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HomeMy WebLinkAboutWPO201300038 Application 2013-06-03 Albemarle Co`lnty Community Development P Department artment 401 McIntire Road Charlottesville,VA 22902-4596 °_' " Planning Application Voice:(434)296-5832 Fax:(434)972-4126 t PARCEL/ OWNER INFORMATION TMP 07700-00-00-040A0 Owner(s): Application # WP0201300038 RIVANNA WATER & SEWER AUTHORITY PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. Scottsville Land Use Primary Public Current AFD Not in A/F District Current Zoning Primary Light Industry APPLICATION INFORMATION Street Address 1171 N MOORES CREEK LN CHARLOTTESVILLE, 22902 Entered By Todd Shifflett Application Type Water Protection Ordinances 06/03/2013 Project Rivanna Pump Station &Interceptor Tunnel Received Date 06/03/13 Received Date Final Submittal Date Total Fees 960.0000 Closing File Date Submittal Date Final Total Paid 1440 Revision Number Comments Legal Ad SUB APPLICATION(s) Type 1 Sub Applicati I Comment Erosion and Sediment Control Plan 06/04/13 ? • •1APPLICANT/ CONTACT INFORMATION ContactTXpe Name I Address CityState I Zip Phone 1 PhoneCell owner>Appilcant RiVANNNNA WATER&SEWER AUTH61kr Y 695 MOORES CREEK LANE =CHARLO t SVtLI ;23902-90 Primary contact MATTHEW D. BUSWELL 4011 WESTCHASE BLVD. SUI RALEIGH, NC 27607 9198337152 Plan Preparer HAZEN AND SAWYER, PC 4011 WESTCHASE BLVD. SUI RALEIGH, NC 27607 9198337152 Signature of Contractor or Authorized Agent Date x Application for Review of /,°' :. Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & �' Stream Buffer Mitigation Plan ❑ Erosion & Sediment Control Plan ❑ Stormwater 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 [x] SWM Plan Resubmittal [x] E&S Plan Resubmittal WPO Application# WP0201300038 WPO Application# WP0201300038 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a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn.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: NEW RIVANNA PUMP STATION AND RIVANNA INTERCEPTOR TUNNEL Tax map and parcel: 77-40A, 78-21B, 77-385 Zoning: Li Amount of Land Disturbance: 4.7 Acres Location of property(landmarks,intersections,or other): MOORES CREEK WWTP 695 MOORES CREEK LANE, CHARLOTTESVILLE VA 22902 Contact Person(Who should we call/write concerning this project?): MATTHEW D. BUSWELL C/O HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD. SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919 ) 833-7152 Fax#(919) 833-1828 E-mail mbuswell@hazenandsawyer.com Owner of Record RIVANNA WATER AND SEWER AUTHORITY Address 695 MOORES CREEK LANE City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434 ) 977-2970 x 202 Fax#(434) 295-1146 E-mail msimpson@rivanna.org Contractor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919 ) 833-7152 Fax#(919 ) 833-1828 E-mail mbuswell@hazenandsawyer.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, .nd/or Mitigation Plan will be complied with and I have the authority to authorize the land disturbing activities and development on the subjekt property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure 27,11 Hance w' the appr 1 :■ Ilan. I 4 ,3ILI-- Signature o Owner,Co' : t Purchaser Date �11 A ' 1AA _ PA0-34) 610 Ce -aC,oLt Print Name ' D ime p ne number of Signatory FOR OFFICE USE ONLY WPO# Lx - \„r Fee Amount$ qQ G 9° Date Paid Z'3 /By who?2e, •rn ii) -'` 3 Receipt#Cq3 9 ZCk#3(0 0ti) By: D2 Revised November 14,2011 Page 1 of 3 • EROSION CONTROL PLAN: (SJBMIT 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 $ 180.00 Revised November 14,2011 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 $150 (TO BE PAID AT TIME OF APPLICATION) 25. SUBTOTAL SWM/BMP PLAN $ TOTAL APPLICATION FEE: (Add lines 18 and 25) $ 480.00 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 & Stream Buffer Mitigation Plan ❑ Erosion & Sediment Control Plan ❑ Stormwater 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 [x] SWM Plan Resubmittal [x] E&S Plan Resubmittal WPO Application# WP0201300038 WPO Application# wP0201300038 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: NEW RIVANNA PUMP STATION AND RIVANNA INTERCEPTOR TUNNEL Tax map and parcel: 77-40A, 78-21B, 77-38B Zoning: LI Amount of Land Disturbance: 3.4 Acres Location of property(landmarks,intersections,or other): MoORES CREEK wwTP 695 MOORES CREEK LANE, CHARLOTTESVILLE VA 22902 Contact Person(Who should we call/write concerning this project?): MATTHEW D. BUSWELL C/O HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD. SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919 ) 833 7152 Fax#(919 ) 833-1828 E-mail mbuswell@hazenandsawyer.com Owner of Record RIVANNA WATER AND SEWER AUTHORITY Address 695 MOORES CREEK LANE City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434 ) 977-2970 x 202 Fax#(434 ) 295-1146 E-mail msimpson@rivanna.org Contractor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919 ) 833-7152 Fax#(919 ) 833-1828 E-mail mbuswell @hazenandsawyer.