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Home My WebLink AboutWPO201900028 Application 2019-04-30 Albemarle C0 un` Communitydhr DevelopmentvillaVA22 O2rtment tlt� +;1 i., :Road Charlottesville.VA22902-4596 47 4:d.l (4341 296-5832 Fax:(434)972-4126 • - Planning Application PARCEL j OWNER INFORMATION TMP 02000-00-00-006AD Owner(s): COMBERG, CHRISTIAN A& PAMELA R COMBERG Application# WP0201900028 PROPERTY INFORMATION Legal Description ADVANCE MILLS FARM 24 PH 2 Magisterial Dist. White Hall Land Use Primar, Unassigned Current AFD Not in A/F District E Current Zoning Primary Rural Areas [APPLICATION INFORMATION Street Address [ Entered By — __ — Iiennifer Pritch j Application Type Water Protection Ordinances I `516/2019 Project Advance Mills Farm Lot 24 - VSMP Received Date 04/30/19 Received Date Final 1 Submittal Date Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applicatio Comment 1 Erosion and Sediment Control Plan 04/30/19 1Stormwater Management/BMP Plan 04/30/19 • APPLICANT / CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCell Ow mar..Nppiia rt COMBERG, CHRISTIAN A&PAMELA R 620 FRAYS RIDGE ROAD EARLYSVILLE4'A 22936 Primary Contact JUSTIN SHIMP 912E HIGH ST CH.ARLOTTESVILL 22902 4342275140 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County i': VAT Project Name: ktlikkka.M111S FGIvv&t,& (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No 0 Is this a revision or resubmission for review? Yes; No 0 County File Number: anac')t9 0O02' (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-401J. 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,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. / }� /� /� �/ f�V'W1k0 oiR/Sr/Alv /T, CoM3CAG c, c A /f 2c/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 Tax Map&Parcel Print Name of Owner Signature of Owner Date Contact information for the Owner(s)to receive correspondence Print Name MA�"t" iyt/1. ,,Jy Address City State Zip Daytime Phone( ) E-mail tyl r C^' bl/ti.l i vv, m j Revised 07/24/18 Page 1 of 2 1 Virginia Stormwater Management Program (VSMP) � Application for Albemarle County �' ft :`• t,a y,-/Rm Project Name: MUM (AIRS 1 Qmt,o- a, i (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No�C Is this a revision or resubmission for review? Yes ❑ No.r County File Number: (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-401J. 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,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. ao-tpAl7 OtRis /Ali A. Colit36 G c) , . (-Rf' //Z6./ 20/1-1 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 Tax Map&Parcel Print Name of Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name M/la 'E-1y it Address City • State Zip �h,� Daytime Phone( ) E-mail [ A- 0 LAM,14 W l . (!1�,,�►'n 1 Revised 07/24/18 Page 1 of 2 0 B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 02 - 2-- Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $290 $145 $20 1 and less than 5 $2,700 $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 $6,100 $3,050 $450 100 100 and more $9,600 $4,800 S700 For(minor)amendments to an approved plan;$200 per review Variances;$150 Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. O G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. O H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person forcorrespondence(usually the plan preparer,consultant or agent) Print NamC) A.ST Il I Address qta.E, tit & City 4"4- 4 State VA Zip l2 ` oz. Daytime Phone 0) al l SiE-mail U S 1.--\�p�j �� *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn.Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# nr Fee Amount$L �7t </ Date Paid By who? ,Receipt# Ck# CC By:if) sU� J a1o4LP) Revised 07/24/18 Page 2 of 2