HomeMy WebLinkAboutWPO201300016 Application 2013-03-01Application for Review of
Erosion & Sediment Control Plan & Stormwater ManagementBMP Plan &
Stream Buffer Mitigation Plan
Erosion & Sediment Control Plan
E &S Plan Amendment
(Previous Plan #)N 0 - 2013 ~L�)
❑ E &S Plan with Variance
# of Variances
❑ E &S Plan Resubmittal
WPO Application #
Stormwater ManagementBMP Plan
❑ SWM Plan Amendment
(Previous Plan # )
❑ Request for Exception
❑ SWM Plan Resubmittal
WPO Application #
a
n Stream Buffer Mitigation Plan
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county comments, the application will be deemed withdrawn.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: s -flake �t5 Sikbdiyilstm
Tax map and parcel: 1Db—%5A '56,--/55 6V 53 Zoning: '
Amount of Land Disturbance: .V. 44 Acores
Location of property (landmarks, intersections, or other): G X4 epi sivn d� L*514,11
b)-t YG
Contact Person (Who should we call /write concerning this project ?): Sci 6011I)aS -- (611aS V (pi7 G r'citll
Address City State Zip
Daytime Phone (___)
Owner of Record _( r tl
Address
Daytime Phone L_)
Fax # (__)
Fax #
E -mail
City .Lhaidt? oy dE State A Zip ;zg t)z
E -mail
Contractor ((wbend bast lUrrrlt°i ' Inc,
Address Moin Sf. & fe .-d/ City I; m -lb ay e, State VA Zip 2 .2''02
Daytime Phone (___)
Fax #
E -mail
Plan Preparer C611t m ell N erK
Address Q&- yee.'l @`l tLt .. Std City 114W Vi/ /C State Zip ce.`?
Daytime Phone (4?-1) P'3. 576. Fax #. (-_)
E -mail Pert?
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
compli a ith th approt,�ed plan. V
5- / -2 -0 13
Signature of O vner_, nttact Purchaser Date
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONiY WPO
Fee Amount ' .;
$_� • W Date Paid L By who? CO I p By:
)1 �iK Li2 �e w Recei t# � C1;tE 239 3 � �
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 revie
(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 .......................... 190
Revised November 14, 2011 Page 2 of 3
STORMWATER MANAGEMENTBMP 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 .................................................................................. ...............................
$150
(TO BE PAID AT TIME OF APPLICATION)
25. SUBTOTAL SWM/BMP PLAN ...................................................... ............................... $
TOTAL APPLICATION FEE: (Add lines IS and 25) ............... ............................... $ / FI)
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 6f 3
A: lication for Review of Or ;'.
Erosion & Sediment Control Plan & Stormwater ManagementBMP Plan & ,77,1
Stream Buffer Mitigation Plan
Erosion & Sediment Control Plan L' Stormwater ManagementBMP Plan .._,] 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# 241.3- I lv
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. I
Project Name: /es.tIaF-. i--1 11`,) Likb( l' t)lb4
Tax map and parcel: 5b- e sA t S 6,--1.5 I 5(c_ 5 3 Zoning: K 1
Amount of Land Disturbance: .27. Acres
i
Location of property(landmarks,intersections,or other): EY fe 5t r) L) Dell m/ ,., f £h yt
Contact Person(Who should we call/write concerning this project?): S i'c f f. !i//,1MS ° a(1ot5 t'1'4 WI
Address _-Cif State Zip
Daytime Phone` ) Fax#( ) E-mail
Owner of Record Li c `_ti tjulL C'reit- L L C
Address Lz4'ij ivy� w/ City _.L: 1 } e y i ilk State Va —Zip_. '/ _
Daytime Phone( )_ Fax# E-mail
Contractor R t t'Cf J hd b r i vt Iviirkthif, I n k.
Address 5ai C M o th Si, w-fe, x6l_ City _._.1401#twit State VA Zip .4.2i/L2
Daytime Phone( ) Fax#( ) _._ E-mail
Plan PreparerG J
._ r. tl_
Address 2Lts GL;iL f - 1 r`„.74- Silt tj _ city [
I "Y' ) s.0,l/� State ✓� zip ,;�,��t•=
Daytime Phone(441) ,1 Fax#
��__-- ( ___) E-mail 5eG"ii-tfiC.' et iii
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
ManagementBMP 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. 1 hereby grant the County of Albemarle the right to enter upon the property as required to ensure
compli e ith th appr ed plan.
