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HomeMy WebLinkAboutWPO201300064 Application 2014-08-04 Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: ''1�2ef--- /00 (The name should be the same as it appears on plans) I Is this an amendment to an approved plan? Yes No 0 Is this a revision or resubmission for review? Yes ❑ No 0 County File Number: 0P(7 io 1i 000(91-1 (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. VIA. 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. 1, I Tax Map&P reel Print Name of Property Owner ,,,ma ture 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 '---.\ ,` ' 'r'� –1 ) � s-e, Address \,b0 4 `cam C 1 -`�� State V� Zip City Daytime Phone Pc:--ILA .L LP) E-mail 1(11- 'DVce ;- h ACL NA 7/1/14,Revised:7/10/14 Page 1 of 2 ❑B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than l $290 $145 $20 1 and less than 5 $2,700 (11,35() $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 $6,100 $3,050 $450 100 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150 Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. (' . Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ 1. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original " signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name ) p�2 / �3 P S lr.� 4,(-9;I Address /d O I\f k f pi-z1 i 1 City CAI ii Q- 'P 7�CiA/t 46' State P} Zip 7,--2A D I _ Daytime Phone 1 i )53 -7 3c-6, �' , l f �r n E-mail B-mail .�-3417r:�j , �� ��` �`7-"'"'" 1��• t� *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. 7 / FOR OFFICE USE ONLY r 1 W PO# �A('� /`] j] ^� Fee Amount$ 13�k044 Date Paid )I1 By who?' /.J a 1 �t' L L C _Receipt#%/O I Ck#. st (2. By;[ `--� 7/1/14,Revised:7/10/14 Page 2 oft Nr.r NOW Application for Review of p:,,1t 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 El'‹WM Plan Resubmittal i&S Plan Resubmittal WPO Application # 2�g..—PD+79 JPOO I ppli ation# 5D'2 g—oe, 9 K-Lo/3 -6 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: "-TA CO A/\ ;/_ �� �G�— —Qw1 O Tax map and parcel: 'SCO At(3Y-- Zoning: C. Amount of Land Disturbance: 1,-7 t. Acres Location of property(landmarks,intersections,or other): iAl nos 17—� Z-'(o C -oe-f71 Contact Person(Who should we call/write concerning this project?): -1C-M fa.)Q Env t^' 1),,v1 Address (l7 ✓tv (42-sr,— 92 , City L'Elsi2-0-. 1/1 State \fi% Zip 2—a 171 Daytime Phone(13``I) 53(`'7 3 g? Fax#( ) E-mail AJA t i (J2 le\ W j�^r 1 ., Ger"-- Owner of Record i.SO-Z. / Address Q(J S ' -t \ U- \ ?L City ( k=3.? 762 State OA Zip2 Daytime Phone( ) Fax#( ) E-mail Contractor Ce> Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer 7%' A Address City State Zip Daytime Phone( ) Fax#( ) E-mail 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/or Mitigation Plan will be complied with and I have the authority to authorize the land disturbing activities and development on�thhesubject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance witl the approved plan. �/ f111 1`C S' r, r )..J Q2 A U Date Lr(*s31 73C2 Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY (� WPO# Fee Amount$4:0"e) Date Paid�'i 1II 1 By who? A)? (70 Receipt#9S-1S(71 Ck# ) JO 6 By: •J Revised November 14,2011 Page 1 of 3 Nome .,.,. 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 :► • II u _ 12, Plan Review,Disturbed Area • - r - • . •- • .. $300 per review (TO BE PAID ' : • •PLICATION AND EACH SUBMITTAL THEREAFTER UN ••'• 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 EACI-I SUBMITTAL THEREAFTER UNTIL APPROVAL) 17. Variances $150/per request (TO BE PAID AT TIME OF APPLICATION) 18. SUBTOTAL EROSION CONTROL PLAN $ Revised November 14,201 1 Page 2 of 3 Now- STORMWATER MANAGEMENT/BMP PLAN & MITIGATION PLAN: (SUBMIT 2 COPIES) . Stormwater Management/BMP Plan. $300/per plan review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) I. • . ' - -n•men o • an $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 $ �D TOTAL APPLICATION FEE: (Add lines 18 and 25) $ 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 Albemarle Coiny Community Development Department { 401 lithe Road Charlottesville,VA 22902-4596 Planning Application Voice:(434)296-5832 Fax:(434)972-4126 'PARCEL, OWNER INFORMATION TMP 056A3-00-00-00900 Owner(s): NOTCH'D LLC Application # WP0201300064 PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. White Hall Land Use Primary Residential --Single-family (incl. modular homes) Current AFD Not in A/F District Current Zoning Primary Planned Development Shopping Center APPLICATION INFORMATION Street Address 5368 THREE NOTCH'D RD CROZET, 22932 Entered By Todd Shifflett Application Type Water Protection Ordinances 10/03/2013 Project Received Date 09/30/13 Received Date Final Submittal Date Total Fees 600 Closing File Date Submittal Date Final Total Paid 600 Revision Number Comments Legal Ad SUB APPLICATION(s) Type LSub Applicati L Comment Erosion and Sediment Control Plan Stormwater Management/BMP Plan (APPLICANT/ CONTACT INFORMATION ContactType j¢_ Name j Address CityState Zip Phone PhoneCell Owner/Applicant NOTCH'D LLC 90 STOCKTON RIDGE PL :GREENWOOD VA 22943 Primary Contact NP ENGINEERING 680 IVY FARM DRIVE CHARLOTTESVILL 22901 4345317387 Signature of Contractor or Authorized Agent Date Apcation for Review of Erosion & Sediment Control Plan & Stormwater Management/BMP Plan & le fit' 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 ❑ 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: Three Notch'd Center - Auto Laundry Tax map and parcel: TMP 56A3/9 Zoning: PDSC Amount of Land Disturbance: 2.32 Acres Location of property(landmarks,intersections,or other): Along Rte 240 approximately 0.10 miles west of intersection of Rte 240 and Parkview Drive. Contact Person(Who should we call/write concerning this project?): NP Engineering Address 680 Ivy Farm Drive City Charlottesville State VA Zip 22901 Daytime Phone(434 )531-7387 Fax#( ) E-mail nat.pe rkins@gma i 1.com Owner of Record Notch'd LLC Address 90 Stockton Ridge Place City Greenwood State VA Zip 22943 Daytime Phone( ) Fax#( ) E-mail Contractor Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer Same as "contact person" listed above Address City State Zip Daytime Phone( ) Fax#( ) E-mail 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/or Mitigatio 1 ' an wil c21 :lied with and I have the authority to authorize the land disturbing activities and development on the subject prope • 1 y . :, ,�ounty of Albemarle the right to enter upon the property as required to ensure compliance the approved ::.i►l�W- i��_/ � 9/30/13 ignatuce-s€Oa, n o r# $' •a: !' ?gent Date W. Perkins .0 S- i S c. (434)531-7387 Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY (� �} WPO# ;p Fee Amount$ WOW Date Paid I a)*( By who?kp ( �,I►C W 1 i eceipt#c1 2P D Ck# 1010 By: 1 ,lhe� J Revised November 14,2011 Page 1 of 3 EROSION CONTROL PLAN: (SI`1B'M1T 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 $ $3 0 0 . 0 0 Revised November 14,2011 Page 2 of 3 Noe - STORMWATER MANAGEMENTBMP 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 $ $3 0 0 . 0 0 TOTAL APPLICATION FEE: (Add lines 18 and 25) $ $6 0 0 . 0 0 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