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Home My WebLink AboutWPO201400082 Application 2014-09-15 gio, Albemarle Cou " Community Development Department 401 McIntire Road Charlottesville,VA 22902 4596 Planning Application Voice:(434)296-5832 Fax:(434)972-4126 9 pP 1PARCEL/ OWNER INFORMATION TMP 061Z0-03-00-00900 Owner(s): COUNTY OF ALBEMARLE C/O FINANCE ADMINISTRATION Application # WP0201400082 RM 149 PROPERTY INFORMATION Legal Description BRANCHLANDS 4 Magisterial Dist. Rio Land Use Primary Forest Current AFD Not in A/F District Current Zoning Primary Planned Unit Development APPLICATION INFORMATION Street Address Entered By Danielle Roth Application Type Water Protection Ordinances 09/15/2014 Project Church Road Stormwater Management Facility Retrofit Received Date 09/10/14 Received Date Final Submittal Date Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applicati Comment Erosion and Sediment Control Plan Stormwater Management/BMP Plan Stream Suffer Mitigation Plan 1APPLICANT/ CONTACT INFORMATION ContactType Name I Address CityState Zip Phone .1 PhoneCell Owner/Applicant ; COUNTY OF ALBEMARIE CJo FINANCE A :401 MCINTIRE ROAD €CHARLOI IESVILL 22902 777 7 Primary Contact FRANK POHL OFD Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: Church Road Stormwater Management Facility Retrofit (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No X Is this a revision or resubmission for review? Yes ❑ No IX County File Number: (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-401]. For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. C'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. I 06/0'6 -03-0o-0010o e gen444c,�- 1, a� ( .� d q �� y Map Tax Ma Parcel Print Na of Property Owner ignature of Owner Date Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: �� Print Name e `'/1/7"/f//2 l CY irri n�- PO 7/Z-- Address 1,y / tGf fG1c-/)7.3 j„).e1/e c app' City / State Zip Daytime Phone( ) / ` 9/ E-mail O ti L , 0 G(13. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed /' 9-3 L—ca--eS Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit �s� de Less than 1 $290 $145 $20 e� [ 1 and less than 5 $2,700 $1,350 $200 fl 5 and less than 10 $3,400 $1,700 $250 j� n rt1/Ll' 10 and less than 50 $4,500 $2,250 $300 Or � 50 and less than $6,100 $3,050 $450 e1 cif ,S 100 (� 100 and more $9,600 $4,800 $700 1 VV fd rr For(minor)amendments to an approved plan; $200 per review Variances; $150 Mitigation Plan; $150 'C. Registration Statement on the official DEQ form. 0'D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. /dE. Stormwater Management Plan satisfying the requirements of code section 17-403. e'F. Pollution Prevention Plan satisfying the requirements of code section 17-404. g G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. 'H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. N/A I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ErJ. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer, consultant or agent) Print Name Frank Pohl (OFD) Address Office of Facilities Development, County of Albemarle City State Zip Daytime Phone( ) Ext. 7914 E-mail fpohl @albemarle.org *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY VPO# Fee Amount$ Date Paid By who? Receipt# Ck# By