HomeMy WebLinkAboutWPO201900039 Application 2020-06-17A1.yF•fi
Virginia Stormwater Management Program (VSMP)
Application for Albemarle County
I;1C:„I
Project Name: Hillcrest Vineyard Tasting & Venue VSMP (WPO 2019-00039)
(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 R No ❑
County File Number: WPO 2019-00039 (to be provided by the County for new applications)
The following are required elements of new applications Lfrom code section 17-401]. For revisions or
amendments, please indicate which items are being amended. Signatures must be provided for any
submission.
® 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, 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 tg ensure
compliance with the approved plans and permits.
06900-00-00-02000 Augusta Pro. Park, LLC
Tax Map & Parcel
Tax Map & Parcel
Print Name of Owner
Print Name of Owner
Tax Map & Parcel Print Name of Owner
6/15/2020
Date
Signature of Owner Date
Signature of Owner
Date
Tax Map & Parcel Print Name of Owner Signature of Owner Date
Contact Information for the Owner(s) to receive correspondence:
Print Name Michael McGinnis, Jr.
Address PO Box 300
City Lyndhurst State VA Zip 22952
Daytime Phone (540) 836-1383 F.-mail mmcginnis@r717.net
Revised 07/24/18 Page 1 of 2
❑ B. All Fees [Code section 17-208]
For new or modified plans; Total acres proposed to be disturbed 13.24
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
S1,350
$200
5 and less than 10
$3,400
S1,700
S250
10 and less than 50
$4,500
S2,250
$300
50 and less than
100
$6,100
S3,050
S450
100 and more
$9,600
S4,800
$700
For (minor) amendments to an approved plan; EUer review
Variances; $150
Mitigation Plan; $150
❑ C. Registration Statement on the official DEQ form.
io D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. (Amendment)
❑ 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 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 Seth Roderick, PE
Address 250 E. Elizabeth St., Suite 114
CityHarrisonburg StateVA Zip 22802
Daytime Phone (540) 820-0898 E-mail soderick@monteverdedesigns.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 4
Fee Amount $ Date Paid By who Receipt Clot By:
Revised 07/24/18 Page 2 of 2