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HomeMy WebLinkAboutWPO201300071 Application 2013-11-21 • c�.ae yF aeeplication for Review of Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & ws- Stream Buffer Mitigation Plan ❑ Erosion & Sediment Control Plan ❑ Stormwater ManagementBMP Plan El Stream Buffer Mitigation Plan El E&S Plan Amendment ❑ SWM Plan Amendment (Previous Plan# ) (Previous Plan # ) ❑ E&S Plan with Variance Request for Exception #of Variances M SWM Plan Resubmittal E&S Plan Resubmittal WPO Application # 9 013 0t'07'_ WPO Application # 2 013 b D o 7 Submit 2 copies each of applicable plans/narrative/computations *When a WPO plan is 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a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Project Name: C D I /vt :eCd J � `� Tax map and parcel: Co /14.3 - `13 - IA raiusl E--( Zoning: (S- 1 Amount of Land Disturbance: 0,y 7 Acres Location of property(landmarks, intersections,or other): jL5-k1 t -Id /)/xi Contact Person(Who should we call/write concerning this project?): jC� a..tr)<�o u- (i Address 1 c(o l (,)m.'`�.lr L. f/ go/ City V r '3 O. State (/A Zip .271-M) Yv Daytime Phone( -'/.'!1 v21/ 3.).20 Fax#Kyfy) )11 3;2,2f E-mail / (�/,.(r I ,/do- �� t-C Owner of Record 57 / - >✓�7 �r'� ?- / LG. ('on nLf e.24/-e_ir To-To //44.s Address /C 7/ 1),4,14.c. City (,Acct qGS Zc c'cN State 114 Zip_,22y a7 Daytime Phone(9/p `/yq - C333 Fax#(Sk) (G//y- Li 5—S— E-mail Contractor Address City State Zip Daytime Phone( ) Fax#( ) 7 E-mail Plan Preparer (ZCr Ass oe dt5 , ,-.nc, }C Address /S—()l C.QMM(I� /�o;, 5c�,/ qe)/ City ( .elf'), , / State VA Zip ) /so,) Daytime Phone(SAID) 021/1- 3 30? 2D Fax#(9/O) c2'/g - „?( E-mail Z.4,4 �(c �.i c�1Z�i . z Owner/Applicant Must Read and Sign By signing this application as owner,I hereby certify that all requirements of the approved Erosion Control Plan,Stormwater Management/BMP Plan,and/or Mitigation Plan 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 plan. Signature of Owner,Contract Purchaser Date Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY 9 2 WPO# y� r } J �j (�I . Fee Amount$ 45©° Date Paid 12,`(3"(-53y who? R 36 LaS()A I1IJ Receipt# q'� ("�Ck# I J-3 32- By: Mai Revised November 14,2011 Page 1 of 3 EROSION CONTROL PLAN: (SSUBMIT 2 COPIES) Land disturbing activity pertaining to single family dwelling unit: 1. Plan Review $150 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 2 Permit and First Year Inspection Fees $150 (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 3. Annual Permit Renewal and Inspection Fees $150 (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 4. Each reinspection $150 (REINSPECTION FEES ARE INVOICED TO THE LANDOWNER) Land disturbing activity pertaining to non-exempt agricultural land: 5. Plan Review $150 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 6. Permit and First Year Inspection Fees $150 (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 7. Annual Permit Renewal and Inspection Fees $150 (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 8. Each reinspection $150 (RE INSPECTION FEES ARE INVOICED TO THE LANDOWNER) All other land disturbing activity: 9. Plan Review, Disturbed Area Less Than One Acre $150 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 10. Permit and First Year Inspection Fees, Disturbed Area Less Than One Acre $200 (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 11. Annual Permit Renewal and Inspection Fees, Disturbed Area Less Than One Acre $200 (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 12. Plan Review, Disturbed Area One Acre or Larger $300 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 13. Permit and First Year Inspection Fees, Disturbed Area One Acre or Larger $100/per disturbed acre (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 14. Annual Permit Renewal and Inspection Fees, Disturbed Area