HomeMy WebLinkAboutWPO201800049 Application 2018-06-20 1,t"
Ir ' Dom munity Development Department
Albemarle oun 401k. e Road Charlottesville,VA22902-4596
:(434)298-5832 Fax:(434)972-4128
\'` 1. Planning Application •
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PARCEL/ OWNER INFORMATION
TMP 07600-00-00-052L0 Own er(s); SIDOH LLC
Application# WP0201800049
PROPERTY INFORMATION
Legal Description / / /OAK HILL MOBILE HOME PARK/
131::
h i
Magisterial Dist.'Samuel Miller ® Land Use Primary+Cominercial _ __
Current AFD 'Nottiin A/F District E Current Zoning Primary R4 Residential
APPLICATION INFORMATION
Street Address 671 COUNTRY GREEN RD CHARLOTTESVILLE,22902 Entered By
Application Typo �^ Jennifer FiritcF�" ,
iWater Protection.Ordinances •
-` ® 6 :3.11-2o18
Project Oak Hill Convenience Store.
Received Date 06/20/18 Received Date Final Submittal Date Total Fees 145
Closing File Date ', Submittal Date Final Total Paid 145
Revision Number
Comments h
V 114 e4L a/ /'1f. ''----I" ', / /.� / �G- L,-€-1/'A r ''!/ ;
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Legal Ad ..,.
SUB APPLICATION(s)
Type Sub Applicatio . Comment
Erosion iand,Sediment Control Plan. 06/20/18 . . • ' • ,
Stormwater Management/BMPPlan 06/20/18
APPLICANT I CONTACT INFORMATION
ContactType Name Address - - Cit;State Zip Phone PhoneCell
O:rrt:rt'.apFli_:-t ' •"=SIDDH LLC ; 1096 FO CUU,ALE'LANE CHP.RLOTTESVILL 22902 - -
Primary ccr.Iact JUSTIN SHIMP 912 E HIGH ST CHARLOTTESVILL 22902 4349536116
Signature of Contractor or Authorized Agent Date
✓ ...di AEI1Vtt
Virginia Stormwater Management Program(VSMP)
Application for Albemarle CouOy
Project Name: DAB- ll\ Dywthieitcl.,510Q, • :
(The name should be tfre same'as i1 appears on plans)
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Is this an,amendment to an approved plan? Yes 0 No�1 .
Is this a revision or resubmission for review? Yes O Nola
County File Number: (to'be provided by.the Cotnttyjor iieiv applications)
The follou,ing are required elements of new applications[from code section 17-401]. For revisions or
amendments,please indicate which items are being amended Signatures must be provided for any
submission.
0 A. Signature of the Property Owner for each parcel: (Required with every submission or revision;NOT
: TO BE SIGNED BY AN AGENT OR CONSULTANT)
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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 ensure
complianee with the approyed.plans and permits.
11,E a
AO"5Z� Dtkcwr,a 1%0e1. •. 6111.0:0IcS
Tax Map&'Parcel Print Name of Property Owner Signature er De
s z s7 GthaliO CIati«
Tax Map&Parcel Print Name`of Property Owner. Signa DatC
Tax Map&Parcel . Print Name of Property Owner Signature of Owner • Date •
lax Map&Parcel PrintName of Property Owner Signature of Owner 'Date
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Contact Information,for the Owners)to receive correspondence:
Print Name 1 J11 a IQ,.Gw` 4veel. . . •
Address
City State -� Zip
Daytime Phone( ) _ _ ]=mail Gthcl,f-[Y\\ o IU- K"ift-0 5 ill GLt I , can
•
•
7/1114,Revised:7/i 0/14,1/7/14;Paget of 2
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•
RECEIVED'
4 Ion
tbiatAbNny
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❑ B. All Fees [Code section 17-208]
For new or modified plans; Total acres proposed to be disturbed 0,CA le
Acres to be Total Fee Fee Due with this Fee with Transfer or
disturbed Application modification of permit
Less than 1 $290 $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;$150
f7 C. Registration Statement on the official DEQ form.
0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
0 E. Stormwater Management Plan satisfying the requirements of code section 17-403.
.0 F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
Nh❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
4❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
ivf ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)
Print Name JuSil V\ ,�A M4
Address 912, E. 14
City Q9,90, l d C,w[LA, State YAr Zip V,1OZ
Daytime Phone(&31f) 5 3- tJ(t(,p E-mail jvi S}-c'( S -en_vA , MY\
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months
from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY WPO#C OcO
Fee Amount$ 1 LAS Date Paid I¢ appr6y who? Receipt#1 EDOQ Ck#_ 0.1e By:
7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2
6/20/2018 Centralized Payments
Item Amount
0 Your Payment OV' ,AL.49
Website Payment $145.00
Was Submitted Item Number: 970683
��C6 Type: Community Development VSMP
t�^ 1.t1', + Notes: Oak Hill Convenience Store
,, --A `_y'+ Disturbance<1 acre
•Transaction ID: 7FD88682M09572818
Transaction 06/20/2018 03:40 " 4 r 7`
-'- Transaction Fee $4.03
Time: PM ' Total $149.03
Total Paid: $149.03 1'` ' _._ _.
We will receive notification of your online payment at the time that it is made and
we will credit your payment as of that day. However, you will not see the payment
on your account for approximately 48-72 hours due to the time that it takes to get
those funds into our bank account.
RECEIVED
JUN 2 0 2010
COMMUNITY
DEVELOPMENT
https://www.albemarlecountytaxes.org/payments/default.aspx 1/1