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WPO201300012 Application 2013-02-11
Application for Review of 4 <,c Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & Stream Buffer Mitigation Plan ❑ Erosion& Sediment Control Plan ❑ Stormwater Management/BMP Plan ❑ Stream Buffer Mitigation Plan ',CE&S Plan Amendment ❑SWM Plan Amendment (Previous Plan# ) (Previous Plan# ) ❑ E&S Plan with Variance ❑Request for Exception #of Variances ❑ 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a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn.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: t 11t (- 1 i CA-m1't I w Pe I✓I/4 EAU T Tax map and parcel: 7 7 4 Az-el- Zoning: 7 j e W A)T z% "A) (1 O r ir'd 4-( Amount of Land Disturbance: ! '9 Acres �I �,J q,,, / Location of property(landmarks,intersections,or other): (d,�/�,� , v� (p2Lt Z-� r !S is PC% >f/T/u►'+A r� ( A go! Contact Person(Who should we call/write concerning this project?): ( c- i ,4--/L)aLA- Address /i.�4' Cad NZ(V1 City ( L22 7 State Zip 22.1 3 Daytime Phone(( ► .tA 42Z:©2 0 Fax#( ) E-mail fl � .-c1,/Y13.7u,/a 6`'y4Di I Ltrlt') Owner of Record ( /� o 2 i �N t 7`L t) M(-'/ -?o))i .l• Address 1156. C LG City ' 'U-A I State V i Zip 12432 Daytime Phone(4✓ 87'23--4-4'2U Fax#(4-F4-42-3'- 44/ E-mail ()/1 fCt 6"' CP07- / vMG -- v Contractor Nor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer DA f° A—M-1 t 1) /4-7j1--(oL1) A-7 c 7A-7-7-' ,/ Address 3f/ / C4'// f (i P / /f. City (�e ZA.Ja. d_i) State VA Zip 72 f 4 Daytime Phone(47.44-u..--300 Fax#( ) E-mail PA-1/71)C` AM/4°"/LA- CO 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 co Banc with a �/r.({o/v/�fe��d plan. r/�� �///�//�////��,. Jr �/O- Signature of Owner,Contract Pu aser Date 1 MI6"1kL- C-ArA it ,04 JI. —0 z) Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# _ Fee Amount$ a W Date Paid 4'4,1 By who. 11( � �i+� ill, Receipt#Q)95 Ck# 1 x By Revised November 14,2011 Page 1 of 3 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 (TO BE PAID AT TIME OF APPLICATION) 18. SUBTOTAL EROSION CONTROL PLAN $ 3& o 1 Revised November 14,2011 Page 2 of 3 -Raw' Nemo 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 (INS PECTION/REINSPECTION FEES ARE INVOICED TO THE 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 Application for Review of Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & Buffer Mitigation Plan Erosion & Sediment Control Plan PO Stormwater Management/BMP Plan Ink Stream Buffer Mitigation Plan ❑ E&S Plan Amendment ❑SWM Plan Amendment (Previous Plan# ) (Previous Plan# ) El E&S Plan with Variance ❑Request for Exception #of Variances ❑ SWM Plan Resubmittal El 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: CHURCH CAMPUS IMPROVEMENTS Tax map and parcel: TM 56A2-01-17 Zoning: DOWNTOWN CROZET DISTRICT Amount of Land Disturbance: /, 17 Acres Location of property(landmarks,intersections,or other): CORNER OF RT.240 AND JARMAN'S GAP ROAD Contact Person(Who should we call/write concerning this project?): MR.DAVID ANHOLD,LLA-ANHOLD ASSOCIATES Address 8311 ROCKFISH GAP TRNPK. City GREENWOOD State VA Zip 22943 Daytime Phone(434) 882-3420 Fax#( ) E-mail DAVID @ANHOLDLA.COM Owner of Record CROZET UNITED METHODIST CHURCH,C/O REVEREND DOUG FORRESTER Address 