HomeMy WebLinkAboutWPO202100071 Application 2022-10-14Virginia Stormwater Management Program (VSMP) or
Virginia Erosion and Sediment Control Program (VESCP)
Application for Albemarle County — Online Form Only
Project Name: ACSA - Avon Maintenance Yard
(The name should be the same as it appears on plans)
The following is a requirement for a nem VSMP or VESCP application [Code §17-401 or 402]. Signatures
nnlst be provided for any submission.
Signature of the Owner for each parcel: (Required with every submission, 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.
09100-00-00-00100 Alexander Morrison c/o ACSA
Map & Parcel Print Name
Tax Map & Parcel Print Name of Owner
Tax Map & Parcel Print Name of Owner
Signature of Owner
Signature of Owner
80/S /Zozz
Date
Date
Date
Tax Map & Parcel Print Name of Owner Signature of Owner Date
* 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within 6 months from the date of county comments, the application will be deemed withdrawn.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. Active permits are subject to annual
maintenance fees [§17-207 and §17-208].
Revised 07/l/21; 7/26/2021; 01/05/2022