HomeMy WebLinkAboutWPO202100048 Application 2021-08-30 it br;Cf*--\,
Community DeveiopmentDepartment
Albemarle CQClt?
la
401 M e Road Char/ottesvoi e.VA22902-4596
Voice.(434)296-5832 Fax: 1,434)972-4126
Planning Application
PARCEL I OWNER INFORMATION
IMP 06200-00-00-016D0 Ot^;ner(s): NEW BELVEDERE, INC
Application# WP0202100048
PROPERTY INFORMATION
Legal Description rs<CREAGE PARCEL 1
Magisterial Dist..Rio = Land Use Primary Residential -- Single-family (incl. modular homes
Current AFD Not in A/F District Current Coning Primary R4 Residential
(APPLICATION INFORMATION
Street Address 1358 DUNLORA FARM RD CHARLOTTESVILLE,22901 Entered B
Application Type Water Protection Ordinances yJenpifer Smith
1 8J12021
Project BELVEDERE SUBDIVISION SA - VS11P
Received Date 08/30/21 ! Received Date Final 1 Submittal Date Total Fees 1591.21
Closing File Date Submittal Date Final i Total Paid 1591.21.
Revision Number
Comments
Legal Ad
1SUB APPLICATION(s)
Type �Sub Applicatio Ct n_
•n-eM
Erosion and Sediment Control Plan 08/30/21
Stormwater Management/BMP Plan 08/30/21
APPLICANT / CONTACT INFORMATION
ContaetType Name Address CityState Zip I Phone PhoneCeil
OY,mer/Appiscsr,t NEW BELVEDERE,INC i P.O.BOX 7505 - CHARLOTTE WILL 22906
Ccrtact KEITH LANCASTER `142 SOUTH PANTOPS DRIVE C-HARLOTTESI•ILL 22911 4342450894
=a art FRANK BALLIF 142 SOUTH PANTOPS DRIVE C-HARLOTTESVILL 22911 4342450894 •
Signature of Contractor or Authorized Agent Date
Virginia Stormwater Management Program (VSMP) tArl:7
.Ateki�
Application for Albemarle County :Nq f,t
,, ,t.
Project Name: Bel t/edere. �ti� :�►S vv� S�
(The name should be the same as it appears on plans)
Is this an amendment,modification,or transfer of an approved plan? Yes ❑ No 0
Is this a resubmission for review? Yes 0 No '
County File Number: WPO- (to be provided by the County for new applications)
The following are required elements of new applications[[17-401]. For amendments and resubmissions,
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,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.
ftvf `ci' (a- I GD Sc, tr►r Pro t t - rYl��aftr/t V/ jz r
Tax Map&Parcel Print Name of Owner ' ignature 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. Fr kkl l
Address: I S;; f n-v.Mp( flf�ve_
City.An LetQsui La. State- VA Zip: 22ot 11
Daytime Phone.(Q139)ZuS 1-0814 E-mail:f.,k.Q e S o p -r -of etl tc0 mend_L CP./NA...-
Revised 07/1/21;7/26/2021
El B. All Fees [Code §17-208]
For new or modified plans: Total acres proposed to be disturbed 2 - .
Fee Due with this Transfer or
Acres to be Disturbed Application Modification Fee
Total Fee=(Application Fee+4%Technology Surcharge)
Single Family Dwelling only $171.60 $23.92
Less than 1 acre ($165+$6.60) ($23+$0.92)
Single Family Dwelling only $171.60 $236.08
1 and less than 5 acres ($165+$6.60) ($227+$9 08)
Less than 1 acre $171.60 $20.80
($165+$6.60) ($20+$0.80)
1 and less than 5 acres $1,591.20 $236.08
($1,530+$61.20) ($227+$9.08)
5 and less than 10 acres $2,004.08 $294.32
($1,927+$77.08) ($283+$11.32)
10 and less than 50 acres $2,652.00 $353.60
($2,550+$102) ($340+$13.60)
50 and less than 100 acres $3,596.32 $530.40
($3,458+$138.32) ($510+$20.40)
100 acres or more $5,657.60 $824.72
($5,440+$217.60) ($793+$31.72)
❑ C. Registration Statement on the official DEQ form.