1156 CROZET AVENUE City CROZET State VA Zip 22932 Daytime Phone(434) 823-4420 Fax#(434)823-8441 E-mail OFFICE(I CROZETUMC.ORG Contractor NOT AVAILABLE AT THIS TIME Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer DAVID ANHOLD-ANHOLD ASSOCIATES Address 8311 ROCKFISH GAP TRNPK. City GREENWOOD State VA Zip 22943 Daytime Phone(434)882-3420 Fax#( ) E-mail DAVID @ANHOLDLA.COM 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 dev lopment on the subject property. I heretxv grant the County of Albemarle the right to enter upon the property as required to ensure co?ip$anee with AI approved plan. c1,- 10L3 Signat re of Owner,ContracaPtir.thaser Date attne. � .�_�. — 434-y.6_o-4'933- Print Name Chour- `;Boar di- of -r +ces Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# Fee Amount S Date Paid By who? Receipt a Ck# By: Revised March 4,2010 Page 1 of 3 Application for Review of �) Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & Stream Buffer Mitigation Plan X] Erosion & Sediment Control Plan 1113 Stormwater Management/BMP Plan lEgi Stream Buffer Mitigation Plan ❑ E&S Plan Amendment ❑ SWM Plan Amendment (Previous Plan# ) (Previous Plan# ) ❑ E&S Plan with Variance ❑ Request for Exception #of Variances ❑ 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: CHURCH CAMPUS IMPROVEMENTS Tax map and parcel: TM 56A2-01-17 Zoning: DOWNTOWN CROZET DISTRICT Amount of Land Disturbance: b 9:74. Acres Location of property(landmarks,intersections,or other): CORNER OF RT.240 AND JARMAN'S GAP ROAD Contact Person(Who should we call/write concerning this project?): MR.DAVID ANHOLD,LLA-ANHOLD ASSOCIATES Address 8311 ROCKFISH GAP TRNPK. City GREENWOOD State VA Zip 22943 Daytime Phone(434) 882-3420 Fax#( ) E-mail DAVID@@ANHOLDLA.COM Owner of Record CROZET UNITED METHODIST CHURCH,C/O REVEREND DOUG FORRESTER Address 1156 CROZET AVENUE City CROZET State VA Zip 22932 Daytime Phone(434) 823-4420 Fax#(434)823-8441 E-mail OFFICE@,CROZETUMC.ORG Contractor NOT AVAILABLE AT THIS TIME Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer DAVID ANHOLD-ANHOLD ASSOCIATES Address 8311 ROCKFISH GAP TRNPK. City GREENWOOD State VA Zip 22943 Daytime Phone(434)882-3420 Fax#( ) E-mail DAVID @ANHOLDLA.COM 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 dev lopment on the subject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure colft lance with4 a roved plan. 11 • -ZI�13 Sign:ture of Owner,Con ct P haser Date • Banc o ex `, T q X10!- 93.3 Print Name L+h ' f . 'Board of Thwites Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# Fee Amount S Date Paid By who? Receipt# Ck# By: Revised March 4,2010 Page 1 of 3 .oimer `I;i Albemarle COQ 1 ty Community Development Department 401 McIntire Road Charlottesville,VA 22902-4596 tr - 1 Planning Application Voice:(434)296-5832 Fax:(434)972-4126 PARCEL/ OWNER INFORMATION TMP 056A2-01-00-01700 Owner(s): CROZET UNITED METHODIST CHURCH C/O REV DOUG Application # WP0201300012 FORRESTER PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. White Hall Land Use Primary Semi-public Current AFD Not in A/F District Current Zoning Primary Downtown Crozet District APPLICATION INFORMATION Street Address 1156 CROZET AVE CROZET, 22932 Entered By Jennifer Durrer Application Type Water Protection