HomeMy WebLinkAboutWPO202100010 Application 2022-09-20Virginia Stormwater Management Program (VSMP)
Application for Albemarle County
Project Name: Belvedere Phase 3 Block 10
(Yhe name should be the same as it appears on plans)
Is this an amendment, modification, or transfer of an approved plan? Yes 0 No W
Is this a resubmission for review? Yes iz No o
County File Number: WPO-2021-00010 (to beProvided by the Countyfor new applications)
Thefollowing are required elements of new applications [§] 7-401]. For amendments and resubmissions,
please indicate which items are being amended. Signatures must be providedfor any submission.
10 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.
062A3-00-00-001 BO Belvedere Long Holdings, LLC cr/'
I as Map & Parcel Print Name of Owner Sivnatiirp. nf n�.�,�
I ax Map & Parcel Print Name of Owner Signature of Owner Date
I ax map & Parcel Print Name of owner Signature of Owner Date
I ax map & Parcel Print Name of Owner Signature of 0 vn�erDatc
Contact Information for the Owner(s) to receive correspondence:
Print Name: Andrew Dondero
Address: 455 2nd St. SE, Suite 201
Charlottesville
Daytime Phone:
VA Zin- 22902
Revised 07/1/21; 7/26/2021; 4/26/2022
1013. All Fees [Code §17-208]
For new or
Odified plans: Total acres to
ed to be disturbed 19.56
is
Fee Due with this Transfer or
�a r or
nsf�
Acres to be Disturbed
T r
Application Modification Fee
odi Icatlon Fee
PTotal Fee = (Application Fee + 4% Technology Surchargc)
% TM olg argc)
Single Family Dwelling only
$171.60
$23.92
Less than I acre
�6 'r
($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 I 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 + S77.08)
(S283 + $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
(S5,440 + $217.60)
($793 + $31.72)
OC. Amendments to an approved plan. Fee = $236.08 per review ($227 fee + $9.08 technology surcharge)
2 D. Registration Statement on the official DEQ form.
10 E. Erosion and Sediment Control Plan satisfying the requirements of Code § 17-402.
10 F. Stonlawater Management Plan satisf��g the requirements of Code § 17-403.
10 G. Pollution Prevention Plan satisfying the requirements of Code § 17-404.
10 H. Stormwater Pollution Prevention Plan satisfying the requirements of Code § 17-405.
1:11. Mitigation Plan satisfying the requirements of Code § 17-406 for any proposed disturbance of
stream buffers. $176.80 (S170 fee + S6.80 technology surcharge)
Ll J. Requested Variations or Exceptions as provided in Code §17-407 and §17-408. $176.80 ($170 fee � $6 80
technology surchuge)
Provide 2 copies ol all Plans and any supporting documents or submit all documenty online. Professional
seals must have original signatures.
Additional information if notprovided onplans and documents:
Name of a Contact Person for correspondence (usually the plan preparer, consultant, or agent):
Name (Print)- Alex Flint
Address: 999 2nd St. SE
Charlottesville
VA 7i�- 22902
Daytime Phone: (AM) _77-25 E-mail: aflint@roudabush.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. Active oermits are quhiert t. M2;-te ----- I— le .1 1..�
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FOR OFFICE USE ONLY WPO #
Fee A-o-t $_Date paio__By �ho? —Rcee'Pt h�--Ckk--By: