HomeMy WebLinkAboutWPO201900036 Application 2019-06-03 Commtrnib�Devclo Development
Department
� �` Albemarle Count 401 MC_ _Road Charlottesville,VA22962-4596
l +�;: Voice: (434)295-5532 Fax: (434)972-4125
y Planning Application
!PARCEL j OWNER INFORMATION
TMP 069130-00-00-04600 Owner(s): SIME,ARIN W &LAUREN C SIME
Application# WP0201900036
PROPERTY INFORMATION
Legal Description 1 ACREAGE '
Magisterial Dist. 'White Hall Land Use Primary Residential -- Single-family (incl. modular homes
Current AFD LNot in A/F District 1: Current Zoning Primary[Rural Areas
APPLICATION INFORMATION
Street Address 130 NEW YORK TRCE GREENWOOD,22943 Entered By
j — iJennifer Smith
Application Type i Water Protection Ordinances 6R20 9
Project SIME POND MAINTENANCE PLAN - VESCP
Received Date 06/03/19 Received Date Final Submittal Date Total Fees 450
Closing File Date Submittal Date Final Total Paid 450
Revision Number
Comments
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SUB APPLICATION(s)
Type Sub Applicatio Comment
Stormwater Management/BMP Plan 06/03/19
Erosion and Sediment Control Plan 06/03/19
APPLICANT / CONTACT INFORMATION
ContactType Name Address CityState Zip Phone PhoneCell.
Orma:iApp:i_5.-.t , SII*IE,ARM W, fx LAUREN C SINE 130 NEW YORK TRACE GREENWOODVA 22943 434996059E
=rim_ry C-mot== tMICHAEL MYERS, PE,CFM - 30 SCALE LLC '871 JUSTIN DRIVE PALMYRA,VA. 22963 4342422366
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Signature of Contractor orAuthorized Agent Date
Virginia Erosion and Sediment Control Program (VESCP) ®_r
Application for Albemarle County '�'-!`
(This application is only to be used for projects exempt from the Virginia
Stormwater Management Program,VSMP,and the DEQ General Permit)
Project Name: Sime Pond Maintenance Plan
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes ❑ No IA
Is this a revision or resubmission for review?' Yes ❑ No C�1
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.
IA 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 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.
69B-46 9„(1 ( S t rr�e. r (11��i=-� 5/s i/1 5
Tax Map&Parcel Print Name of Owner '/Signature of)wner Date
Tax Map&Parcel Print Name of Owner Signature of Owner 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 La..&reJr. v
Address \`2,C) i\`) _e ) \tr'cAC' •
-
City (.r,'iv_,'E its co LAP State VA Zip 22-!`L3
Daytime Phone(L(34) (Act g E-mail 1 C+i,,,�r v b t.1 6 dYlGt,l t. 1 YVi
7/1/14.Revised:7/10/14. 1/7/15. 10/17/18 Pane 1 of 2
DI B. All Fees [Code section 17 1]
Total acres proposed to be disturbed 1.20
Acres to be disturbed Total Fee
Less than 1 $150 per review
More than 1 $300 per review $300
For amendments to an approved plan;$200 per review
Variances;$150(per request) $150
Exceptions;$240
Mitigation Plan; $150
Construction Record Drawing;$300
R:l C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
N/A ❑ D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
LI E. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
N/A ❑ 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 MICHAEL MYERS, PE, CFM
Address 30 SCALE, LLC,871 JUSTIN DRIVE
City PALMYRA State VA Zip 22963
Daytime Phone( 434) 242-2866 E-mail mike@30scale.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 C:9019 —3L4
Fee Amount sere Date Paid (.1 9y who? 50:k Ili. Receipt#I I I f U-Ck#f' By: 3-S
7/1/14,Revised:7/10/14, 1/7/15, 10/17/18 Page 2 of 2