HomeMy WebLinkAboutWPO201500087 Application 2015-11-206't 4
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`"f72 South Pantops Drive
Dominion
Engineering
Charlottesville, VA 22911
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434.979.8121 (p)
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434.979.1681 (f)
DominionEng.com
Transmittal Cover Sheet
To:
Albemarle County Community Development Date:
11.20.15
ATTN: Justin Deel, EIT
Address:
401 McIntire Road Transmitted:
By Mail
By Hand
From:
Michael Myers, P.E.
By Email
Application:
VSMP Plan
Project:
Hollymead Town Center - Block C4
a For Pick-up
Project #:
WPO 2015-00087
Quantity
Item Description
1
VSMP Application for resubmission
2
E+S/SWM Plans
2
SWPPP Notebooks
1
Comment -Response Letter to Justin - PLEASE DELIVER TO JUSTIN
Comments:
The purpose of this plan submission is to change the name on the WPO Bond to Town
Properties, LLC.
Delivered by: Dominion
Engineering
Client
Received By: Other
Date:
For Pick-up: At Dominion
cc: Katurah Roell Engineering
Virginia Stormwater Ma gement Program (VSMP) `"`
Application for Albemarle County fikn
��RGIN�A
Project Name:
(The name shbuld be the same as it appears on plans)
Is this an amendment to an approved plan? Yes ❑ No
-61C'A /G
Is this a revision or resubmission for review? Yes No ❑
2o/ 5 - OOo>B.�,�.
County File Number: J U (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.
VA. 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.
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) U.S
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Tax Map & Parcel
Print Name of Pro erty 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
Tax Map & Parcel Print Name of Property Owner
Contact Information for the Owner(s) to receive correspondence:
Print Name I OW/1 Vr0Tur+11r
Address
Signature of Owner Date
Signature of Owner Date
r
City_ ckprt o'�J V ' �G V State V/ 1 Zip 2�02_
Daytime Phone 1(D l(/�Q-�201� E-mail GJ r (.
CPM
7/1 /14 Revkpd- 7/1 n/14 1 /7/14 Pnae 1 of 7
❑ 8. All Fees [Code section 208]
For new or modified plans; Total acres proposed to be disturbed
XC.
�D.
�F.
XG.
en
Acres to be
disturbed
Total Fee
Fee Due with this
A plication
Fee with Transfer or
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
Registration Statement on the official DEQ form.
Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
Stormwater Management Plan satisfying the requirements of code section 17-403.
Pollution Prevention Plan satisfying the requirements of code section 17-404.
Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
❑ 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 L" L
Address [ � 2. 5
City Wrall�1 n.eSV i �,{� I State VA Zip
Daytime Phone �(3 E-mail S / w ,
*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 #
Fee Amount $ Date Paid By who? Receipt # Ck# By:
7/1 /14 Revised- 7/10/14 1 /7/14 Paoe 7 nf 7