity will receive Annual Permit Maintenance and Permit Modification Fee invoices(if applicable). Name: Contact Person: Address: City,State Zip Code: Phone Number: Primary Email: CC Email: C. May we transmit correspondence electronically? You must choose YES and include a valid email in order to pay by credit card and to receive your permit coverage approval letter via email: YES I NO El Rev 04/2019 PAGE 1 18 CONSTRUCTION GENERAL PERMIT(VAR10)REGISTRATION STATEMENT 2019 Section II. Construction Activity Location Information. Project site information. A. Include a site map showing the location of the existing or proposed land-disturbing activities,the limits of land disturbance,construction entrances and all water bodies receiving stormwater discharges from the site. B. Construction Activity Name: Lewis and Clark Drive Sewer Extension Address: 4211 Lewis and Clark Drive City and/or County and Zip Code: Charlottesville,VA 22911 Latitude and Longitude (6-digit, decimal degrees format): 38.146487,-78.43957 C. Construction Activity Entrance Location (description,street address and/or latitude/longitude in decimal degrees): Northern dead end of Innovation Drive Section III. Offsite Support Activity Location Information. List all offsite support activities to be included under this permit registration. Enter additional areas on a separate page.Offsite areas not included on this registration may need to obtain coverage under a separate VPDES permit. A. Offsite Activity Name: Address: City and/or County and Zip Code: Latitude and Longitude (6-digit,decimal degrees format): B. Offsite Activity Entrance Location (description,street address and/or latitude/longitude in decimal degrees): Section IV. Site Information. Rev 04/2019 PAGE 2 18 CONSTRUCTION GENERAL PERMIT(VAR10) REGISTRATION STATEMENT 2019 A. Acreage totals for all land-disturbing activities to be included under this B. Estimated Project Dates permit coverage. Report to the nearest one-hundredth of an acre. (MM/DD/YYYY) Total land area of development(including the entire area to be disturbed as approved in the Stormwater 455.85 AC Start date: 3/01/2019 Management Plan): Primary estimated area to be disturbed (portions with 7.36 AC Erosion and Sediment Control Plan approval only): Completion date: 3/01/2020 Offsite estimated area to be disturbed (if applicable): C. Property Owner Status: FEDERAL ❑ STATE ❑ PUBLIC ❑ PRIVATE D. Nature of the Construction Activity Description(i.e. commercial,industrial, residential, agricultural, environmental): Utility:Sanitary Sewer E. Municipal Separate Storm Sewer System (MS4) name(if discharging to a MS4): Albemarle County Service Authority F. Is this construction activity part of a common plan of development or sale? YES ® NO ❑ • G. 6th Order Hydrologic Unit Code(HUC)and Receiving Water Name(s). Attach a separate list if needed. HUC RECEIVING WATERBODY(S) 02080204 RIVANNA Section V. Other Information. A. 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 the Registration Statement. By signing the Registration Statement,the operator is certifying that the SWPPP has been prepared. B. Has an Erosion and Sediment Control Plan been submitted to the VESCP Authority for review? YES,© NO ❑ Erosion and Sediment Control Plan Approval Date(for estimated area to be disturbed).: 61/319//fr' C. Has land disturbance has commenced? YES ❑ NO D. If this project is using approved Annual Standards and Specifications(AS&S),attach the completed AS&S Entity Form. AS&S Entity Name (if different from the Operator identified in Section II.A.): SEE THE FOLLOWING PAGE FOR SIGNATURE Rev 04/2019 PAGE 3 18