Loading...
HomeMy WebLinkAboutWPO201800051 Action Letter 2022-09-20 oFA v.vir• - - , .. � ®w ///.0.9/ 7.-- friii-ao V COUNTY OF ALBEMARLE Department of Community Development 401 McIntire Road,North Wing Charlottesville,Virginia 22902-4596 Phone (434)296-5832 Fax (434)972-4126 0 EROSION CONTROL PERFORMANCE BOND RELEASE 0 MITIGATION PERFORMANCE BOND RELEASE VSTORMWATER MANAGEMENT PERFORMANCE BOND RELEASE PROJECT NAME: �C�C,c)k.. ; U \$ScvLp `3�.cx. 6-e0A--onCAQr 5l� ) PLAN/PERMITNO.: W Q 0 aC7( 000 5 I Date As-built plan was approved b Engine ring Division: .—/8-2.'2— or N/A DEQ Termination Date .O Z Z'_or N/A DEQ Permit No.: OAR 17 ill Ha( or N/A , If townhomes in a Common Plan,list Common Plan DEQ Permit No.: N 1 4 This project has been satisfactorily completed and the performance bond may be released at this time if all re-ins ction and annual maintenance fees invoiced have been p id. �^ DATE: g 2 Z Ero on Control Inspector Community Development Department All fees invoiced on the above project have been / ed. Director of Commu ity Dev Iopment/Coun y Engineer � Date Cc: Ana Kilmer Revised:04/11/2022 VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM CONSTRUCTION ACTIVITIES (VAR10) NOTICE OF TERMINATION 2019 Permit Coverage Number(VAR10####): VAR10M149 Section I. Operator/Permittee Information.The person or entity that has active permit coverage approval and operational control over construction activities to ensure compliance with the general permit. A person with signatory authority for this operator must sign the certification in Section VII(per Part Ill. K.of the VAR10 Permit). Construction Activity Operator Name: Brookhill Apartments, LLC Contact Person: Adam Swartout Address: 230 Court Squar ; Suite 202 City,State,Zip Code: Charlottesvill , VA 22902 Phone Number: 434-962- 96 Primary Email: aswart t@castledp.com CC Email: Section II. Construction Activity Location Information. Project site information. Construction Activity Name: Brookhill Development Block 4 Address: Rt 29 Seminole Trail Rd and Rt 643 Polo Ground Rd City and/or County and Zip Code: Charlottesville (Albemarle County) 22902 Latitude and Longitude 78° 27' 17.77/38° 06' 13.47 (6-digit,decimal degrees format): Section III. Reason for Terminating Coverage under the General Permit. The operator shall submit a Notice of Termination within 30 days after meeting one or more of the following conditions(select one or more): XA. Necessary permanent control measures included in the SWPPP for the site are in place and functioning effectively and final stabilization has been achieved on all portions of the site for which the operator is responsible.When applicable,long-term responsibility and maintenance requirements for permanent control measures shall be recorded in the local land records prior to the submission of a Notice of Termination; ❑ B.Another operator has assumed control over all areas of the site that have not been finally stabilized and obtained coverage for the ongoing discharge; ❑ C.Coverage under an alternative VPDES or state permit has been obtained;or ❑ D.For residential construction only,temporary soil stabilization has been completed,the operator has provided written notification to the homeowner about the importance of final stabilization and incorporating a copy of the notification and signed certification statement into the SWPPP, and the residence has been transferred to the homeowner. Rev 04/2019 PAGE 1 16 CONSTRUCTION GENERAL PERMIT (VAR10) NOTICE OF TERMINATION 2019 Section IV. Participation in a Regional Stormwater Management Plan. If your site discharges to a regional stormwater management facility, provide information related to the regional stormwater management plan. Attach a separate list if discharging to multiple regional facilities. Regional Stormwater Management Facility Type: Address: City and/or County and Zip Code: Latitude and Longitude (6-digit, decimal degrees format): Total Acres Treated by Regional Facility (report to one-hundredth of an acre): Impervious Acres Treated by Regional Facility (report to one-hundredth of an acre): Section V. Perpetual Nutrient Credits. If your site is utilizing nutrient credits, provide information related to the