HomeMy WebLinkAboutFDP202100014 Application 2022-03-04COUNTY OF ALBEMARLE
Department of Community Development
401 McIntire Road
Charlottesville, Virginia 22902-4596
Phone (434) 296-5832 Fax (434) 972-4126
FLOODPLAIN DEVELOPMENT PERMIT
This form is intended to aid the Department in documenting and characterizing the nature of development proposed in the
floodplain. Development includes buildings or other structures, mining, dredging, filling, grading, paving, excavation or
drilling operations or storage of equipment or materials. The form responses will be used to determine whether a
floodplain impact plan or special use permit is required.
Please check one: X New Submittal with no anticipated floodplain impact (no floodplain impact plan)
❑ New Submittal with an anticipated floodplain impact. Please include a floodplain impact
plan. FEE required with submittal: $323 (Code 18-35.1g)
❑ FEMA Letter of Map Change (LOMA, LOMR) Please include a complete copy ofall
material to be submitted to FEAM. Include any computer models (HEC-RASfles) on a disc.
FEE required with submittal: $161(topographic info only), or $323 (floodplain
modeling)
❑ New Submittal with a Zoning Special Use Permit. Please include a floodplain impact plan.
FEE required with submittal: $323
❑ Resubmittal (Floodplain Development Permit Number ) Please include your
response form from the original submittal. FEE as above required with each resubmittal.
A Floodplain Impact Plan, Special Use Permit, or FEMA Map Change will need to follow Zoning Floodplain Overlay
District requirements (County Code 18-30.3), found at
htto://www.albemarle.ore/unload/imaees/Forms Center/Departments/County Attomev/Forms/Albemarle_ County Code
Ch18 ZonimQ0 Overlay Districts.t)
Section 4 of the Design Standards Manual provides a list of required items to be included in a Floodplain Impact Plan.
This can be found at hM://www.albemarle.orgLepartrnent.asp?department=cdd8uelRage=4447.
-5.141 CftA&1 a,'YCS1A6Lf LGC
Owner Name (Print) Home Phone Office / Other Phone
elitU PL"A
Address
City
Tax Map & Parcel Number 02� So --DI - dU --o004o
Project Name (if applicable) L .(Gw ra1n
Building Permit or Project Number (if applicable) Syi3 Y ai r - UO I S�
Zip Code
lutrzol5
Please describe the nature of the development activity proposed within the floodplain (e.g. new structure, grading for a
playing field, driveway stream crossing, installation of a fence, etc.):
A64-'4C SAON-W7 S,CyA- CA rSF.v4
(Please attach any plans or photos to this application)
1. If a structure is proposed, is the structure accessory to a recreational or agricultural use? Yes ❑ No N/A
2. Does the proposed activity involve a stream crossing for a pedestrian trail or driveway
serving a single family dwelling? Yes ❑ No ® N/A
3. Does any proposed fencing cross a stream channel? Yes ❑ No ® N/A
4. If any fill is proposed, please a proximate the proposed amount of fill in the floodplain A114
Owner / Agent Sign: Date 6/ Yr�o IV
(FOR OFFICE USE ONLY)
Checked By
(for resubmittals) Fee Amount $ Date Paid By
Receipt #
Check
Date
11/1/2015