HomeMy WebLinkAboutWPO201800010 Bond Release WPO VSMP 2023-02-21 (2) Registration Statement
General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10)
(Please Type or Print All Information)
1. Construction Activity Operator: (General permit coverage will be issued to this operator. The Certification in Item #12 must be
signed by the appropriate person associated with this operator.)
Name:March Mountain Properties, LLC
Contact:David Brockman, Development Manager
Mailing Address: 1005 Heathercroft Circle, Suite 100
City:Crozet State:VA Zip:22932 Phone:702-985-9088
Email address(if available):
Indicate if DEQ may transmit general permit correspondence electronically: Yes ✓ No
2. Existing General Permit Registration Number(for renewals only):VAR100043
3. Name and Location of the Construction Activity:
Name: Old Trail Village Subdivision
Address(if available):
City:Crozet State:Virginia Zip:22932
County(if not located within a City):Albemarle
Latitude(decimal degrees):38.0583 Longitude(decimal degrees):78.7106
Name and Location of all Off-site Support Activities to be covered under the general permit:
Name:
Address(if available):
City: State: Zip:
County(if not located within a City):
Latitude(decimal degrees): Longitude(decimal degrees):
4. Status of the Construction Activity(check only one): Federal State Public Private ✓
5. Nature of the Construction Activity(e.g.,commercial,industrial,residential,agricultural,oil and gas,etc.):
Residential
6. Name of the Receiving Water(s)and Hydrologic Unit Code(HUC):
Name:Lickinghole Creek Name:
HUC:JRO2 HUC:
7. If the discharge is through a Municipal Separate Storm Sewer System(MS4),the name of the MS4 operator:
8. Estimated Project Start and Completion Date:
Start Date(mm/ddlyyyy):05/31/2014 Completion Date(mm/dd/yyyy):05/31/2019
9. Total Land Area of Development(to the nearest one-hundredth acre):237.35
Estimated Area to be Disturbed(to the nearest one-hundredth acre): 136.08
10. Is the area to be disturbed part of a larger common plan of development or sale? Yes No
11. A stormwater pollution prevention plan (SWPPP) must be prepared in accordance with the requirements of the General
VPDES Permit for Discharges of Stormwater from Construction Activities prior to submitting this Registration Statement.
By signing this Registration Statement the operator is certifying that the SWPPP has been prepared.
12. Certification: "I certify under penalty of law that I have read and understand this Registration Statement 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:Suzan J. Br
rooks Title: Manager
Signature / Date: .2M.17/8
(Please sign in INK. is Ce ication must be signed by the appropriate person associa ed wwith the operator identified in
Item#1.)
07/2014 Page 1 of 1
® B. All Fees [Code section 17-207]
Total acres proposed to be disturbed G.Li0
Acres to be disturbed Total Fee
_s than I $150 pe review
More than 1 $300 per review
For amendments to an approve p an; 200 per review
Variances;$150(per request)
Exceptions;$240
Mitigation Plan;$150
Construction Record Drawing;$300
® C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
❑ D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ E. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ F. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)
Print Name Jeremy Fox
Address 914 Monticello Rd.
City Charlottesville State VA
Zip 22902
Daytime Phone(434) 977-0205 E-mail jfox@roudabush.com
*When applications and plans are reviewed,but not approved,and a response to comments is not received
within 6 months from the date of county comments,the application will be deemed withdrawn. Applications
without valid owner's signatures will not be considered valid.
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Fee Amount$ ?"v Date Paid! 2t I3 By who?gZWCIG�`li '�GtfXec`cipt# I I a / 0 Ck# a 90 13 `
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7/1/14,Revised: 7/10/14, 1/7/15 Page 2 of 2