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Home My WebLink AboutWPO201500026 Application 2015-04-20Albemarle cat _ --, .�, M e 4W�;: _ �w�_ F:,, :� _ ":-47 " Planning Application 06100-00-Dti-Q4100= . MAGRUDER, RONALD L Application #1 WP02015000261 IOPERTY INFORMATION Leal Ge__ ptiur. ACREAGE D:st, lack iouett • Land Use P,�mar Residential Single-family (incl. modular home t_F + Not in Af F District Curren€ <on�. Pnmar� R2 Residentialwj APPLICATION INFORMATION _ _ __ _ _-.._... ..___......--__ 2628 i?£CP,4,..VLTC PC' C .AR.LOI .LS.•". ...i_ ., ..)l ..W .-"r1t GCE• i L°'j �•cP`s�a €,anTk 3e Water Protection Ordinances 1 nie le Roth pr=ije.t Barracks Road Sidewalk Improvements - VSMP tieces.ed Date 44J20J15 r.e eiTt Late r'nas _ibm naf Lute; Total Fee.: closmg Fie Late _ uEn st aI ate F€na€ T-tai Pa, _- Revi '�r. Number �� .. w ---. _........ . . ........ ...., w _ ..... i'Qal -, SUB APPLICATON(s _..-------_.� _____ ______....__._.._ _.____ Erasion and Sediment Control Flan - Storntwater ManagementJBMP Plan Stream Buffer Mitigation Plan APPLICANT / CONTACT INFORMATION t �at'T t 7 . _ ...�.. > rt €� M.._ 1 �f _m vi2 €rRi4 - af�.LEi, LP-_LG L N9 C,-ULXtt 9 _ �� FL�# _.ILL _I P,C-cTEF5 PE .. _... _... Ri _`i `x3' _' +.+Sl'tr' icttCtrco-.Authonzetd 49ent, .�=3.k ,yOF AI,R�. Virginia Stormwater Ma agement Program (VSMP) Application for Albemarle County;�r�;' �IRGyt•`lA Project Name: Barracks Road Sidewalk Improvements (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No Is this a revision or resubmission for review? Yes ❑ No W County File Number: (to be provided by the County for new applications) The following are required elements of new applications Lfrom code section 17-401 J. For revisions or amendments, please indicate which items are being amended. Signatures must be provided for any submission. W 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. Not Applicable VDOT Locally Administered Project 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 Frank Pohl - Project Manager Albemarle County Office of Facilities Development Address 401 McIntire Road, Room 222 City Charlottesville State VA Zip 22902 Daytime Phone 4( 34) 872-4501 E-mail fpohl@albemarle.org 7/l/14, Revised: 7/10/14, 1/7/14 Page 1 of Iftow 91 B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 0.94 Acres to be disturbed Total Fee Fee Due with this Application 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 91 C. Registration Statement on the official DEQ form. 0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. ® F. Pollution Prevention Plan satisfying the requirements of code section 17-404. W G. 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 Brian McPeters, PE Address 1700 Willow Lawn Drive, Suite 200 City Richmond State VA Zip 23230 Daytime Phone 8( 04) 672-4721 E-mail brian.mcpeters@kimley-horn.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 # Fee Amount $ Date Paid By who? Receipt # Ck# By: 7/1/14, Revised: 7/10/14, 1/7/14 Page 2 of 2 m cm i s Virginia Stormwater Management Program (VSMP) Application for Albemarle County . r A Project Name: Barracks Road Sidewalk Improvements (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 [I County File Number: WP02015-00026 (to be provided by the Countyfor new applications) The following 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. a 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. NA Virginia DOT, Barracks Rd. ROW Tax Map & Parcel Print Name of Property Owner afore Iler Date NA County of Albemarle (Easements) AhA 2/1/17 Tax Map & Parcel Print Name of Property Owner SI gOature of Owner Date �J Tax Map & Parcel Print Name of Property Owner Signature of Owner Date Tax Map & Parcel Print Name of Property Owner Contact Information for the Owner(s) to receive correspondence: Print Name John E. Anderson, PE Address 401 McIntire Road, FES-PMD, COB, 4th floor City Charlottesville Signature of Owner Date Daytime Phone 4( 34 ) 872-4501 E-mail janderson2@albemarle.org 7 --/-f State VA Zip 22902 7/1/14, Revised: 7/10/14, 1/7/14 Page 1 of 2 0 B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed NA, County Acres to be disturbed Total Fee Fee Due with this Application 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 ❑ C. Registration Statement on the official DEQ form. 21 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. ❑ 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. ❑ H. Mitigation Plan satisfying the requirements of code section 17406 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 17422. 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 Brian McPeters, Kimley-Horn & Associates, Inc. Address 1700 Willow Lawn Drive, Suite 200 City Richmond Daytime Phone 8( 04) 672-4721 State VA Zip 23230 E-mail brian.mcpeters@kimley-horn.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 # Fee Amount $ Date Paid By who? Receipt # Ck# By: 7/1/14, Revised: 7/10/14, 1/7/14 Page 2 of 2