O D. Erosion and Sediment Control Plan satisfying the requirements of Code §17-402.
O E. Stormwater Management Plan satisfying the requirements of Code §17-403.
❑ F. Pollution Prevention Plan satisfying the requirements of Code §17-404.
❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of Code §17-405.
O H. Mitigation Plan satisfying the requirements of Code §17-406 for any proposed disturbance of
stream buffers. $176.80($170 fee+$6.80 technology surcharge)
❑ I. Requested Variations or Exceptions as provided in Code §17-407 and §17-408. $176.80($170 fee+$6.80
technology surcharge)
Provide 2 copies of all plans and any supporting documents or submit all documents online. Professional
seals must have original signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant,or agent):
Name(Print): frP,1 Lrv.,-,..<'(--cT
Address: 1 Li 2-, S o tx-k1. P .•cps Or:ve-
City: C k nr to toi v t(l e State: l/fl• Zip: 229 1 I J
Daytime Phone:(1(3(-I)1-4S-Uri/ E-mail: 'lu,,,,,-„({e r L s o uALe„rr.—dev.e 1p rr,••.Ak,C.r,..e•-,
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6
months from the date of county comments,the application will be deemed withdrawn.Applications without valid owner's
signatures will not be considered valid.Active permitsl are subject to annual maintenance fees [§ 17-208].
FOR OFFICE MI
ONLY
�� WPO# X X. 7tn\�—y�1� P l�(y �� (�` r� \`
Fee Amount$ 1✓ I I a J-Qate Paid �I By who „" ' 1 `11's 1 eceip #V`J3 3 H ck#V 1 Icvty:W
Revised 07/1/21;7/26/2021
. ►4
County of Albemarle 123877
Department of Community Development p IA
�
PH: (434)296-5832 Date ol3`fix
RECEIVED FROM: SokAiun e tV LW ►D MhQmn I) VQ1C\fiWR I-l3M
AMOUNT: $ I__J'"'I i-�ra\(0�
307 3% 1 -�J (�• o`-13 510 (-Check O4 loCU(-Y
For: � - cash
� t'Id r ' ` �rc ceditc
By
041206 ,/ 08/30/21 041206
• Southern Property LLC
VENDOR 110105 Albemarle County
INVOICE DATE DESCRIPTION GROSS AMT DISCOUNT NET PAID
BL 0821 08/26/21 VSMP perm PH 5 1,591 20 00 1,591.20
1,591.20 00 1,591.20
� COUNTYlV1A]
OF ALBS
w :•
Department of Community Develol
40l McIntire;
VS NIP T7� Charlottesville,Virginia 2:
SM pplication Completeness Check
Project Title: lie(,/ec ef( �?
File Number: 'pc /✓«
Date: Z ( �( — 4-'6 y 5 A4 P
Reviewer:
Your application has been checked for completeness per section 17-409 of the County Code. All
items must be received and correct for the application to be deemed complete.
❑ This application is complete and plan review has begun
o This application is not complete. Please provide the missing items
checked below.
Received
Y N Correct
0 Completed application 1' N N/A
0 0 Signatures of the Property Owners for each parcel affected ❑ ❑ ❑
7 0 Correct Fees Paid ❑ ❑ ❑
❑ Registration Statement on the official DEQ form, with correct LDA ❑ ❑ ❑
0 ❑ ' Erosion and-Sediment Control Plan satisfying ❑ ❑ ❑
of code section 17-402.13 the requirements
0 Stormwater Management Plan sanEying the re
s ❑ ❑ o
requirements of code
section 17-403.
❑ ❑ Pollution Prevention Plan sanEying the re
s ❑ ❑ ❑
requirements of code
section 17-404. The EPA template should be used.
/❑ 0 Stornmwater Pollution Prevention Plan satisfying ❑ ❑ ❑
of code section 17-405. The EPA template should e requirements
.Mitigation Plan sans ❑ ❑ ❑
fying the requirements of code section
17-406 for any proposed disturbance of stream buffers.