1 V P cV S— /-2-9 6
Signature of Owner,Cc ntract Purchaser
Date
Print Name t tw-. �. 7-47(.4- - y F y S ? Z.r
Daytime phone number of Signatory
FOR OFFICE USE ONLY WPO#
Fee Amount$&Cr Date Paid 1:Z1.1✓) By who? ,t \t,n)'Gnr ceipt#CI j3 Ck# 25 1:� By. 1 Kb
C_
Revised November 14,2011 Page 1 of 3
EROSION CONTROL PLAN: (S.i3MIT 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 $
Revised November 14,2011 Page 2 of 3
'tioro *we
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 $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
0,1.4 - (A,,96)0 13 - f_C
Aication for Review of ..rt'LI
Erosion & Sediment Control Plan & Stormwater Mana ementBMP Plan & .. l ~
Stream Buffer Mitigation Plan '""
It Erosion & Sediment Control Plan Z.Stormwater Management/BMP Plan I 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: N es.-H a,k e ✓j l is S Kb dt v I Sid 4
Tax map and parcel: 5(p–gE7A; 56,-158; 56-- 53 Zoning: 7 -1
Amount of Land Disturbance: ,z7, 44 Acres
Location of property(landmarks,intersections,or other): EX-Fen Sior) e-f` a1 e .i-hall (>i-,ye
Contact Person(Whc should we call/write concerning this project?): SSE)ti- a iiihs -- ll ,.S
kyt'Yt CeYcy
Address City
State Zip
Daytime Phone(_ _j Fax#( ) E-mail
Owner of Record LiCkiit�Ih k CV�k-, LIC
Address :24,,z1 ivy R(&1 '/
Cih' (hark/t t Vt'ille. State yak. ZiP eALZ
Daytime Phone( ) Fax#( ) E-mail
Contractor RC.VCrbend beve fop IA till-, Inc.
Address 52/ C AAA.n 3.f, wilt .z 1 Cit y
ehe it#f e:41/le State VA Zip .22162
Daytime Phone( ) Fax#( ) E-mail
Plan Preparer alit. En1 eir„
,s - e Address 94 7C VP H" JiY Lt City 1 4' l'iGlt"eSvi le State A Zip ,2.2e/4,q-
Daytime Phone(434) ,.Vt3.37lei Fax#( )
E-mail SCrk& t'i aiks ey3,Lerir15-C-Cni.
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
compli e ith th appr9'ed plan. ./ q s-- /-2_9 6
Signature of Owner,C ntract Purchaser `�
Date
,4-te,t,... /2. `T- c-0-'' y 3 y Zys- 99? z
Print Name Daytime phone number of Signatory
g rY
FOR OFFICE USE ONLY WPO#
Fee Amount$ CJ Date Paid / -5°1)By who? / 4 efk) ek4k45A-t
Receipt# 4 a316 Ck#1,25q
i By: Ca
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
(TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) $150 per review
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
(TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) $180/per plan review
17. Variances
(TO BE PAID AT TIME OF APPLICATION) $150/per request
18. SUBTOTAL EROSION CONTROL PLAN $ 3a1)
Revised November 14,2011 Page 2 of 3
STORMWATER MANAGEMENT/BMP PLAN & MITIGATION PLAN: (SUBMIT 2 COPIES)
