HomeMy WebLinkAboutWPO201700081 Correspondence 2019-04-01VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY FOR OFFICE USE ONLY
GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM ID Number:
CONSTRUCTION ACTIVITIES (VAR10) Technical Criteria: IIB ❑ HC ❑
REGISTRATION STATEMENT 2019
NEW ISSUANCE ❑ RE -ISSUANCE N
MODIFICATION WITH ACREAGE INCREASE ❑ MODIFICATION WITHOUT ACREAGE INCREASE ❑
Existing Permit Coverage Number (if applicable, VAR10####): VAR10L131 'AJ(14
Section I. Operator/Permittee Information.
A. Construction Activity Operator (Permittee). The person or entity that is applying for permit coverage and will have
operational control over construction activities to ensure compliance with the general permit. A person with
signatory authority for this operator must sign the certification in Section VI. (per Part III. K. of the VAR10 Permit).
Construction Activity
Operator Name: Brookdale Partners, LP
Contact person: William N. Park
Address: 1821 Avon Street, Suite 200
City, State, Zip Code: Charlottesville, VA 22902
Phone Number: 434-979-2900
Primary Email: wpark@pinnacleconstructionva.com
CC Email: gschimming@pinnacleconstructionva.com
B. Billing Information (leave blank if same as the Operator identified in Section I. A. above). This entity will receive
Annual Permit Maintenance and Permit Modification Fee invoices (if applicable).
Name:
Contact Person:
Address:
City, State Zip Code:
Phone Number:
Primary Email:
CC Email:
C. May we transmit correspondence electronically? You must choose YES and include a valid email in order to pay by
credit card and to receive your permit coverage approval letter via email:
YES N NO ❑
Rev 04/2019
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CONSTRUCTION GENERAL PERMIT (VAR10) REGISTRATION STATEMENT 2019
Section II. Construction Activity Location Information. Project site information.
A. Include a site map showing the location of the existing or proposed land -disturbing activities, the limits of land
disturbance, construction entrances and all water bodies receiving stormwater discharges from the site.
B. Construction Activity Name:
Address:
City and/or County and Zip Code:
Latitude and Longitude
(6-digit, decimal degrees format):
C. Construction Activity Entrance Location
(description, street address and/or
latitude/longitude in decimal degrees):
Brookdale
910 Upper Brook Court
Charlottesville, VA 22902
IRO \A/ 74 r) )QrI -
Section III. Offsite Support Activity Location Information. List all offsite support activities to be included under this
permit registration. Enter additional areas on a separate page. Offsite areas not included on this registration may need
to obtain coverage under a separate VPDES permit.
A. Offsite Activity Name:
Address:
City and/or County and Zip Code:
Latitude and Longitude
(6-digit, decimal degrees format):
B. Offsite Activity Entrance Location
(description, street address and/or
latitude/longitude in decimal degrees):
Section IV. Site Information.
A. Acreage totals for all land -disturbing activities to be included under this
permit coverage. Report to the nearest one-hundredthvf an acre.
Total land area of development (including the entire
area to be disturbed as approved in the Stormwater
5.76
Management Plan):
Primary estimated area to be disturbed (portions with
Erosion and Sediment Control Plan approval only):
5.55
Offsite estimated area to be disturbed (if applicable):
C. Property Owner Status:
B. Estimated Project Dates
(MM/DD/YYYY)
Start date: 6/1/2018
Completion date: 6/1/2020
FEDERAL ❑ STATE ❑ PUBLIC ❑ PRIVATE
D. Nature of the Construction Activity Description (i.e.
commercial, industrial, residential, agricultural,
environmental): Residential
E. Municipal Separate Storm Sewer System (MS4)
name (if discharging to a MS4):
Rev 04/2019
,N/A~
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CONSTRUCTION GENERAL PERMIT (VAR10) REGISTRATION STATEMENT 2019
F. Is this construction activity part of a common plan of development or sale? YES ❑ NOIZ
G. 61' Order Hydrologic Unit Code (HUC) and Receiving Water Name(s). Attach a separate list if needed.
HUC RECEIVING WATERBODY(S)
JR15 Moores Creek
Section V. Other Information.
A. A stormwater pollution prevention plan (SWPPP) must be prepared in accordance with the requirements of the
General VPDES Permit for Discharges of Stormwater from Construction Activities prior to submitting the Registration
Statement. By signing the Registration Statement, the operator is certifying that the SWPPP has been prepared.
B. Has an Erosion and Sediment Control Plan been submitted to the VESCP Authority for review? YES ® NO ❑
Erosion and Sediment Control Plan Approval Date (for estimated area to be disturbed).: 1/29/2018
C. Has land disturbance has commenced? YES ® NO ❑
D. If this project is using approved Annual Standards and Specifications (AS&S), attach the completed AS&S Entity
Form. AS&S Entity Name (if different from the Operator identified in Section II. A.):
SEE THE FOLLOWING PAGE FOR SIGNATURE
AND CERTIFICATION REQUIREMENTS AND INFORMATION
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