The URL can be used to link to this page

Home My WebLink AboutWPO201400084 Application 2014-09-18 II iliil `'�. Albemarle CoU tL v Community Development Department 0 401 McIntire Road Charlottesville,VA 22902-4596 °177z!~ Planning Application Voice. (434)296-5832 Fax: (434)972-4126 [PARCEL / OWNER INFORMATION TMP 093A1-00-00-00200 Owner(s): COUNTY OF ALBEMARLE & EAST RIVANNA VOLUNTEER Application # WP0201400084 FIRE CO INC PROPERTY INFORMATION Legal Description GLENMORE PARCEL X FIRE STATION Magisterial Dist. Scottsville Land Use Primary Public Current AFD Not in A/F District Current Zoning Primary Neighborhood Model District (APPLICATION INFORMATION Street Address 3501 STEAMER DR KESWICK, 22947 Entered By Danielle Roth Application Type Water Protection Ordinances 09/19/2014 Project Glenmore Ground Storage Tank, Pump Station, and Water Main Project Received Date 09/18/14 Received Date Final Submittal Date Total Fees 1350 Closing File Date Submittal Date Final Total Paid 1350 Revision Number Comments Legal Ad [SUB APPLICATION(s) Type Sub Applicati Comment Erosion and Sediment Control Plan Stormwater Management/BMP Plan Stream Buffer Mitigation Plan • [APPLICANT/ CONTACT INFORMATION ContactType j Name Address CityState _ Zip j Phone PhoneCell Owner/Applicant COUNTY OF ALBEMARLE & EAST RIVANN 3501 STEAMER DRIVE KESWICK VA 22947 Primary Contact JEREMY M LYNN, P.E.-ACSA 168 SPOTNAP ROAD CHARLOTTESVILL 22947 4349774511 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) E Application for Albemarle County Project Name: Glenmore Ground Storage Tank,Pump Station and Water Main Project (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No $1 Is this a revision or resubmission for review? Yes 0 No IX County File Number: (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. M 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 com fiance with the a proved laps and ermits. Easement acquisition in progress ax ap arce rm ame o ropey caner Signature of Owner Date Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 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 Jeremy M.Lynn,P.E.-Albemarle County Service Authority Address 168 Spotnap Road City Charlottesville State VA Zip 22947 Daytime Phone(434 ) 977-4511 ext. 114 E-mail jlynn@serviceauthority.org 7/1/14,Revised:7/10/14 Page 1 of 2 IX B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed I + 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 $6,100 $3,050 $450 100 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150 Mitigation Plan;$150 C. Registration Statement on the official DEQ form. D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. IX E. Stormwater Management Plan satisfying the requirements of code section 17-403. a4 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. IX G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigati. ' . 's• ' g the requirements of code section 17-406 for any proposed disturbance of stream buffers. Not aoolicable ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408.,No�a oli able ❑ J. Construction Record Drawing . -b '1 . any existing facilities in the proposal satisfying the requirements of code section 17-422 Not aoolicable Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Address City State Zip Daytime Phone( ) E-mail *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# glib COL L' // Q (] Fee Amount$alb� Date Paid 9)�� I'L By who? glib C v nlAlsceceipt#97I 7 Ck#'7735]By yDS vict 7/1/14,Revised:7/10/14 Page 2 of 2