perpetual nutrient credits that were acquired in accordance with § 62.1-44.15:35 of the Code of Virginia.Attach a separate list if needed. Nonpoint Nutrient Credit Generating Entity NELCO Holdings, LLC (Bank Name): Perpetual Nutrient Credits Acquired (pounds/acres/year): 0 33 pounds/year Include the affidavit of sale for all nutrient credits acquired. Is the affidavit of sale of nutrient credits attached? ®YES NO Section VI. Permanent Control Measures. If applicable, list the post-development stormwater management facilities or best management practices(BMPs)that were constructed and installed as part of this activity to comply with the stormwater management technical criteria (structural and nonstructural, on-site and off-site). Attach a separate list if needed. If you have permanent control measures,the following items are required to be included with this form in order to complete your Notice of Termination submittal: ® A. Engineer's Certification Statement ® B. As-built plans(construction record drawings)—digital ❑ C. As-built plans(construction record drawings)—full-sized, paper ® D. Stormwater Management Plans—digital ® E. BMP Maintenance Agreement—notarized original,for public and private projects under DEQ's VSMP Authority Stormwater Management Facility Types(please choose from the following bmp types): Bioretention 1 Extended detention-enhanced Other IIC(manufactured Soil Amendments Bioretention 2 Filtering Practice 1 treatment device,etc.) Urban Bioretention Bioretention basin Filtering Practice 2 Permeable Pavement 1 Vegetated filter strip Bioretention filter Grass Channel Permeable Pavement 2 Vegetated Roof 1 Constructed Wetland 1 Grassed swale Rainwater Harvesting Vegetated Roof 2 Constructed Wetland 2 Infiltration(1 x WQ Vol) Retention basin I(3 x WQ Vol) Wet Pond 1 Constructed wetlands Infiltration(2 x WQ Vol) Retention basin II(4 x WQ Vol) Wet Pond 2 Dry Swale 1 Infiltration 1 Retention basin III(4 x WQ Vol Wet Swale 1 Dry Swale 2 Infiltration 2 with aquatic bench) Wet Swale 2 Extended detention(2 x WQ Vol) Other IIB(manufactured Sand filter Extended Detention Pond 1 treatment device,etc.) Sheetflow to Vegetated Filter or Extended Detention Pond 2 Conserved Open Space 2 Rev 04/2019 PAGE 2 16 CONSTRUCTION GENERAL PERMIT(VAR10)NOTICE OF TERMINATION 2019 Stormwater Management Facility#1 nn g BMP Type: 1P : S( E-K(3w'io'V67> txr-ED C%L. c&f nr E12vcDO,S, Date BMP Became Functional: 1 -2 1 Address(if available): `183— C i iw- C(Z City and/or County and Zip Code: e14.4121.0715) utw L 22?O2- Latitude and Longitude (6-digit,decimal degrees format): 3 8, /G 79 —78, cgfLf 2, Receiving Water(s) (outfall discharge): 12-1uAoasdPi Total Acres Treated (report to one-hundredth of an acre): 1, 2 y Impervious Acres Treated (report to one-hundredth of an acre): d• 26— i Stormwater Management Facility#2 BMP Type: P4RR1' E)( e OOA Dcrea4-r,-Popo r Date BMP Became Functional: 3 1'2 Address(if available): 118 CQi4rrai--3 G2 City and/or County and Zip Code: ( -Li9'EC IW£ 22g0 'a Latitude and Longitude o o t it (6-digit,decimal degrees format): O/o /6.4R, -s.78 2.7 2 l• 3 3 Receiving Water(s) (outfall discharge): Total Acres Treated (report to one-hundredth of an acre): 2 I r4L Impervious Acres Treated (report to one-hundredth of an acre): 3,30 A L Stormwater Management Facility#3 BMP Type: PI �'x7f i t�o-� ©a+� 2-- Date BMP Became Functional: )^2 Address(if available): "j 8 ga1{r City and/or County and Zip Code: C'- ' r 'Jk•W L 2-2.' O Z Latitude and Longitude a ,� �• (6-digit,decimal degrees format): 38 ` 30,23 '7p 27� 19, 37 t Receiving Water(s) (outfall discharge): 1` A'" \V Total Acres Treated (report to one-hundredth of an acre): 5 t 0_i f}L Impervious Acres Treated (report to one-hundredth of an acre): 3,70 4c_ Rev 04/2019 PAGE 3 16 CONSTRUCTION GENERAL PERMIT(VAR, e • - s 'MINATION 2019 Stormwa r Management Facility# etenti•- •• d wit :,• 0'4 Ietent 0 .nd CD 'retrea menx Structure BMP Type: — - Date BM Became Functional: Marth 1, 2021 Add -ss(if available): 485 Crafton Circl: City and/or County a d Zip code: Charlottesville(Albemarle Count 22902 Latitude and ongitude 78° 27' 21.3,3", 38° 06' 16 99" (6-digit,decimal degrees •rmat): Receiving Wa er(s) Downstream pond on adjace •roperty (WP•'01800013), with ultimate/ (outfall dischar:e): outfall to Rivanna River \ /' Total Acres Treat_• A L/ '\ ) (report to one-hundredth of an acre).4. 