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 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. 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 WPO# �{ /'gip pax' /�/ Fee Amount$ Date Paidb' I Ay who'' f'2L1 " Nqt 8eipt#q�j�asel Ck# 11)17".I By.1-J (Z 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 $ 180.00 Revised November 14,2011 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 $150 (TO BE PAID AT TIME OF APPLICATION) 25. SUBTOTAL SWM/BMP PLAN $ TOTAL APPLICATION FEE: (Add lines 18 and 25) $ 480.00 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 -ea- -C- \,, OZoV300036 Application for Review of Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & Stream Buffer Mitigation Plan ❑ Erosion&Sediment Control Plan I Stormwater Management/BMP Plan ❑ Stream Buffer Mitigation Plan [x] E&S Plan Amendment ❑ SWM Plan Amendment (Previous Plan# WP0201200060 (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: NEW RIVANNA PUMP STATION AND RIVANNA INTERCEPTOR TUNNEL Tax map and parcel: 77-40A, 78-21B, 77-38B Zoning: LI Amount of Land Disturbance: 4.2 Acres Location of property(landmarks,intersections,or other): MOORES CREEK WWTP 695 MOORES CREEK LANE, CHARLOTTESVILLE VA 22902 Contact Person(Who should we call/write concerning this project?): MATTHEW D. BUSWELL C/O HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD. SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919) 833-7152 Fax#(919) 833-1828 E-mail mbuswell@hazenandsa wyer.com Owner of Record RIVANNA WATER AND SEWER AUTHORITY Address 695 MOORES CREEK LANE City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434) 977-2970 x 202 Fax#(434) 295-1146 E-mail msimpsonnrivanna.org Contractor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD SUITE 500 City RALEIGH State NC Zip 27607 P DaytimePhone(919) 833-7152 Fax#(919 ) 833-1828 E-mail mbuswellehazenandsa wyer.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/.r Mitigation Plan will be complied with and I have the authority to authorize the land disturbing activities and development on the subject pri pe . I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance w'th the approve, p n. Signature of Owner,Cont .'k •ur' aser Data �f e f I l ' , Si D - 0-,3 4 ) 7 7--a.9 7 0 X Oq Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# Fee Amount Date Paid 7/6/i y who? N -'6c �e.�t�kR�e i p # g1%7 Ck# a d B y: V5 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 $ 180.00 Revised November 14,2011 Page 2 of 3 Nilo" *ewe STORMWATER MANAGEMENT/BMP PLAN&MITIGATION PLAN: (SUBMIT 2 COPIES) 19. Stormwater Management/BMP Plan. . .(..90/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) $ 480.00 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 rare t t; P Print Form I Mail To: CSX Transportation,Inc. FORM CSXT#A01 03/30/09 ATTN:Corridor Occupancy Services Reset Form J 500 Water Street,J-180 Page 1 of 2 Jacksonville,FL 32202 Submittal Must Include Drawin• s and Review Fee s APPLICATION FOR FACILITY/UTILITY INSTALLATIONS Application Date: CSXT File/Agreement Number: C5x 7`32 eiD/ SEC LION 1: FACILITY OWNER INFORMATION TO BE COMPLETED BY APPLICANT Owner/Legal Company Identification Owner's Complete Legal Rivanna Water and Sewer Authority ( � t U � I V E rn Company Name: ( n r Legal Address(1): 695 Moores Creek Lane IC J 2 9 2012 Legal Address(2): PROPTRANSPORTATION ERTY SERVICES City: Charlottesvine State:IVA Zip: 22902 Business Type: 0 Corporation 0 Limited Liability Company 0 Limited Partnership 0 Municipality El Limited Liability Partnership 0 General Partnership State of Incorporation: Virginia Other Business Type-Describe: Political Subdivision Billing Address 0 (Check box if same as above);if not,please complete below. Billing Address(1): Billing Address(2): City: I State:I Zip: Owner Contact Information Contact Name: Michelle Simpson