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HomeMy WebLinkAboutWPO201800072 Application 2018-09-12 `h Albemarle Count— ., t' Community Development Department ie 401 Mc'-� -Road Charlottesville.VA22902-4696 '�41J VI (434)296-5832 Fax:(434)972-4126 lt„ 4 •—•.e. Planning Application PARCEL / OWNER INFORMATION TMP 03100-00-00-00700 Owner(s): WOOD, BARRY W Application# WP0201800072 PROPERTY INFORMATION Legal Description I ACREAGE t Magisterial Dist. Rio I Land Use Primary Forest Current AFD Not in A/F District H Current Zoning Primary Rural Areas . ILAPPLICATION INFORMATION _ Street Address Entered By --- - -n Jennifer Pritch . Application Type Water Protection Ordinances I I 1 9/20/2019 Project St. Francis Ave - VSMP Received Date 09/19/18 Received Date Final Submittal Date 09/20/18 Total Fees 1350 Closing File Date Submittal Date Final Total Paid 1350 Revision Number Comments Legal Ad f SUB APPLICATION(s) Type Sub Applicatio Comment Stormwater Management/BMP Plan 09/20/18 Erosion and Sediment Control Plan 09/20/18 APPLICANT /CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCell iDv:-en!4pob art WOOD,BARRY'N 4190 EARLYS\QLLE RD EARLYS\TLLEVA 22936 1=--3-, Cora=t Keane Rucker a912 E High St Charlottesville,\- 22902 4342999843 I 1 1 Signature of Contractor or Authorized Agent Date of Virginia Stormwater Ma ement Program (VSMP) Application for Albemarle County .: Project Name: St. Francis Ave (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No WI Is this a revision or resubmission for review? Yes ❑ No d 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. ® 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. 03100-00-00-00700 Barry W. Wood 9/12/2018 Tax Map&Parcel Print Name of Property Owner Signature a Date 03100-00-00-012B0 Barry W. Wood 9/12/2018 Tax Map&Parcel Print Name of Property Owner Signature of ner 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 Justin Shimp, P.E. Address 912 E High St City Charlottesville State VA Zip 22902 Daytime Phone(434) 227-5140 E-mail Justin@shimp-engineering.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 4 ® B. All Fees [Code section .08] For new or modified plans; Total acres proposed to be disturbed 3.00 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;$150 ® C. Registration Statement on the official DEQ form. ID D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. to b( 0 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. prd4.40. D A NCyck ® G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. 503.11, I ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Keane Rucker Address 912 E High St. City Charlottesville State VA Zip 22902 Daytime Phone(434) 299-9843 E-mail keane©shimp-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# 20i E'- 0.2 3 Fee Amount$ /3 Date Paid 9/��/0 G By who? Receipt# V� CCleft �_ By: UP / f g(lgA101131 )g 14 / 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2