5' l Impervious Acres Treated /� (report to one-hundredth of an acre): 3 aC S ,z. 1 Stormwater Management Facility#2 . , ,/1� �pe�f BMP Type: v, J c Mar - 121 Date BMP Became Functional: 485 Cr.fton Circle Address(if available): City and/or County and Zip Code: Ch. rlotte•ville (Albemarle County) 22902 Latitude and Longitude ; ° 27' 15. ", 38° 06' 28.40" (6-digit,decimal degrees format): Receiving Water(s) (outfall discharg Existing on-sit: stream, with ultimate outfall to Rivanna River Total Acres Tre. ed (report to one-hundredth of an •cre): ''V/acres Z ` Impervious Acres eated (report to one-hundredth of :n acre): 0.25 acres g•e; 6 777‘eff-- Stormwater Managem, t Facility#3/ Extended De tion Pon'Af \vith I.olator Row Pretreatment Structure BMP Type. \ I March 1, 2021 Date BMP :ecame Functional: 485 Crafton Circle Address(if available): City a ./or county and zip Code: Charlottesville (Albe arle aw u ',y) 22902 Latitude and Longitude 780 27' 19.37", 38° 06' 30.2 " (6-• git,decimal degrees format): Receiving Water(s) Existing on-siteetream, with , Iti at outf II to Rivanna River (outfall discharge): Total Acres Treated eport to one-hundredth of an acre '82 acres �� r, c g i . Impervious Acres Treated ' 70 acres (report to one-hundredth of an acre): Rev 04/2019 PAGE 3 16 r u 5`e'E c�7cf /ER A r --nn&4Jv4£s P�9( 3((o p p N .)44-S' . CONSTRUCTION GENERAL PERMIT(VAR10) NOTICE OF TERMINATION 2019 Section VII. Certification. This Certification must be signed by a person representing the operator identified in Section I. and meeting the requirements of 9VAC25-880-70 Part III K. Certification: "I certify under penalty of law that I have read and understand this Notice of Termination and that this document and all attachments were prepared in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information,the information submitted is to the best of my knowledge and belief true, accurate,and complete. I am aware that there are significant penalties for submitting false information including the possibility of fine and imprisonment for knowing violations." /� Printed Name: A DA ,ti /' t Sc� A -r Signature (signed in ink): Date: 7/l( / Section VIII.Submittal Instructions. Please submit this form to the Virginia Stormwater Management Program (VSMP)Authority that has jurisdiction for your construction activity. If the locality is the VSMP Authority, please submit your form directly to the locality;do NOT send this form to DEQ. A list of local VSMP Authorities is available here: VSMP Authorities. If DEQ is the VSMP Authority, please send to: If the locality is the VSMP Authority, please send to: Department of Environmental Quality The Local VSMP Authority(insert address below) Office of Stormwater Management Suite 1400 PO Box 1105 Richmond VA 23218 constructiongp@deo.virginia.gov Permit terminations may be delayed if there are outstanding annual permit maintenance fee balances due. Rev 04/2019 PAGE 4 16 COUNTY OF ALBEMARLE Community Development 401 McIntire Road Charlottesville,Vriginia 22902-4596 (434)296-5832 EROSION CONTROL PERMIT Date of Application: 06/26/2018 Permit Effective Date: 02/25/2019 Number: WPO-20 1 8-0005 1 DEQ Permit#: VAR10M149 LANDOWNER: HAUGH,CHARLES R&E J OGLESBY JR T Phone: 435 PARK ST CHARLOTTES VILLEVA22901 CONTRACTOR: A.G.Dillard;DJ Banton Phone: (434)906-2165 295 Memory Lane Troy,VA 22974 REPONSIBLE LAND Delton Banton Phone: (434)906-2165 DISTURBER: 295 Memory Lane Troy,VA22974 Certification/License#: 07934 Type: Responsible Land Disturber Plans Prepared By: Bohler Engineering Plans Dated: 12/20/2018 Last Revised: Plans Entitled: Brookhill Blks 4A and 4B Apartments Location: Dist. 19.26 Acreage: Tax Map: 04600-00-00-01800 Hydrological JR08 04600-00-00-01900 Unit: 04600-00-00-018A0 Additional Information: Annual Maintenance Fees[Sections 17-207&208 of the Albemarle County Code]-Annual maintenance fees will be assessed in March of every year this permit is active. Fees cannot be prorated after the first year of permit issuance. Issued By:Kenny Thacker Title:Erosion Control Officer cp C -ZS- '/ -.1'47 Signature Date Request for Pre-construction Meeting and Grading Permit from Albemarle County 41$10" Approved Plan Number: WPO- 2U I 700 U Approved Plan Name: trovkkl (( 1310(4-5 yq an4 YE? Arfe.tisie.h V ra►hta ,/orMk/k d- m.44.....A4- Pio " (Plans must be approved prior to a pre-construction meeting.) (I Bond issued date: ^/,<} Bond Number: ,V/A (Bonds must be approved and posted prior to a pre-construction meeting or permit.) Responsible Land Disturber: ,• ._ 12 44h Pq✓!4orl Print Name: ..