Contact Title: Senior Civil Engineer Office Phone: (434)977-2970 Ext.: 202 Mobile Phone: 434-906-2621 Email: msimpson @rivanna.org Emergency Phone: 434-906-0762 SECTION 2: PROJECT CONTACT INFORMATION TO BE COMPLETED BY APPLICANT $ Chock here if address is the same as legal address above. j', It not the same as above,check here if agreement should be mailed to this address Project Engineer/Consultant/Agent Information Engineer/Consultant/ Hazen and Sawyer,PC Agent Company Name: Contact Name: Matthew Buswell Mailing Address: 4011 Westchase Boulevard,Suite 500 City: Raleigh State: NC Zip: 27607 Office Phone: 919-833-7152 Mobile Phone: Email: mbuswell @hazenandsawyer.com a (XX Application for Facility/Utility Installation FORM CSXT#A01 03/30/09 Page 2 of 2 • • SECTION 3: PROJECT INFORMATION/LOCATION TO BE COMPLETED BY APPLICANT Project Reference Is this covered by an existing CSX permit/agreement or master agreement: ❑ Yes Provide Agreement#and/or date: p No Is this project related to another transaction/project with CSX: • Yes Describe: The proposed installation is a replacement&relocation of an existing utility crossing. ❑ No Provide utility owner project reference number: Copy of approved permit attached. Project Scope Check box to indicate type of installation request ❑ New Installation Request • Upgrade/Repfacement/Relocation of Existing Facilities Will proposed installation connect to an existing facility within railroad corridor ❑ Yes Provide name of connecting facility owner: p No Check all boxes that apply to indicate type of installation request: • Sub-grade ❑ Aerial If"Sub-grade,"check all boxes that apply to indicate proposed method of installation: ❑ Jack&Bore ❑ Horizontal Directional Drill Other Describe: Tunneling Project Description Description/Scope(Include:purpose,scope of work,materials,equipment,geographic features,special conditions): The Rivanna Water and Sewer Authority is proposing to extend their 60"sanitary sewer interceptor from an existing pump station(to be taken out of service)to a new pump station located at the Moores Creek Wastewater Treatment Plant(MCWWTP). In order to complete this project,1,826 linear feet of centrifugally cast fiberglass reinforced polymer mortar(CCFRPM)gravity sewer pipe will be installed through an 8 ft diameter tunnel constructed with a tunnel boring machine. CCFRPM is needed because of the corrosive nature of the wastewater. A work shaft at the proposed pump station and a exit shaft at the existing pump station will be required for construction of the 8 ft diameter tunnel. Intermediate pits will not be necessary for this length of tunneling. The work shaft at the MCWWTP is located approximately 1,000 linear feet from the railroad tracks,and the exit shaft at the existing pump station will be constructed 600 linear feet from the railroad tracks. The 60"gravity sewer pipe will be installed under AAR DOT intersection number 226214R. The tunnel will be installed approximately 80'below the CSX railroad track. A minimum of 290 ft of steel liner plate will be installed directly under the railroad to ensure that the liner plates extend beyond the theoretical railroad embankment line. The steel liner plates will serve as a casing pipe for the 60"gravity sewer line. The annular space between the 60"gravity sewer and the liner plates will be filled with grout. Boring logs have been provided on both sides of the rail road tracks as specified in CSX Railroad's design specifications. The results of these boring logs have been included as apart of this submittal and can be seen on the plan section of the drawings. Once the new Rivanna Pump Station is in service,the existing 36"Force Main will be abandoned in-place. Approximately 85'of the existing force main crosses under the 80'CSX railroad right-of-way,and is appropriately 6'below the railroad tracks. In an effort to meet the requirements of CSX railroad and to ensure that the pipe does not degrade or collapse,the entire abandoned portion of the main will be filled with flowable fill. Project Location City: Charlottesville County: Aibermarle State: Virginia Will facility installation be located entirely within public road right-of-way: 0 Yes Provide AAR/DOT Crossing Inventory Number of Road(posted at crossing): 225214R ❑ No • 2013041,3.39P U:\31037-RAL\31097-042\drawngs\t;IVIL,CSX\CI d.9 9y.BEDWARD)Last Saved 9y bedwards A 5. A m N ear --- Z A _ 40 Ad ` O SO a a I. 1SOd3lIW aV02il1d21 ➢ o V w. a. O N/s+ N ;1 Ao (2 01 n o", m O r Z, yDy k. Fj1 = m-j m N� m Z *M Ir � �1 M ➢Z r- Z C7 Z n t-m < 13. 