❑ uested Variations or Exceptions as provided in code sections ❑ o
17-407 and 408,if applicable. (SSF,MMT,etc)
❑ Construction Record Drawings(as-builts)for any existing facilities ❑ ❑u-
in the proposal satisfying the requirements of code section 17-422. p o
./E/
Comments:
a
VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT#:
GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM PLAN/ID#:
CONSTRUCTION ACTIVITIES (VAR10) TECHNICAL CRITERIA: IIB 0 IIC 0
REGISTRATION STATEMENT 2019
Application type. X NEW PERMIT ISSUANCE
(CHOOSE ONE) ❑ MODIFICATION WITH ACREAGE INCREASE
❑ MODIFICATION WITHOUT ACREAGE INCREASE
❑ EXISTING PERMIT RE-ISSUANCE
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 V. (per Part III. K.of the VAR10 Permit).
Operator Name: c„ pro iN LLC_
Contact person: r fir.
Address: i`)Z s Pow-Ao S
City,State and Zip Code: C1,hr,1 eta Wa- VA Qvtl
k
Phone Number: y3y„2t( _p�S't
Primary and CC Email: kto." ti c:em
B. Electronic correspondence. To receive an emailed coverage letter or to pay b'credit card,you must choose YES
and include a valid email. May we transmit correspondence electronically? YES NO ❑
Section II. Construction Activity 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 waterbodies receiving stormwater discharges from the site.
B. Project site location information.
Construction Activity Name: P S tw..NA tU c ir, SA
Address:
City and/or County and Zip Code: �} -2 \
Construction Activity Entrance Location Ik,,r S$riiet ®
(description,street address and/or
latitude/longitude in decimal degrees):
Latitude and Longitude -ig,LFS
(6-digit,decimal degrees format):
32f.Or7 S141, )A99
C. Acreage totals for all land-disturbing activities to be included under this permit coverage. Report to the nearest
one-hundredth of an acre.
Total land area of development(include entire area to be
disturbed as approved in the Stormwater Management Plan): Z A,C..
Primary estimated area to be disturbed(include portions with
Erosion and Sediment Control Plan approval only): 2-rte-
Off-site estimated area to be disturbed(if applicable):
D. Property Owner Status: FEDERAL ❑ STATE CI PUBLIC ❑ PRIVATE,®
E. Nature of the Construction Activity Description(i.e.commercial, Qesda,
industrial, residential,agricultural,environmental, utility):
F. Municipal Separate Storm Sewer System (MS4) name(s)(if the
site is discharging to a MS4):
G. Estimated Project Dates(MM/DD/YYYY).
Start Date: C1 j IS 1 ZI
Completion Date: 9 1S/43
H. Is this construction activity part of a larger common plan of YES rji NO ❑
development or sale?
Rev 11/2020 PAGE 1 J 6
CONSTRUCTION GENERAL PERMIT(VAR10) REGISTRATION STATEMENT 2019
I. 6th Order Hydrologic Unit Code(HUC)and Receiving Water Name(s). include additional areas on a separate page.
HUC NAME(S)OF RECEIVING WATERBODY
(y, a2odoL0 4f0I Rivct 123vel`
Section III. Off-site Support Activity Location Information.
List all off-site support activities and excavated material disposal areas being utilized for this project. Include additional
areas on a separate page.
Off-site Activity Name:
Address:
City or County:
Off-site Activity Entrance Location(description,street
address and/or latitude/longitude in decimal degrees):
Latitude and Longitude(6-digit,decimal degrees format):
Is this off-site activity an excavated material disposal YES❑ NO El
area?
If this off-site activity is an excavated material disposal
area,list the contents of the excavated fill material:
Will a separate VPDES permit cover this off-site activity? YES 0 NO 0
Section IV. 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 YES @] NO ❑
submitted to the VESC Authority for review?
Erosion and Sediment Control Plan Approval Date(for
the estimated area to be disturbed MM/DD/YYYY):
C. Has land-disturbance commenced? YES DA NO❑
D. Annual Standards and Specifications. If this project is utilizing approved Annual Standards and Specifications
(AS&S),attached the completed AS&S Entity Form.
AS&S Entity Name(if different from the Operator
Identified in Section I):
E. Billing information(leave blank if same as the Operator identified in Section I.above). This entity will receive
Annual Permit Maintenance and Permit Modification Fee invoices(if applicable).