� •'' •� • �1•�,� . State Certification Number: 01/ 3/ ,,/ ) Daytime Phone(-,)f) 9 04 � C - E-mail (i{✓/ Q 71/1//A4.Gowi Primary Contractor: Print Name 4, C,t . Pix rI •• VS .,4-0.7 Address 2 q 6 Mandl �b►.t City �(b J State Zip 2IA/ Daytime Phone(VI) /0i Z/G7 E-mail di di 114 e • cos, Permit Issuance and First Year Maintenance Fees: (Request must include payment) Total acres proposed to be disturbed is contained on the approved plan and application: VSMP: Acres to be disturbed Fee Due at Grading Permit Less than 1 $63.80 1 and less than 5 $594.00 5 and less than 10 $748.00 4- 10 and less than 50 $990.00 TAM 50 and less than 100 $1,342.00 100 and more $2,112.00 For plans exempt from VSMP, VESCP fees were paid with the application. 7/1/14,Revised: 7/10/14 Page 1 of 3 RECEIVED JAN 1 7 7019 COMMUNITY DEVELOPMENT Person(s)to attend the Pre-construction Meeting: Names(type or print) Firm Contact Number or email Ado SwA/4'u1A' Ca t .,-- N34- 102- ?GI B ,e9 4 , Yu .BOI le,r S +".ly V' n5 y DT 134 ko- AG 9;Ilf.41 431- 40.4 -Z16c Trill 1Rec- 'Pillk*of 4Y1- Dory Tea .51',W on 12%�c(,eJ TaNde-Q9pw. " - ', 'I- 3/65i ' i2y'h GTood ts.h l5izelw (oNsirv&,h f►i 7t N 'Sl i/ - 2IC$' e Pa C v�Y /3/iz cN cord-rya,.o n Z' l 11 The second part of the application fee is required to be paid with this request. This fee amount is; FOR OFFICE USE ONLY Permit Issued Date By who? Fee Received C 0t0 Received Date RECEIVED' t t 1(.°1 JAN 1 7 7n19 Received By COMMUNITY' DEVELOPMENT • 7/1/14,Revised: 7/10/14 Page 2 of 3 information for Permit applicants; 9-Month Permanent Stabilization Deadline: Code Sec. 17-808 Duty to stabilize denuded areas with permanent vegetation within nine months after commencing land disturbing activity A. When permanent vegetation required. The owner shall install on all denuded areas on the site within nine(9) months after the date the land disturbing activity commenced,except for areas that the administrator determines are necessary parts of the construction that are subject to an active building permit and areas where erosion is prevented by a non-erosive surface,including,but not limited to,the following surfaces: (i) roadways and sidewalks covered by gravel,asphalt pavement,or concrete;(ii)trails or paths covered by gravel,stone dust,or mulch; (iii)buildings and other permanent structures;and such other surfaces that the administrator determines would adequately provide a permanent barrier to erosion. (see code 17-808 for information about possible extensions) Notice to Comply and Permit Revoked for Overdue Fees Late fees will incur interest,and enforcement actions per code section 17-210. (1) Owners with late payments of fees required by 17-207C6 will be issued a Notice to Comply(NTC). The notice gives 7 days to make payments. (2) At the end of the NTC time period,the permit will be revoked,and a Stop Work Order will be issued for working without a current permit. Disturbed Area Reductions Acreage for the purpose of fee computations will be the entire permitted acreage. This is the disturbed acreage on approved plans. If fees are to be reduced,an application for plan amendment must be made,and areas reduced by changes in limits of disturbance and appropriate plan changes. Such amendments must be approved prior to the fee due date. Amendments to remove disturbed areas can only be approved when such areas are completely stabilized and all erosion control measures(including traps and basins)removed. Refunds The County does not have a refund program. Fees will not be refunded based on completion within the year. Fees will not be pro-rated at payment,other than the first year VSMP fee as indicated in code section 17-209B. Re-inspection Fees Re-Inspection Fees will be charged for inspections following a Notice to Comply or a Stop Work Order. Fees are$250 per inspection,or as given in code sections 17-207 and 17-208. 