One Acre or Larger $100/per disturbed acre (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 15. Each reinspection $250 (REINSPECTION FEES ARE INVOICED TO THE LANDOWNER) 16. Amendment to Approved Plan $180/per plan review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 17. Variances $150/per request (TO BE PAID AT TIME OF APPLICATION) 18. SUBTOTAL EROSION CONTROL PLAN $ ISO- G� Revised November 14,2011 Page 2 of 3 *we Noe STORMWATER MANAGEMENT/BMP PLAN & MITIGATION PLAN: (SUBMIT 2 COPIES) 19. m Management/BMP ... $300/per plan review (TO tor BE PAID water AT TIME OF APPLICATION Plan AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 20. Major Amendment of Plan $180/per plan review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 21. Request for exception $240 (TO BE PAID AT TIME OF APPLICATION) 22. Request for development in a stream buffer or for reduction or modification of stream buffer and mitigation plan(if not part of another document)—Single family dwelling unit or accessory structure $85 (TO BE PAID AT TIME OF APPLICATION) 23. Each inspection or reinspection $60 (INSPECTION/REINSPECTION FEES ARE INVOICED TO THE LANDOWNER) 24. Mitigation Plan $150 (TO BE PAID AT TIME OF APPLICATION) 25. SUBTOTAL SWM/BMP PLAN $ 36 0 ov TOTAL APPLICATION FEE: (Add lines 18 and 25) $ S G THE OWNER SHALL BE RESPONSIBLE FOR ALL REINSPECTION AND/OR ANNUAL RENEWAL FEES WHICH MAY BE CHARGED TO THIS PROJECT. Revised November 14,2011 Page 3 of 3 Finn Albemarle CO'rr ' Community Development Department 401 ritire Road Charlottesville,VA 22902-4596 13 Voice Application Voice: (434)296-5832 Fax:(434)972-4126 (PARCEL/ OWNER INFORMATION TMPI 061W0-02-0B-001A0 Owner(s): Application # WP0201300071 ]MC ENTERPRISE LLC PROPERTY INFORMATION Legal Description ACREAGE PARCEL El Magisterial Dist. Rio Land Use Primary Office Current AFD Not in A/F District Current Zoning Primary C1 Commercial APPLICATION INFORMATION Street Address Entered By Todd Shiflett Application Type Water Protection Ordinances 11/21/2013 Project (Collins Medical Center Received Date 11/18/13 Received Date Final Submittal Date Total Fees 480 Closing File Date Submittal Date Final Total Paid 480 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applicati j Comment Erosion and Sediment Control Plan (APPLICANT/ CONTACT INFORMATION ContactType Name Address , GltyState Zip Phone m{ i'honeCell owner /Applicant )MC ENTERPRISE i i C 2571 DUKE RD WAYt�E56QRC?V ,2298ti' ;, 'Primary Contact �BALZER&ASSOC.,INC... 1561 COMMERCE RD. STE 40 VERONA,VA 24482 5402483220 "uvvvv y Signature of Contractor or Authorized Agent Date App ication for Review of `"'' ► . ice.. Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & r Stream Buffer Mitigation Plan ❑ Erosion & Sediment Control Plan ❑ Stormwater Management/BMP Plan ❑ Stream Buffer Mitigation Plan rogi E&S Plan Amendment ❑ SWM Plan Amendment (Previous Plan #5-ppzix4-c c,',i) (Previous Plan# ) 14 E&S Plan with Variance ❑Request for Exception #of Variances 1 ❑ SWM Plan Resubmittal ❑ E&S Plan Resubmittal WPO Application# WPO Application# Submit 2 copies each of applicable plans/narrative/computations *When a WPO plan is 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. Project Name: C6.7L-y,;, ,E"p;c-qt_ e .1T L Tax map and parcel: 'T/Y p: 6/k/-Z-TS-/q 1711-447. E.,--/ Zoning: 6- Amount of Land Disturbance: t 17 Acres Location of property(landmarks,intersections,or other): MJ F5�+7 '�}f? - 3c Fr C-4Si er '504.1;.✓e.--c l tz. Contact Person(Who should we call/write concerning this project?): P1jfrt, P 4i2 1 L-Z�-�2- 4 di$ .. Address City State Zip Daytime Phone( ) Fax#( ) E-mail Owner of Record i 44- 7-q2 pA;4i'C , L!_4- - -q)pj6. -r j.vAS 6t,-;-c Address / -7 I D - (2D City AX4fisCi2vie-e State ✓/ Zip 2 Z MO Daytime Phone( ) 94 9-1-333 Fax#( i) 649-42V5-5— E-mail Contractor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer r/LZ 'i 1,� -.