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Do not submit plans and specifications.Submit 1 copy of this form with all attachments.Form will expand as you enter information. Project Title: (as it appears on plans) New Rivanna Pump Station and Rivanna Interceptor Tunnel P.E. Seal Date on Cover: September 2013 Specifications Title and Date: New Rivanna Pump Station and Rivanna Interceptor Tunnel: September 2013 Location of Project: Moore's Creek Wastewater Treatment County/City: Albemarle/Charlottesville Plant Receiving Wastewater Collection System(s): Moores Creek Wastewater Treatment Plant Receiving Sewage Treatment Plant(s)/Reclamation System: Moores Creek Wastewater Treatment Plant PROJECT OWNER: Rivanna Water and Sewer Authority PROJECT ENGINEER Owner Contact Name:Michelle Simpson Name: Janice R.Carroll Title:Senior Civil Engineer Company Name:Hazen and Sawyer Address:Rivanna Water&Sewer Authority Address:4035 Ridge Top Rd#400, Fairfax,VA 22030 695 Moores Creek Lane Charlotteville,VA 22902 Phone:434-977-2970;202 Phone:703-267-2743;213 Email:msimpson @rivanna.org Email:jcarroll @hazenandsawyer.com Owner Signature and dat : ' ilii I.C 1"3---°'Nf if I 1 3 1 1 For Sewage Tree ent Works and Sewage Collection Systems: Attach Project Description Attach Letter(s)of Acceptance from Receiving Facility/Utility for sewage collection system projects Attach Reliability Class: (1) For Pump Stations attach Reliability Class Worksheet. (2) For Sewage Treatment Plants note the Reliability Class rating from the VPDES or VPA permit and method of meeting reliability classification requirements. For a sewage treatment plant project, provide the VPDES or VPA permit number: VA0025518 Design Sewage Flow(Sewage Plant): (a)average daily flow(MOD): 15(b) peak daily flow(MGD): 37.5 Design Sewage Flow(Pump Station): (a)average daily flow(MGD): 6(b) peak hour flow(MGD): 53 Please check the appropriate components of your project: Gravity and/or Vacuum Sewer ■ New Sewage Treatment Plant ❑ Pump Station(s) 0 Modification of Existing Sewage Treatment Plant ❑ Force Main(s) ❑ Expansion of Existing Sewage Treatment Plant ❑ For Reclamation or Satellite Reclamation System,Attach Page 2: Page 2 Attached? Yes ❑ No l� The following statement must be signed and sealed by the Virginia licensed design engineer: "As discussed in 9 VAC 25-790-240.C., the referenced design documents are in substantial compliance with Part Ill-Manual of Practice For Sewerage Systems and Treatment Works, of the Sewage Colle t" d Treatment Regulations (9 VAC 25-790-310 et seq.)" a ±!y r :v - . C Oa wy Xr J / i. 1 ,� < ,a-�w t�. O b S �V i • �` r �1r :'t.o -34408 =7 I Licensed Design Engineer's Signature and original seal(signed and dated) iCt` `a ❑Design exceptions and justifications are attached in accordance with 9 VAC 25-790-240.C. r,0 `N," (,-,.�► For DEQ use only: ��� # In accordance with the Code of Virginia 1950, as amended,Title 62.1, Section 62A-44.19, this form,signed by the appropriate DEQ representative,constitutes your Certificate to Construct. This Certificate is valid for a period of five years from the date of issuance. Other permits and authorizations may be necessary. Please contact your Regional DEQ Office if you have any questions. Name Signature Date CTC PTL Number Department of Environmental Quality Authorized Representative Note: Once the project is complete,an application for a Certificate to Operate must be submitted to the appropriate DEQ Regional office. Page 1 -03/11/2010 Reliability Classification Worksheet for Sewage Pumping Stations Pump Station Name: New Rivanna Pump Station Location: Charlottesville, Virginia Average Daily Design Flow/Peak Design Flow(MGD/MGD): 6 MGD 153 MGD Complete Part I and Part II of this form, and submit this form with your CTC application. All assessments are based on the average daily design flow of the pump station(not peak flow or current flow). Part I. Reliability Classification Assessment 1. Is the station located in the Dulles Watershed (9 VAC 25-401)or in the Occoquan Watershed (9 VAC 25-410)? ❑ If yes, STOP- Reliability is Class I with special construction requirements (see 9 VAC 25-401 and/or 410). w" If no, proceed to Question 2. 