7/1/14,Revised:7/10/14 Page 3 of 3 /Y* . Albemarle Coun Community Development Department l� *�; 401 h re Road Charlottesville,VA22902-4596 tW J '" Voice:(434)296-5832 Fax:(434)972-4126 Planning Application PARCEL70WNER INFORMATION IMP 04600-00-00-01800 Owner(s): HAUGH, CHARLES R&E J OGLESBY JR T Application# WP0201800051 PROPERTY INFORMATION Legal Description PARCEL A + -/ Magisterial Dist Rivanna Land Use Primal-, Residential -- Single-family (incl. modular homes' Current AFD Not in A/F District v Current Zoning Primary Neighborhood Model District iv! ;APPLICATION INFORMATION Street Address ;2571 SEMINOLE TRL CHARLOTTESVILLE, 22911 Entered By Application Type Water Protection Ordinances (� Je26/201fer mith 16,•`26J2018 Project BROOKHILL VSMP FOR BLOCK 4 (APARTMENTS) - VSMP - DIGITAL Received Date 06/26/18 Received Date Final ! Submittal Date Total Fee_. 2250 _I Closing File Date Submittal Date Final Total Paid j 2250 Revision Number Comments �_.. .. Legal Ad SUB APPLICATION(s) Type I Sub Applicatio( Comment Stormwater Management/BMP Plan 06/26/18 Erosion and Sediment Control Plan 06/26/18 APPLICANT / CONTACT INFORMATION ContactType Name Address j CityState Zip Phone PhoneCell __ = HAUGH, CHARLES RA E J OGLESBY JRT i 435 PARK ST CHARLOTTESVILL 1 22901 • _ = _ RYAN YAUGER.P.E. 28 BLACKWELL PARK LANE, 'WARRENTON,VA 20187 5403494500 ALAN TAYLOR-RIVERBEND :455 SECOND STREET SE, CHARLOTTESVILL 22903 4342454932 Signature of Contractor or Authorized Agent Date of AlAt Virginia Stormwater Management Program (VSMP) . Application for Albemarle County Project Name: Brookhill Virginia Stormwater Management Plan for Block 4(Apartments) (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No El Is this a revision or resubmission for review? Yes 0 No El County File Number: (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-401J. For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. ® A. Signature of the Property Owner for each parcel: (Required with every submission or revision, NOT TO BE SIGNED BY AN AGENT OR CONSULTANT) By signing this application as the owner,I hereby certify that all requirements of these plans and permits will be complied with,and I have the authority to authorize the land disturbing activities and development on the subject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance with the approved plans and permits. HAUGH, CHARLES R& E J 04600-00-00-01800 OGLESBY JR TRUSTEES f°Lr✓"— Tax Map&Parcel Print Name of Property Owner Signature of•ewner ..I,a,. Date CROCKETT CORPORATION C/O 04600-00-00-01900 HAUGH &HELVIN Tax Map&Parcel Print Name of Property Owner Signature of Date HAUGH, CHARLES R & E J 04600-00-00-018A0 OGLESBY JR TRUSTEES Tax Map&Parcel Print Name of Property Owner Signature of•Owtter Ikm -• I Date Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Alan Taylor Address 455 Second Street SE,Suite 400 City Charlottesville State VA Zip 22903 Daytime Phone(434 ) 245-4932 E-mail alan@riverbenddev.com 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 3 B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 16.64 Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than I $290 $145 $20 1 and less than 5 $2,700 $1,350 $200 5 and Tess than 10 $3,400 $1,700 $250 10 and less than 50 $4,500 $2,250 $300 50 and less than 100 $• 6,100 $3,1750 $450 100 and more $• 9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150(per request) Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. 0 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Ryan Yauger,P.E. Address 28 Blackwell Park Lane,Suite 201 City Warrenton State VA Zip 20187 Daytime Phone(540 ) 349-4500 E-mail ryauger@bohlereng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdraw n. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt## Ck# By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 • • Virginia Stormwater Management Program (VSMP) Application for Albemarle County VOL Project Name: Brookhill Virginia Stormwater Management Plan for Block 4(Apartments) (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes El No Is this a revision or resubmission for review? Yes El No NI County File Number: WPO201800051 (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-4011 For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. 