Ordinances 02/11/2013 Project CHURCH CAMPUS IMPROVEMENTS Received Date 02/11/13 Received Date Final Submittal Date 02/11/13 Total Fees 300 Closing File Date Submittal Date Final Total Paid 300 Revision Number Comments Legal Ad SUB APPLICATION(s) Type h Sub APQhcatl Comment Erosion and Sediment Control Plan l 02/11/13 ; APPLICANT/ CONTACT INFORMATION ContactType I Name I Address CityState 1 Zip Phone PhoneCell owne€/AIicant CROZET UNITED METHODIST CHURCH C 10'0 SOX 70 _CROZET VA 22932; Primary Contact DAV AN IDHOLD 8311 ROCKFISH GAP TURNPI GREENWOOD,VA,22943 4348823420 General Contractor TBD Signature of Contractor or Authorized Agent Date Application for Review of �\ Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & r..'",:: Stream Buffer Mitigation Plan NJ Erosion & Sediment Control Plan TO Stormwater Management/BMP Plan Ink Stream Buffer Mitigation Plan ❑ E&S Plan Amendment ❑ SWM Plan Amendment (Previous Plan# ) (Previous Plan# ) ❑ E&S Plan with Variance ❑ Request for Exception #of Variances ❑ SWM Plan Resubmittal ❑ E&S Plan Resubmittal WPO Application# WPO Application # Submit 2 copies each of applicableplans/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: CHURCH CAMPUS IMPROVEMENTS Tax map and parcel: TM 56A2-01-17 Zoning: DOWNTOWN CROZET DISTRICT Amount of Land Disturbance: / V-- Acres Location of property(landmarks,intersections,or other): CORNER OF RT.240 AND JARMAN'S GAP ROAD Contact Person(Who should we call/write concerning this project?): MR.DAVID ANHOLD,LLA-ANHOLD ASSOCIATES Address 8311 ROCKFISH GAP TRNPK. City GREENWOOD State VA Zip 22943 Daytime Phone(434) 882-3420 Fax#( ) E-mail DAVID @ANHOLDLA.COM Owner of Record CROZET UNITED METHODIST CHURCH,C/O REVEREND DOUG FORRESTER Address 1156 CROZET AVENUE City CROZET State VA Zip 22932 Daytime Phone(434) 823-4420 Fax#(434) 823-8441 E-mail OFFICE @CROZETUMC.ORG Contractor NOT AVAILABLE AT THIS TIME Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer DAVID ANHOLD-ANHOLD ASSOCIATES Address 831 I ROCKFISH GAP TRNPK. City GREENWOOD State VA Zip 22943 Daytime Phone(434)882-3420 Fax#( ) E-mail DAVID @ANHOLDLA.COM 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 dev lopment on the subject property. I here grant the County of Albemarle the right to enter upon the property as required to ensure co `rance with a roved plan. �l� . Jr. 747A- 2 7.$1/1 3 Signature of Owner,Contract P haser g Date /14'' (i L- C ii,li 4. Jam_ A- 4 '/ -4 2-e3gc, Print Name fl//AJf ' p Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# Fee Amount$ = Date Paid 21 0 By who: '6 0 (Aryt Receipt# i&t2/) Ck# [2-0 By: `L/ (t1 ) Revised March 4,2010 Page 1 of 3 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) 0'Ian 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 $760/per request (TO BE PAID AT TIME OF APPLICATION) 18. SUBTOTAL EROSION CONTROL PLAN $ 300 Revised March 4,2010 Page 2 of 3 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 THE LANDOWNER) 24. Mitigation Plan $860 (TO BE PAID AT TIME OF APPLICATION) 25. SUBTOTAL SWM/BMP PLAN $ TOTAL APPLICATION FEE: (Add lines 18 and 25) $ NOT REQUIRED THE OWNER SHALL BE RESPONSIBLE FOR ALL REINSPECTION AND/OR ANNUAL RENEWAL FEES WHICH MAY BE CHARGED TO THIS PROJECT. Revised March 4,2010 Page 3 of 3