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HomeMy WebLinkAboutWPO202100034 Application 2021-06-16Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: Victorian Heights (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 ❑ No County File Number: (to be provided by the County, for new applications) The following are required elements of new applications [from 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 to ensure compliance with the approved plans and permits. 68C2 & 68EO Tax Map & Parcel Tax Map & Parcel Riverbend Development Print Name of Owner Print Name of Owner Tax Map & Parcel Print Name of Owner Tax Map & Parcel Print Name of Owner Contact Information for the Owner(s) to receive correspondence: Print Name Alan Taylor Address 455 2nd Street NE, Suite 400 City Charlottesville Signature of Owner Signature of Owner Signature of Owner Signature of Owner State VA Daytime Phone 4( 34) 245-4970 E-mail alan@riverbenddev.com 617/2'1 Date I1. Zip 22902 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 5_04 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 $1,350 $200 5 and less than 10 1$3,400 $250 10 and less than 50 $4,500 $2,250 $300 50 and less than 100 $6,100 $3,050 $450 100 and more 1 $9,600 1 $4,800 1 $700 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. ® 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. ® L 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 Collins Address 200 Garrett Street, Suite K City Charlottesville Daytime Phone 4( 34) 293-3719 VA E-mail scott@collins-engineering.com 22902 *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 # Fee Amount $ Date Paid Bywh0 Receipt# Ck# By: Revised 07/24/18 Page 2 of 2