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Home My WebLink AboutWPO201800025 Application 2018-04-09 ::;4 Albemarle Co ity CommurntyDevelopment Department t w Aclntire Road Charlottesville,VA22902-4596 Voice. (434)296-5832 Fax•(434)972-4126 Planning Application PARCEL / OWNER INFORMATION TMP 05700-00-00-010AO Owner(s): RIVANNA WATER &SEWER AUTHORITY Application# WP0201800025 PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. White Hall Land Use Primal-, Forest .1 • Current AFD Not in A/F District v Current Zoning Prnnai, Rural Areas .1 APPLICATION INFORMATION Street Address [ Entered By Jennifer Smith.l Application Type Water Protection Ordinanceslw 14`16j2018 Project Crozet Water Treatment Plant Expansion and Rehabilitation Project - VSMP Received Date 04/09/18 Received Date Final r Submittal Cate Total Fees 290 Closing File Date Submittal Date Final Total Paidr 290 Revision Number Comments Legal Ad E SUB APPLICATION(s) Type Sub Applicatio Comment Stormwater Management/BMP Plan 04/09/18 Erosion and Sediment Control Plan 04/09/18 APPLICANT / CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCell RIVANNA WATER&SEWER AUTHORITY 695 MOORES CREEK LN CHARLOTTESVILL 22902 ='_3y c= === DOUGLAS MARCH .3299 WATTS PASSAGE CHARLOTTESVILL 22911 4344090464 • TOM FREEMAN- RIVANNA WATER AND 695 MOORES CREEK LANE :CHARLOTTESVILL s 22902 4349972970 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County ;: Project Name: Crozet Water Treatment Plant Expansion and Rehabilitation Project (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No FE Is this a revision or resubmission for review? Yes 0 No El County File Number: R)if X Fj- CFc 7ZS (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-4011 For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. ® A. Signature of the Property 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. 57-10A (05700-00-00-010A0) 4i pot Si Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 57-29B (05700-00-00-029B0) /20(p Tax Map&Parcel Print Name of Property Owner Signature of Owner ate P rtY � Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Rivanna Water and Sewer Authority-do Tom Freeman Address 695 Moores Creek Lane City Charlottesville State VA Zip 22902 Daytime Phone(434) 997.2970 x170 E-mail TFreeman@rivanna.org 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of2 l B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 0.49 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 $1,350 $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 100 $6,100 $3,050 $450 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150(per request) Mitigation Plan;$150 i C. Registration Statement on the official DEQ form. O D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. l F. Pollution Prevention Plan satisfying the requirements of code section 17-404. El G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. O H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Douglas March Address 3299 Watts Passage City Charlottesville State VA Zip 22911 Daytime Phone(434) 409-0464 E-mail dmarch@sehin.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. Vo FOR OFFICE USE ON{{ 1 LY WPO# [(rpp) — Fee Amount$?�0'v°DatePaiaAN ` V Bywho9 j �1ar\NA k/Vi),�'"Receipt# ( ) Ck# !By. 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2