Billing Name:
Contact Name:
Address:
City,State and Zip Code:
Phone Number:
Primary and CC Email:
Rev 11/2020 PAGE 2 I 6
CONSTRUCTION GENERAL PERMIT(VAR10)REGISTRATION STATEMENT 2019
Section V. Certification. A person representing the operator as identified in Section I.A. and meeting the requirements
of 9VAC25-880-70. Part Ill. K must physically sign this certification. A typed signature is not acceptable. Please note that
operator is defined in 9VAC25-870-10 as follows:
"Operator"means the owner or operator of any facility or activity subject to the Act and this chapter. In the context of stormwater
associated with a large or small construction activity,operator means any person associated with a construction project that meets
either of the following two criteria:(i)the person has direct operational control over construction plans and specifications,including
the ability to make modifications to those plans and specifications or(ii)the person has day-to-day operational control of those
activities at a project that are necessary to ensure compliance with a storm water pollution prevention plan for the site or other state
permit or VSMP authority permit conditions(i.e.,they are authorized to direct workers at a site to carry out activities required by the
stormwater pollution prevention plan or comply with other permit conditions). in the context of stormwater discharges from
Municipal Separate Storm Sewer Systems(MS4s),operator means the operator of the regulated M54 system.
9VAC25-880-70. Part iii.K.Signatory Requirements.Registration Statement.All Registration Statements shall be signed as follows:
a.For a corporation:by a responsible corporate officer.For the purpose of this chapter,a responsible corporate officer
means:(i)a president,secretary,treasurer,or vice-president of the corporation in charge of a principal business function,or
any other person who performs similar policy-making or decision-making functions for the corporation;or(ii)the manager
of one or more manufacturing,production,or operating facilities,provided the manager is authorized to make management
decisions that govern the operation of the regulated facility including having the explicit or implicit duty of making major
capital investment recommendations,and initiating and directing other comprehensive measures to assure long-term
compliance with environmental laws and regulations;the manager can ensure that the necessary systems are established or
actions taken to gather complete and accurate information for state permit application requirements;and where authority
to sign documents has been assigned or delegated to the manager in accordance with corporate procedures;
b.For a partnership or sole proprietorship:by a general partner or the proprietor,respectively;or
c.For a municipality,state,federal,or other public agency:by either a principal executive officer or ranking elected official.
For purposes of this chapter,a principal executive officer of a public agency includes:(i)the chief executive officer of the
agency or(ii)a senior executive officer having responsibility for the overall operations of a principal geographic unit of the
agency.
Certification: "I certify under penalty of law that I have read and understand this Registration Statement and that this
document and all attachments were prepared in accordance with a system designed to assure that qualified personnel
properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage
the system or those persons directly responsible for gathering the information,the information submitted is to the best
of my knowledge and belief true,accurate,and complete. I am aware that there are significant penalties for submitting
false information including the possibility of fine and imprisonment for knowinggiolations."
Printed Name: Frn.nk ' ►11 /'Ve1frf LCC
Signature(signed in ink): 4"f
Date Signed: c-/z_c, 2 I77 /
l
Section VI.Submittal Instructions. Submit this form to the VSMP Authority. If the locality is the VSMP Authority, please
send your Registration Statement submittal directly to the locality; do NOT send this form to DEQ. A list of local VSMP
Authorities is available here: VSMP Authorities.
If DEQ is the VSMP Authority,please send to: If the locality is the VSMP Authority,please send to:
Department of Environmental Quality The Local VSMP Authorit insert address below
Office of Stormwater Management Suite 1400
PO Box 1105
Richmond VA 23218
constructiongp@deq.virginia.gov
Rev 11/2020 PAGE 3 1 6
❑ B. All Fees [Code §17-208]
For new or modified plans:Total acres proposed to be disturbed Zr
Fee Due with this ! Transfer or
Acres to be Disturbed ! Application Modification Fee
Total Fee=(Application Fee+4%Technology Surcharge)
Single Family Dwelling only $171.60 $23.92
Less than 1 acre ($165+$6.60) ($23+$0.92)
Single Family Dwelling only $171.60 $236.08
1 and less than 5 acres ($165+$6.60) ($227+$9.08)
Less than 1 acre $171.60 $20.80
($165+$6.60) ($20+$0.80)
1 and less than 5 acres $1,591.20 $236.08
($1,530+$61.20) ($227+$9.08)
5 and less than 10 acres $2,004.08 $294.32
($1,927+$77.08) ($283+$11.32)
10 and less than 50 acres $2,652.00 0
($2,550+$102) [$340 40++$1$13.60)
50 and Iess than 100 acres $3,596.32 $530.40
($3,458+$138.32) ($510+$20.40)
100 acres or more $5,657.60 $824.72
($5,440+$217.60) ($793+$31.72)
❑ C. Registration Statement on the official DEQ form.