2. The default Reliability Classification for all other pump stations within Virginia is Class I. Is the pump station to be constructed to meet Reliability Class I? ® If yes, STOP- Reliability is Class I. ❑ If no, proceed to Question 3. 3. Is the design average daily flow to the pump station greater than or equal to 0.5 MGD? ❑ If yes, STOP-Reliability is Class I. ❑ If no, proceed to Question 4. 4. Is the pump station located in the any of the following localities? Counties of Accomack, Charles City, Essex, Gloucester, Isle of Wight,James City, King and Queen, King George, King William, Lancaster, Mathews, Middlesex, New Kent, Northampton, Northumberland, Richmond, Southampton, Surry,Westmoreland or York; or Cities of Chesapeake, Franklin, Hampton, Newport News, Norfolk, Poquoson, Portsmouth, Suffolk,Virginia Beach or Williamsburg. ❑ If yes, STOP-Reliability is Class I. ❑ If no, proceed to Question 5. 5. Is a public water supply surface water intake within 5 miles downgradient of the pump station or within 1 tidal cycle upstream of the pump station? [Contact the appropriate field office of VDH's Office of Drinking Water http://www.vdh.virginia.gov/drinkingwater/contacts/. Provide VDH with latitude/longitude information for the pump station and the average and peak design flows.] ❑ If yes, STOP-Reliability is Class I. ❑ If no, proceed to Question 6. 6. If the pump station were to overflow, is there high probability of public contact with the wastewater? [Is the station close to residential/commercial/institutional areas and/or recreational areas(boat landings, posted swimming/fishing/boating areas, parks)such that an overflow would likely present a public health hazard?] ❑ If yes, STOP- Reliability is Class I. ❑ If no, proceed to Question 7. 7. Is average daily design flow to the pump station <2000 gpd? ❑ If yes, STOP- Reliability is Class II. ❑ If no, proceed to Question 8. 8. Is there a perennial surface water located within 1500 ft downgradient of the facility? (Perennial stream defined as a solid blue line on USGS quad map or determined from field investigation.) ❑ If no, STOP- Reliability is Class II. ❑ If yes, proceed to Question 9. Reliability Classification Assessment for Sewage Pump Stations 10/22/10 Page 1 of 2 9. Does the perennial surface water considered in Question 8 above provide less than a 10:1 dilution (7Q10 receiving water flow to average daily design flow); OR is the perennial surface water a 303d listed impaired segment? [See http://www.deo.virginia.gov/wastewater/MunicipalNonWQIFProcedures032010 for location and list of stream gauges and 7Q10 information,and http://www.deq.virainia.gov/woa/303d.html for 303d listings] ❑ If yes to either of the questions, STOP-Reliability is Class I. ❑ If no, STOP- Reliability is Class II. Based on the Part I assessment, the designated reliability classification for this pump station is I. Note that DEQ has determined that Reliability Class III is not protective of water quality and is not a valid classification for a new pump station. Part II. Method of Complying with Reliability Classification For this pump station, select your method of complying with the reliability class requirements. Reference 9 VAC 25-790-390 through 420. Reliability Class I: Option A: Emergency generator with automatic transfer switch or dual electrical feeds, Class I must monitor main power supply, auxiliary power supply,failure of pump to discharge, and high liquid level in wet/dry wells; a test function must also be provided.On-site audio-visual alarm required with telemetry or autodialer to site manned 24 hours a day. ❑ Option B: Permanently installed engine-driven emergency pump. Wet well storage above the high water alarm equal to or greater than documented response time of owner/service provider(i.e., no overflow is allowed).Automatic transfer in the event of a power failure is preferred. The emergency pump must pass the peak flow and must monitor main power supply,failure of pumps to discharge, and high liquid level in wet/dry wells;a test function must also be provided. On-site audio-visual alarm required with telemetry or autodialer to site manned 24 hours a day. Battery or other acceptable backup for pump controls is required. ❑ Option C: 24 hour emergency storage. Class I must monitor main power supply,failure of pump to discharge, and high liquid level in wet/dry wells; a test function must also be