19. Stormwater Management/BMP Plan...
(TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) $300/per plan review
20. Major Amendment of Plan
(TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) $180/per plan review
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 $ 45
TOTAL APPLICATION FEE: (Add lines 18 and 25) $ -731)
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
'1111 Albemarle COty Community Development Department
40 i clraire Road Charlottesville,VA 22902-4596
�, "` Planning Application Voice:(434)296-5832 Fax:(434)972-4126
PARCEL/ OWNER INFORMATION
TMP 05600-00-00-05300 Owner(s):
LICKINGHOLE CREEK LLC
Application # WP0201300016
PROPERTY INFORMATION
Legal Description ACREAGE
Magisterial Dist. White Hall Land Use Primary Forest
Current AFD Not in A/F District Current Zoning Primary R1 Residential
APPLICATION INFORMATION
Street Address Entered By
Todd Shifflett
Application Type Water Protection Ordinances 03/01/2013
Project 'Westlake Hills- Phase 1
Received Date 02/28/13 Received Date Final Submittal Date 02/28/13 Total Fees 600
Closing File Date Submittal Date Final Total Paid 600
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Type. ,,, Sub A••licati Comment
Erosion and Sediment Control Plan 02/28/13
Stormwater Management/BMP Plan 02/28/13
'APPLICANT/ CONTACT INFORMATION
ContactTXpe Name w , .Address I CityState I Zip Phone PhoneCell
Owner/Applicant 1 L CK1NGF1OLE CREEK LLC 100 10TH ST ME SUXTF 301 CHAR.LQTI SVILi x 29021 '
Primary Contact COLLINS ENGINEERING 200 GARRETT SKEET,SUITE CHAR-LOTTESVILL 22902 4342933719
Applicant RIVERBEND MANAGEMENT 321 E. MAIN STREET NE CHARLOTTESVILL 22902 4342454900
Signature of Contractor or Authorized Agent Date
A``p' lication for Review of ~_ k
Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & , ;.
Stream Buffer Mitigation Plan
tg Erosion& Sediment Control Plan XStormwater Management/BMP Plan ❑ 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: th-41TL44 ( /l)L,t f - PfrAg sE: _ 610) 12 ? ,
Tax map and parcel: 5 SS, SI-95i� fd•9$A Zoning: /2-/ "�tJ
Amount of Land Disturbance: Acres
Location of property(landmarks,intersections,or other): ("On O f 4,47 h146t /)M,,/t , 70 PA Astir
OP &-ASP-ivArs[ ,l°H041 ]T.
Contact Person(Who should we call/write concerning this project?): C-I,LLIA,J Af,... ../C,i-„,�(/
Address 2.40 6144.01.4,7 Sjl SV//c k City CL/61,f State
Zip ZZfdZ
Daytime Phone ./31 Z 43” 37/'' Fax#( ) E-mail Sc.:Fe 41,41.,/• 4,...A. -v,I
Owner of Record L!(.A y44,14( Ci6Ve / ae..
Address /(70 Po` ,r7,4 ,4r /V e.
s-t+.71'+ 301 City G1,144.4 State / Zip 22 702
Daytime Phone( ) Fax#
Antev4 7 ( ) E-mail
Contractor /2g _/.f4.' "Cos/T
Address 32 I E. ft 4V I $r—. 5' M Zo 4 i
/ City ! /L dir State 1.41 Zip Z Z'702
Daytime Phone )) 29s-- 9 fol. Fax#( ) E-mail
ho
Plan Preparer t .L.CL.( .tt„,/(4i14...-C
Address 2060 G,Qyft./Ct r7" S7. dv6)( A. City - ti/Gt,4 State
LP/ Zip oL2 fat
Daytime Phone( ) Fax#( ) E-mail
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 wyl the appr ved an.
-17—q/ 17
Signature oo wner,Contra Purchaser Date
M16,—._ 7-7--/ •-n,'7 Z L C (f ?2-
Print Name J Daytime phone number of Signatory
FOR OFFICE USE ONLY WPO# c Cs 1,3-jb
Fee Amount SUNK-) Date Paid 2:2k&0 By who?2I\tQ r ini I ian t#90252 Ck# 1 2-165 B (�� al
Y: 1 I vaA J
Revised November 14,2011 Page 1 of 3
Niume
EROSION CONTROL PLAN: (SUBMIT 2 COPIES)
Noe
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 $ 3a)
Revised November 14,2011 Page 2 of 3
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STORMWATER MANAGEMENT/BMP PLAN & MITIGATION PLAN: (SUBMIT 2 COPIES)
19. Stormwater Management/BMP Plan.
(TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) 300/per pla 1 @w
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 $ 7kG
TOTAL APPLICATION FEE: (Add lines 18 and 25) $ �a(�
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