❑ D. Erosion and Sediment Control Plan satisfying the requirements of Code §17-402.
❑ E. Stormwater Management Plan satisfying the requirements of Code §17-403.
❑ F. Pollution Prevention Plan satisfying the requirements of Code §17-404.
❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of Code §17-405.
❑H. Mitigation Plan satisfying the requirements of Code §17-406 for any proposed disturbance of
stream buffers. $176.80($170 fee+$6.80 technology surcharge)
❑I. Requested Variations or Exceptions as provided in Code §17-407 and§17-408. $176.80(S 170 fee+$6.80
technology surcharge)
Provide 2 copies of all plans and any supporting documents or submit all documents online. Professional
seals must have original signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant,or agent):
Name(Print): L^v.rdC' J`
Address: NZ,Z, S a ukL Pa•1'4n(t r Q�ti
City: Cknrtotot;v:110 State: VA- Zip: 2.Z9 II
Daytime Phone:(L(3(4)ZL1 S-off g i( E-mail: kick.,rA {�r€`?.s 0 t cA1nt,,y"_Jei,t is i,„•,,, ‘c,r„w•-•._
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6
months from the date of county comments,the application will be deemed withdrawn.Applications without valid owner's
signatures will not be considered valid.Active permits are subject to annual maintenance fees[§17-208].
FOR OFFICE USE ONLY WPO#
Fee Amount$ Date Paid By who? Receipt# Ck# _By:
Revised 07/1/21;7/26/2021
Virginia Stormwater Management Program (VSMP) Aetif, t!
Application for Albemarle County ef
'""
Project Name: utt,ete_ S vv� S1t
(The name should be the same as it appears on plans)
Is this an amendment,modification, or transfer of an approved plan? Yes 0 No 0
Is this a resubmission for review? Yes 0 No te
County File Number: WPO-'2021 -r*jpj p9g (to be provided by the County,for new applications)
The following are required elements of new applications[,'17-401J.For amendments and resubmissions,
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,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.
C1.'°,i+a2- 16 0 'SctAtvaelk
Tax Map&Parcel Print Name of Owner ���� g�z6 fa
ignature 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: fr A.v.k. NO k;
Address: 1 Sinaskkk P r.i4or
City:L nvt`tlgSVtt1Q
State: VA Zip: 2Z9
n �(
Daytime Phone:(189)a q S .l' t E-mail: r� �S o c i." .erv.-oo e re tO rme d. C..e,w,._
Revised 07/1/21;7/26/2021
• ATLANTIC UNION BANK 041206
Southern Property, LLC Charlottesville,VA 22911
DBA Southern Development Homes 41e/e14
142 S Pantops Dr
Charlottesville,VA 22911 08/30/2021
PAY TO THE Albemarle County ORDER OF _ ( $ ******1,591.20
EXACTLY*******1,591 DOLLARS AND 20 CENTS
DOLLARS
Albemarle County
401 McIntire Road
Charlottesville, VA 22902-4596 �'""/
MEMO
,.�..SMIS OOCU�NT FONTy,I�,eC�LORF.O BBC(Lpq UNOSS{ HiT�P�gEq.MGROPRNT��OG4rli,��g QNZTN�W4gN_u5y�N{j_„ .__ .
Southern Property,LLC/DBA Southern Development Homes
Southern Property LLC 041206 08/30/21 041,Z�
VENDOR' 110105 Albemarle County
INVOICE DATE DESCRIPTION GROSS AMT DISCOUNT NET PAID
BL 0821 08/26/21 VSMP perm PH 5 1,591.20 .00 1,591.20
1,591.20 .00 1,591 20