--C . Address /9*(4 4),yJ,sy��2,, /Zi7 Sr. - 4,1 City V6-gew4 State V.4 Zip -244-p Z Daytime Phone(64 )2 -'5 Z 2 Fax#(5-;/o ) L4-''j"Z 2--I E-mail jZ-Bt.c%-iegic c..V --2-C j41-- e-i ,Cc Owner/Applicant Must Read and Sign By signing this application as owner,I hereby certify that all requirements of the approved Erosion Control Plan,Stormwater Management/BMP Plan,and/or Mitigation Plan 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 comp h proved plan. SignatLire f Owner,Contract Purchaser Date VA03 A/ Btii-ik p Cam-- 6-fo- Z-f e- 3z zo Print Name Daytime phone number of Signatory FOR OFFICE SE ONLY WPO 4 ir' Fee Amount$ Date Paid i I'�B 1.B who?_ - .)/' A A 7 _ Recei t 4�1 �j1 n Ck# 1 .y ( BY MP Revised November 14,2011 Page 1 of 3 Noe EROSION CONTROL PLAN: (SUBMIT 2 COPIES) Land disturbing activity pertaining to single family dwelling unit: 1. Plan Review $150 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 2 Permit and First Year Inspection Fees $150 (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 3. Annual Permit Renewal and Inspection Fees $150 (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 4. Each reinspection $150 (REINSPECTION FEES ARE INVOICED TO THE LANDOWNER) Land disturbing activity pertaining to non-exempt agricultural land: 5. Plan Review $150 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 6. Permit and First Year Inspection Fees $150 (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 7. Annual Permit Renewal and Inspection Fees $150 (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 8. Each reinspection $150 (REINSPECTION FEES ARE INVOICED TO THE LANDOWNER) All other land disturbing activity: 9. Plan Review, Disturbed Area Less Than One Acre $150 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 10. Permit and First Year Inspection Fees,Disturbed Area Less Than One Acre $200 (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 11. Annual Permit Renewal and Inspection Fees,Disturbed Area Less Than One Acre $200 (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 12. Plan Review,Disturbed Area One Acre or Larger $300 per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 13. Permit and First Year Inspection Fees,Disturbed Area One Acre or Larger $100/per disturbed acre (TO BE PAID PRIOR TO SCHEDULING PRECONSTRUCTION CONFERENCE FOR EROSION CONTROL PERMIT) 14. Annual Permit Renewal and Inspection Fees,Disturbed Area One Acre or Larger $100/per disturbed acre (TO BE PAID ANNUALLY,STARTING WITH SECOND YEAR,UNTIL COMPLETION OF APPROVED PLAN REQUIREMENTS) 15. Each reinspection $250 (REINSPECTION FEES ARE INVOICED TO THE LANDOWNER) 16. Amendment to Approved Plan $180/per plan review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 17. Variances $150/per request . l(2_ (TO BE PAID AT TIME OF APPLICATION) yZ18. SUBTOTAL EROSION CONTROL PLAN $ Revised November 14,2011 Page 2 of 3 • rr.✓ ,.ter STORMWATER MANAGEMENT/BMP PLAN & MITIGATION PLAN: (SUBMIT 2 COPIES) 19. Stormwater Management/BMP Plan $300/per plan review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 20. Major Amendment of Plan $180/per plan review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 21. Request for exception $240 (TO BE PAID AT TIME OF APPLICATION) 22. Request for development in a stream buffer or for reduction or modification of stream buffer and mitigation plan(if not part of another document)—Single family dwelling unit or accessory structure $85 (TO BE PAID AT TIME OF APPLICATION) 23. Each inspection or reinspection $60 (INSPECTION/REINSPECTION FEES ARE INVOICED TO TILE LANDOWNER) 24. Mitigation Plan $150 (TO BE PAID AT TIME OF APPLICATION) 25. SUBTOTAL SWM/BMP PLAN $ TOTAL APPLICATION FEE: (Add lines 18 and 25) $ THE OWNER SHALL BE RESPONSIBLE FOR ALL REINSPECTION AND/OR ANNUAL RENEWAL FEES WHICH MAY BE CHARGED TO THIS PROJECT. Revised November 14,2011 Page 3 of 3