HomeMy WebLinkAboutWPO201600038 Application 2016-05-18 •
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+ - .j Planning Application
PARCEL/ OWNER INFORMATION _
TNP '115500-00-00-11000 FRO
EHUNG FROEHNG&ROBERTSON INC , . ,
Application# •WP0201600038 . .
PROPERTY INFORMATION • I
Legal Description 1 ACREAGE . ' ,
Magisterial Dist.` White Hall �,1 Land Use Primary: Commercial
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CurrentAFD Not in A/F District : ti i Current Zoning Primary ,HighwayCommercial • , • t•I
APPLICATION INFORMATION
Street Address 6183 ROCKFISH GAP TPKE CROZET,22932 Entered By
In
Application Type ater Protection Ordinan •ces ' 1� ,5 9ily Lan
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Project Crozet Business Office--VSMP • .
Received Date 05/18/16 Received Date Final : Submittal Date ,• Total Fees 1350
Closing File Date ° Submittal Date Final Total Paid 1350
Revision Number
Comments n I
• ` I
Legal Ad �'
SUB APPLICATION(s)
Type - Sub Applicatio :. - , Comment ,
Stormwater Management/BMP Plan
Erosion and Sediment Control Plan
Stream'Buffer"Mitigatio`n;Plan'.
APPLICANT/ CONTACT INFORMATION
ContactType' , . .. - . :.'-Nate - -• , . • Address` CityState Lip::., ' .:...Phone:. .•. PhoneCell
Jrrnerr y :.,r_e rt•: r,FRO EHLING'Lac!BERTSON INC:., :-"?r . 3015,DIJFIBARTON:POAD.':'''',;; RICHMOND VA .;"23228, :: .�
Rrimarf Cartect CLYDE SIMMONS 6181 ROCKFISH GAP CROZET VA 23932 4348235154
•
Signature of Contractor or Authorized Agent Date
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Virginia Stormwater Management Program (VSMP) != ®� -n
Application for Albemarle County
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Project Name: Crozet Business Office
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes ❑ No 21
Is this a revision or resubmission for review? Yes 0 No
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
amendnzents,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.
05500-00-00-11000 Clyde Simmons Sit G f(G
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 for the Owner(s)to receive correspondence:
Print Name Clyde Simmons
Address 6181 Rockfish Gap Turnpike
City Crozet State VA Zip 23932
Daytime Phone(434) 823-5154 E-mail csimmons@FandR.com
7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2
VI B. All Fees [Code section 17-208] •
For new or modified plans;Total acres proposed to be disturbed 1.53 acs
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.
CI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
CO E. Stormwater Management Plan satisfying the requirements of code section 17-403.
® F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
® G. Stonnwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
ID H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
D 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 D. Kent O'Donohue Jr.
Address 1561 Commerce Road, Suite 401
City Verona State VA Zip 24482
Daytime Phone(540) 248-3220 E-mail dodonohue@balzer.cc
*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 VITO#
Fee Amount$11350.12' Date Paid Jrligf I ID By who? Foe h41 nod>_ Receipt# 1044101 Ck 11405 By: E.424.
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7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2