HomeMy WebLinkAboutWPO201900064 Application 2019-11-06 JAIbemar/e
�,�Un 401 M, tntire Road Charlofesville,V\229D2-459B
'" :(434)29B-5832 Fax:(434)972-4'126
A jPlanning Application
PARCEL/ OWNER INFORMATION I
TNMP 06306-00-00-01900 Owner(s): COLLIER, REBECCA ANNE C/O REBECCA ANNE COLLIER CASAD
Application# WPO201900064
PROPERTY INFORMATION
Legal Description ACREAGE •, r
Magisterial Dist. Rivanna • s" Land Use PrimaryiAgricUltural
Current AFD Not in A/F District' " Current Zoning Primary Rural Areas, ' • • , , - . , u'
APPLICATION INFORMATION
Street Address Entered By
Buck Smith 1iAPRIication TypeWater Protection Ordinances • `.; 11}-512019.•T
Project 'MARSHALL
Received Date 11/04/19 Received Date Final Submittal Date 11/04/19 Total Fees' 200
Closing File Date • Submittal Date Final Total Paid 200
Revision Number ,
Comments
Fr i
Legal Ad ., •
, .I
i
SUB APPLICATION(s)
- . - •: Ti,,'pe : :-- .- Sub Applicatio : : Comment
Erosion.and SedinieitControl Plan 11/04/.19.:, ,
APPLICANT/CONTACT INFORMATION ,
ContactType • . : :,blame_- 1.; : , -.Address . .CityState Zip, ''Phone : •-PhoneCell
4-r/r._r1.4Fill,srt_; ': COLLIER,.REBECCA ANNE' �`0'REBECCA:.-_, 580'WOLFTRAPRD:1,.:•,"t' 1 22911
i.:.;.:...:._..i:..:.:.......:...:..':..:::p:-:.-._ __..:--= '----:.... .,. ,,,..;.�.. . . � ;1,' CHaRLOTTESl+ILL .......... _.............._..........:
Prim_ry Cent!:t CHRISTINE DOBSON 91 BEAVER DAM CT KESWICKVA 22947 4345314976
•
Signature of Contractor or Authorized Agent Date
Virginia Erosion and Sediment Control Program (VESCP) i71
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: ` '(\ S\rv,�
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes ❑ No 0
Is this a revision or resubmission for review? Yes 0 No 0
County File Number :c9-di5 'c Gr (to be provided by the County for new applications)
The following are required elements of new applications[from code section 17-401 J. 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. 6)/id19
to 3 1 q ka.0 rev,cam. l 1714a- ha ( 0,b-LI/JVQ.A 601D 0 •
Tax Map&Parcel Print Name of Property Owner Signature of Owner DatedMONO-
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 IMQVIS uJ k,I) La re e /
C_ l.. V - - Loaren Ce- C. a'5�2 II
Address 3 2 C a -&nn d LYl
City I h'vif lle state - Zip a9O-
Daytime Phone( ) 5 f ( 7 3 / E-mail Lu A e. IQ- a -Sha 11 a#o(S0/1
7/1/14,Revised:7/10/14 Page 1 of 2
'-%
❑B. All Fees [Code section 17-207]
Total acres proposed to be disturbed
Acres to be disturbed Total Fee
Less than 1 $150 per review
More than 1 $300 per review
For amendments to an approved plan;$200 per review
Exceptions;$240
Mitigation Plan;$150
Construction Record Drawing;$300
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)-
Print Name l ; S 4 i r>2 bS o ✓� b �j M,�1,( MO
,0
Address C)j Pli ✓y- CI•
City e w,C State V A Zip 2aq y 7
Daytime Phone(L4 ) J )' Z 7 71 E-mail 0�v S4i - P doLD o rl £8 �v i �r)•
*When applications and plans are reviewed,but not approved,and a response to comments is not received within
6 months from the date of county comments,the application will be deemed withdrawn. Applications without
valid owners signatures will not be considered valid.
/ I
FOR OFFICE USE ONLY WPO# / 0(i �f
1 / C(/!//��
Fee Amount$r //2 Date Paid l! hL`L By who?A j f•c. /4.7/41 e.5 Receipt#f Ck#J�� -2 By:
7/1/14,Revised:7/10/14 Page 2 of 2
COUNTY OF ALBEMARL E
+;; Department of Community Development
' '" 401 McIntire Road rli
Charlottesville,Virginia 22902
VSMP Application Completeness Check
Project Title:&I/14,44516
File Number: &)P020i
Date: it-Lr,/
Reviewer:
•
Your application has been checked for completeness per section 17-409 of the County Code. All
items must be received and correct for the application to be deemed complete.
a This application is complete and plan review has begun
a This application is not complete. Please provide the missing items
checked below.
Received
Y N Correct
Y N N/A
A. a Completed application 0 ❑ ❑
a Signatures of the Property.Owners for each parcel affected ❑ o a
to 0 Correct Fees Paid ❑ ❑ 0
0 0 Registration Statement on the official DEQ form, with correct LDA ❑ a ❑
❑ ❑ ' Erosion and'Sediment Control Plan satisfying the requirements
of code section 17-402. 0 ❑ ❑
•
o ❑ Stormwater Management Plan satisfying the requirements of code
•
section 17-403. ❑ ❑ o
❑ ❑ Pollution Prevention Plan satisfying the requirements of code
section 17-404. The EPA template should be used. - ❑ a 0
0 ❑ Stormwater Pollution Prevention Plan satisfying the requirements
of code section 17-405. The EPA template should be used. ❑ ❑ ❑
❑ g Mitigation Plan satisfying the requirements of code section
17-406 for any proposed disturbance of stream buffers. ❑ a ❑
❑ A Requested Variations or Exceptions as provided in code sections
17-407 and 408,if applicable. (SSF,MMT,etc) ❑ ❑ 0
❑. A, Construction Record Drawings(as-builts)for any existing facilities
in the proposal satisfying the requirements of code section 17-422. ❑ ❑ A
•
Comments:
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