provided. On-site audio-visual alarm required with telemetry or autodialer to site manned 24 hours a day. (24 hour storage based on average daily design flow.) ❑ Option D: Closing the facility to eliminate generation of sewage.On-site audio-visual alarm required with telemetry or autodialer to site manned 24 hours a day. (Only available to facilities that will close during a power outage such as schools,certain industries,some recreational and park areas.) ❑ Option E: Portable Equipment(e.g., pumps and generators). [Only available for facilities to be owned and operated by a locality,utility, or service authority.] Wet well storage above the high water alarm equal to or greater than documented response time of owner/service provider. Owner/Service Provider has sufficient portable equipment(see 9 VAC 25-790- 410 for details). Portable pump and/or portable generator hookup provided. Class I must monitor main power supply, failure of pump to discharge, and high liquid level in wet/dry wells; a test function must also be provided.On-site audio- visual alarm required with telemetry or autodialer to site manned 24 hours a day. ❑ Option F: For facilities in the Dulles Watershed Only: In addition to complying with Reliability Class I requirements in 9 VAC 25-790, the facility also complies with 9 VAC 25-401-30.D. ❑ Option G: For facilities in the Occoquan Watershed Only: In addition to complying with Reliability Class I requirements in 9 VAC 25-790,the facility also complies with 9 VAC 25-410-20-F.5. Reliability Class II: ❑ Option A: Portable/standby generator(manual transfer switch or quick connect). On-site audio-visual high water alarm. ❑ Option B: Emergency pump connection(and access to a portable pump). On-site audio-visual high water alarm. ❑ Option C: Closing the facility to eliminate generation of sewage.On-site audio-visual high water alarm. (Only available to facilities that will close during a power outage such as schools, certain industries,some recreational and park areas.) Form to be completed and signed by Design Engineer. Form completed by; (signature) Printed name Janice R. Carroll Reliability Classification Assessment for Sewage Pump Stations 10/22/10 Page 2 of 2 New Rivanna Pump Station and Rivanna Interceptor Tunnel Project Description The Rivanna Water and Sewer Authority (RWSA) operates the Moores Creek WWTP (MCWWTP), and an interceptor system that conveys wastewater to the MCWWTP. The RWSA system serves an overall population of approximately 90,200, and includes 60 miles of interceptor sewer between 8 and 60 inches in diameter. The interceptor system includes seven pump stations, the two largest of which serve the objective of pumping directly to the MCWWTP: the Moores Creek Pump Station (MCPS), which is located on the MCWWTP site, and the Rivanna Pump Station (RPS), which is located off-site in the Woolen Mills neighborhood, adjacent to Riverview Park. The MCPS has recently been upgraded to a firm capacity of 32 mgd. The current firm capacity of the RPS is 25 mgd. The New Rivanna Pump Station and Rivanna Interceptor Tunnel project will increase the firm capacity of the RPS to 53 mgd, and will relocate the RPS to the MCWWTP property. The project will extend the Rivanna Interceptor approximately 1,600 LF by construction of a deep tunnel. The firm capacity for the RPS was determined by a study completed by others. In 2010. the RWSA completed a Comprehensive Sanitary Sewer Interceptor Study (prepared by Greeley and Hansen) that determined the interceptor capacity and peak wet weather flows into the MCWWTP. RWSA, the City of Charlottesville and the Albemarle County Service Authority agreed to design flows for the two pump stations based on a Year 2020 and Year 2060 two-year return period storm hydrograph. In 2011, these parties were placed under Consent Orders by the Virginia Department of Environmental Quality (VADEQ) to reduce I&I in their respective collection systems by 25% by 2020 and to increase the pumping capacity at both the Moores Creek and Rivanna Pump Stations. Based on this agreement, the peak wet weather design flow for the RPS is 53 mgd. The design required for the wet weather flows will accommodate the current annual average flow of 6 mgd though the future projected flow of 12 mgd for the year 2060. The Rivanna Interceptor Tunnel will consist of an approximately 1600 linear feet of 90-inch all rock tunnel