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HomeMy WebLinkAboutWPO202000010 Application 2020-05-15Virginia Stormwater Management Program (VSNIP) Application for Albemarle County 1 Project Name: STOUDT PROPERTY 1lie nunre .should he the scrnre u.r (t rpl errs on plans) Is this an amendment to an approved plan? Yes ❑ No© Is this a revision or resubmission for review? Yes © Nor-1 County File Number: WP0202000010 to )e provided hr the Coanrtr f(n• ilk' It, upphculrons] 111e 1bUou'ing are required elenlel)ls o, 17ell- C1p1)1iva1101ZS r%1"0/17 coele seelion 17-401/. i'or rel'isions of a171el7C1111e11LS, plecise indiccae it-hich 1lenu are bein CIlIwnclect .ail tatures / usi be 1)/Yll'lt1('t1 f01' Ct/71 .Slibi 7ission. ® 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 oir, ner, I hereht certify that all requirements of these plans anti permits v, ill be complied ii ith, And I have the authorit- to authorize the land disturbing activities and de,. elopment on the subject property. I hereb% grant the County of Albemarle the right to enter upon the roperty as required to ensure compliance rl ith the approved plans and permits. w 17-18F 1':►\ Map & PETER & ALICE STOUDT alvel Pi int Lgame of Oliner Tug Map & Parcel Print Name t►f thracr -Cap Map &� Parcel Print Name of shiner W Date signature of Oliner pate Nignature of Oliner Date -1 a\ Map & Parcel Print Name of Ulmer Signature of Wrier Date Contact Inftn-nlation for the 0%xiier(ti) to receiic correspondence Print Name Peter & Alice Stoudt Add, -es.,; 2278 Chapel Spring Lane Cit-, Free Union State VA /ill 22940 Dal -time Phone !_) E-mail Revised 07/2-1/11) 1'a,,e I oft RI B. All Fees [Code section 17-208] For neu or modified plans: Total acres proposed to be disturbed 0.99 ac RIC JD RI E. RI F. ®G Acres to be disturbed Less than 1 -l'otal FCC Fee Due n-tth this Applicalion $1 i 5f -- — Fee with Transfer or mcxiilication ofpernut $20- -- $290 I and less than 5 $2,700 $1.350 $200 3 and less than 10 $3A00 $ t-700 $2-5 10 and less than 50 $4.500 $2.250 $3U0 SU and less than IUU $C,,IUU $3.050 --1 —$450 IUU and more $9,6UU $4.900 $700 For (minor) amendments to an approved plan: $200 per review Variances: $150 Miti-a►ion Plan: $1 ill 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. 91. 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. M-ovicle ? copies of all plans and C1111° s11pp0/7117- clociclllc'IIIS. P1-(Y..4.5-ioI1CI1.SCaI.S IIIII.C1 11C1Ye 01'i lnal .vi malure.s% AtIditiunal iii1brnlation if not proYiclecl on plems and documents: Name of -a Contact Person for correspondence (usually the plan preparer_ consultant or agent) Print Name Justin Shimp Address 912 East High St. City Charlottesville State VA dip 22902 Daytime Phone t; 434 227-5140 _ E-mail justin@shimp-engineering.com "When applications and plans are reviewed, but not approved, and a response to comments is not received within ! months from the date of county comments, the application will Ire deemed withdrawn. Applications without valid mi ner's signatures will not he considered valid. FOR 01;11C'L USE. ONLY IVPO Fee r�nutmt S Date Paid Ry WIIki' Receipt = lt. Rv: Revised 07/24/18 Page 2 of 2