0:1 A. Signature of the Property Owner for each parcel: (Required with every submission or revision, NOT TO BE SIGNED BY AN AGENT OR CONSULTANT) By signing this application as the owner,I hereby certify that all requirements of these plans and permits will be complied with,and I have the authority to authorize the land disturbing activities and development on the subject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance with the approved plans and permits. HAUGH, CHARLES R& E J 04600-00-00-01800 OGLESBY JR TRUSTEES 9/20/18 Tax Map&Parcel Print Name of Property Owner Signature of'Owrrer ..kYwv4 F.,••Lr w- Date CROCKETT CORPORATION C/O 04600-00-00-01900 HAUGH & HELVIN 9/20/18 Tax Map&Parcel Print Name of Property Owner Signature of Date HAUGH, CHARLES R & E J 04600-00-00-018A0 OGLESBY JR TRUSTEES 9/20/18 Tax Map&Parcel Print Name of Property Owner Signature of Owrtcr Date Tax Map& Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Alan Taylor Address 455 Second Street SE, Suite 400 City Charlottesville State VA Zip 22903 Daytime Phone(434 ) 245-4932 E-mail alan@riverbenddev.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of2 4 111 B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 16.64 Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $290 $145 $20 1 and less than 5 $2,700 $1,350 $200 5 and less than 10 $3,400 $1,700 $250 10 and less than 50 $4,500 $2,250 $300 50 and less than 100 $6,100 $3,050 $450 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150(per request) Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Ryan Yauger,P.E. Address 28 Blackwell Park Lane,Suite 201 City Warrenton State VA Zip 20187 Daytime Phone(540 ) 349-4500 E-mail ryauger@bohlereng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who9 Receipt# Ck# By 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 • RECEIVED SEP 1 4 21118 COMMUNITY DEVELOPMENT 1Q 4 Date Received: 11 I LQ I G FeePaid: a50•Received by: -I Matt [ '' '�'!!!,' 9'P /l/, //U �( � Intake: Forward to Management Analyst LmAit `�RGIT4�P REQUEST TO ESTABLISH A BOND APPROVED PLAN # WP0201800051 PROJECT NAME: Brookhill Block 4(Apartments) (As listed on the approved plan) All parcels in the project, including any off-site work if easements are not provided, and current owners. Use a separate sheet if more owners are required. Owner and tax map information must be correct, and plans must be approved prior to bond estimates being prepared. TAX MAPs/PARCELs:04600-00-00-01800 OWNER'S NAME:Haugh,Charles R&Douglas Oglesby SIGNATURE:_ (L date: Ii/151/8 TAX MAPs/PARCELs: 04600-00-00-01900 OWNER'S NAME:Crockett Corporation C/O Haugh&Helvin SIGNATURE: ()Ld - date: ii/icli$ TAX MAPs/PARCELs: 04600-00-00-018A0 OWNER'S NAME: Haugh,Charles R&E J Oglesby JR Trustees SIGNATURE: (k. t' date: 11�l S�Ig TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date: TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date: NOTE: If ownership of the property is in the name of any type of legal entity or organization including, but not limited to the name of corporation, partnership, limited liability company, trust, association, etc., documents acceptable to the County must be submitted certifying that the person signing above has the authority to do so. The requested estimates are; O VESCP Erosion & Sediment Control per Water Protection Ordinance section 17-207; $0 fee • VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water Protection Ordinance section 17-208; $250 fee required O Subdivision (roads, drainage,etc.)per Subdivision Ordinance section 14-435; & Water& Sewer per Subdivision Ordinance section 14-435; $269 fee required A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please provide contact information. EMAIL:ryauger@bohlereng.com OR REGULAR MAIL ADDRESS: Bohler Engineering VA,LLC Att: Ryan Yauger, P.E. 28 Blackwell Park Lane, Suite 201,Warrenton, VA 20186 Revised 6/20/2014, 11/3/2015 RECEIVED- NOV 1 6 2018 COMMUNITY DEVELOPMENT