with a 60-inch FRP carrier pipe. For the new RPS, a horizontal pump arrangement will be constructed and the pump station will have high and low flow pumps. The odor control technology is chemical scrubber due to the consistent reliability of this technology. The New RPS will discharge into the existing 36-inch Rivanna Force Main. In summary, the following is planned for the new RPS: • Split self-cleaning wet well • 3 horizontal centrifugal pumps per side o Two 350 Horsepower o One 200 Horsepower • Variable Speed Drives with Reduce Voltage Soft Starters • Standby Generator • Chemical Odor Scrubber • Three Influent Channels o 30/35 mgd grinders in two primary channels o Manual Bar Screen Following the construction of the New RPS and the Rivanna Interceptor Tunnel, the existing RPS and its appurtenances will be demolished. The existing Rivanna Force Main that is between the New RPS and the existing RPS will be abandoned in place and filled with flowable fill. Albemarle Comity Community Development Department 40111eIntire Road Charlottesville,VA 22902-4596 t' - Planning Application Voice:(434)296-5832 Fax:(434)972-4126 'PARCEL/ OWNER INFORMATION TMP 07700-00-00-040A0 Owner(s): Application # WP020I300038 RIVANNA WATER &SEWER AUTHORITY PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. Scottsville Land Use Primary Public Current AFD Not in A/F District Current Zoning Primary Light Industry APPLICATION INFORMATION Street Address 1171 N MOORES CREEK LN CHARLOTTESVILLE, 22902 Entered By Todd Shifflett Application Type Water Protection Ordinances 06/03/2013 Project Rivanna Pump Station &Interceptor Tunnel Received Date 06/03/13 Received Date Final Submittal Date Total Fees 180 Closing File Date Submittal Date Final Total Paid 180 Revision Number Comments Legal Ad SUB APPLICATION(s) Type I Sub Applicati I Comment Erosion and::Sediment Control Plan °06/04/13 'APPLICANT/ CONTACT INFORMATION ContactType Name { Address CityState I Zip I Phone { PhoneCell Owner/Applicant ;RIVANNA WATER&SEWER AUTHORITY 1695 MOORES CREEK LANE CHARLOTTESVILL 122902-90 Primary Contact MATTHEW D. BUSWELL 4011 WESTCHASE BLVD.SUI RALEIGH, NC 27607 9198337152 Plan Preparer HAZEN AND SAWYER, PC 4011 WESTCHASE BLVD.SUI RALEIGH, NC 27607 9198337152 Signature of Contractor or Authorized Agent Date VC/ 4 Application for Review of '"; N Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & Stream Buffer Mitigation Plan ❑ Erosion & Sediment Control Plan ❑ Stormwater Management/BMP Plan ❑ Stream Buffer Mitigation Plan N E&S Plan Amendment ❑ SWM Plan Amendment (Previous Plan# WP0201200060 (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: NEW RIVANNA PUMP STATION AND RIVANNA INTERCEPTOR TUNNEL Tax map and parcel: 77-40A, 78-21B, 77-38B Zoning: Li Amount of Land Disturbance: 4.2 Acres Location of property(landmarks,intersections,or other): MOORES CREEK WWTP 695 MOORES CREEK LANE, CHARLOTTESVILLE VA 22902 Contact Person(Who should we call/write concerning this project?): MATTHEW D. BUSWELL C/O HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD. SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919 ) 833-7152 Fax#(919) 833-1828 E-mail mbuswell@hazenandsawyer.com Owner of Record RIVANNA WATER AND SEWER AUTHORITY Address 695 MOORES CREEK LANE City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434 ) 977-2970 x 202 Fax#(434) 295-1146 E-mail msimpson@rivanna.org Contractor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer HAZEN AND SAWYER, PC Address 4011 WESTCHASE BLVD SUITE 500 City RALEIGH State NC Zip 27607 Daytime Phone(919 ) 833-7152 Fax#(919 ) 833-1828 E-mail mbuswell @hazenandsawyer.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 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 operty. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance with the ap rove p n. Signature of Owner,Cont c Purc aself r Date H 1 c k e i �SI �, s c,n e-3 �--) q 77- a 97o e'f-Fay; Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# i�''`` 2 ` C .� r�+ ,n, Fee Amount$ ' Date Paid k J . JBy who? (�I 11Nedeipt# 14 Ck# t�v(_'� By: -(fv JJJ 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 $ 180.00 Revised November 14,2011 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 $150 (TO BE PAID AT TIME OF APPLICATION) 25. SUBTOTAL SWM/BMP PLAN $ TOTAL APPLICATION FEE: (Add lines 18 and 25) $ 180.00 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