HomeMy WebLinkAboutWPO201900042 Application 2020-05-04Virginia Stormwater Management Program (VSMP) Pes
Application for Albemarle County
Project Name: SPRINGHILL VILLAGE
(The name should be the same as it appears on plane)
Is this an amendment to an approved plan? Yes 0 No ❑
Is this a revision or resubmission for review? Yea ❑ No 0
County File Number: WP02019-00042 (to be provided by the Countyfor new applicmiom)
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.
0 A. Signature of the 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,) 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. 1 hereby grant the County of Albemarle the right to enter upon the property n required to ensure
compliance with the approved plans and permits. on/ - �
5-4-20
Tax Map & Parcel Print Name of Owner Signature of Owner Date
Tax Map &Parcel Print Name of Owner Signature of Owner Date
Tax Map & Parcel Print Name of Owner Signature of Owner Date
Contact Information for the Outcasts) to receive comespondance:
Print Name SPRING HILL LAND DEVELOPMENT, LLC
Address 2635 S BENNINGTON ROAD
City CHARLOTTESVILLE State VA zip 22901
Revised 07/24/18 Page 1 of
0 B. All Fees [Code section 17-208]
For new or modified plans; Total acres proposed to be disturbed 15.32 AC
Acres to be
disturbed
Total Fee
Fee Due with this
Application
Fee with Tmmfer or
modification of permit
Less than 1
E290
$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 plimCROer review
Variances; $150
Mitigation Plan; $150
❑ 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.
❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17405.
❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ 1. 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 1 copies ofall plans and any supporting documents. Professional seals most have original
signatures.
Additional information if not provided on plans and documents:
Name of Contact Person for correspondence (usually the plan prepai er, consultant or agent)
Print Name SCOTT COLLINS - COLLINS ENGINEERING
Address 200 GARRETT STREET, SURE K
Ciry CHARLOTTESVILLE State VA Zip 229M
Daytime Phone(434) 293-3719 Dmail scottlilicollins-engineenng.com
•When applications and plans arc 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 WPON
Fw Amounts Date Pdd------jBs vfiot RaeiptM C'hl ar.
Revised 07/24/18 Page 2 of 2