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Home My WebLink AboutWPO201400006 Application 2014-11-11 01 ll.ly.. Virginia Erosion and Sediment Control Program (VESCP) `��z► dra Application for Albemarle County (This application is only to be used for projects exempt from the Virginia Stormwater Management Program,VSMP,and the DEQ General Permit) Project Name: (D l tat ja letrok t—aro, 514.1 ,► 0:0 G,l /(7 (The name should he the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No, Is this a revision or resubmission for review? Yes' No ❑ County File Number: I,02oZ0/ I iOOt* (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. i4 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. /7/1/#7,../( / Tax Map &Parcel Print Name of I i operty Owner Si ure�f wher �a 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 recei e correspondence: Print Name '�/�-- /ti1/7(EI_ r((- (9'i •tZ1C-0,6h i IJ 'Address' City, I 4L- L t /State �✓J7V r Zip 2�i',9/ .DaytimRPhci,ne J( � I ) / ) E-mail trf ICI_ e A( % / ' (1i�I 1 �.,�i�I- 7/1/14,Revised:7/10/14 Page 1 oft 2'g. All Fees [Code section 17-207] Total acres proposed to be disturbed Acres to be disturbed ■-,.. '-- Less than 1 $150 per review More than 1 $ I i .- re`iew For amendments to an approved plan: $200 per review Exceptions; $240 Mitigation Plar, $150 0 Construction Rec. • Drawing;$300 Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence (usually the plan preparer,consultant or agent) Print Name A)a in 4-(0,41,(1: v., Address L1 Z� �q ^ {J�y City ( (D L 1;t- State /A Zip Daytime Phone(4-(3 l—S,j`-`/ E-mail 44,-3 (I t��n (;:a *When applications and plans are reviewed, but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY /� %PO# 3 Fee Amount$. Date Paid 1 I-1(1-iABy who'? sic-- ,4-e ,s 11ceipt# '161 I v Ck# (. 130 By e t ✓ I v. , 4er_ 7/1/14,Revised: 7/10/14 Page 2 of 2 o' 1IJjF, Albemarle County Water Protection Ordinance ✓�® ;T Request regarding development in a stream buffer Required Information for application; C,� A. Signature of the Property Owner for each parcel: (Required, NOT TO BE SIGNED BY AN AGENT, BUILDER,CONSULTANT,or anyone other than the owner) 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 a permi\t's.. Tax Map &Parcel Signature of i er ate r s Contact Information for the Owner to receive correspondence: Print Name /I/0 1 Y 1 Address ' 6LEtkLioao J/,/i, City �/��Ql IFS �l� �//' / State �/V7� Zip 71 JP1 Daytime Phone( 43 7f )-2-(f-(0 E-mail f"[ik '�`' (4?(.*t/t /]T Oii' J • (- fi�'B. A description or drawing of the proposed disturbance. (Typically this is a driveway, house, garage, grading activity, etc. It does not matter that it may be theoretical or exploratory. Any additional information, like a professional stream or buffer assessment, will be helpful.) Sew Pla FOR OFFICE USE ONLY WPO# Fee Amount$_ Date Paid By who __ Receipt# Ck# By w x 7/1/2014 Albemarle Ccinty Community Development Department 401 McIntire Road Charlottesville,VA 22902 4596 1' Planning Application Voice:(434)296-5832 Fax:(434)972-4126 1PARCEL/ OWNER INFORMATION TMPI 05900-00-00-001P0 Owner(s): DEEP ACRES LLC Application # WP0201400006 PROPERTY INFORMATION Legal Description OLD BALLARD FARM 16 Magisterial Dist. Samuel Miller Land Use Primary Unassigned Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address Entered By Judy Martin Application Type Water Protection Ordinances 102/12/2014 Project bold Ballard Farm Sub.-Lots15/16 Driveway I Received Date 02/10/14 Received Date Final Submittal Date 02/10/14 Total Fees 300 Closing File Date Submittal Date Final Total Paid 300 Revision Number Comments Legal Ad SUB APPLICATION(s) Type I Sub Applicati f Comment Erosion and Sediment Control Plan Streantstiffer Miti"a g ,: . APPLICANT/ CONTACT INFORMATION ,ContactType I Name ! Address 1 CityState Zip I Phone I PhoneCell DEEP ACRES i,IC €944 aENWOOD STATiON LA CHARLOTTESVI : 22901 Primary Contact ALAN FRANKLIN, PE4-.,.... -0427 CRANBERRY LANE CROZET,VA.",- - �22932 4345315544 General Contractor T/B/D Signature of Contractor or Authorized Agent Date •fir r,�► Application for Review of -au 1i Erosion & Sediment Control PIan & Stormwater Management/BMP Plan & Stream Buffer Mitigation Plan Erosion & Sediment Control Plan ❑ Stormwater Management/BMP Plan Pk 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. �� J . t �G� IJJ/h DrrJc? .�(ty Project Name: � �G,'�/ •ti'�atr►`^ ..� J.�i � t?'1 Tax map and parcel: 5 - c2 Zoning: g A Amount of Land Disturbance: D - I Acres Location of property(landmarks,intersections,or other): o lA Cfra Contact Person(Who should we call/write concerning this project?): A IA/1 1---ceif7 W) Address ttl'"? ( rev, 0,4f '( City t roZ6 ` Stated VA Zip Zzg3z Daytime Phone(l�y) 5e3/"'55 y c/ Fax#(�—j- —'-1 E-mail flat. 1 e/d /;:erxj; rs re Owner of Record e A t-ee S �LL G . 1^Z- (94fp,e1 ,41 Jv�Y) Address � Y f &�Q✓ W y i7 f1 1,0:1( [� Y 00 f r1, � State VA- IZi a zip Daytime Phone(q ) 7' - / 5 g (1 Fax#(`3y) /7b —3k°(-/ E-mail ')'/ Y 1-1,5,-17;7l y/0+7915 • e Contractor f 3.D Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer �Gv/1 I r/r✓s��. 1 �i Address +2 / C.,ray, b.2 r(`/ L - 1.1 e City C CO Z 111— State 1/*1/*y Zip OZ/3z Daytime Phone oh 53) 55y y Fax# (�� ---—_- E-mail aj�'/1 4 1091/;!✓IIC.�;n pc a c 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 the subject property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure com7rance with he a roved plan. /J 404 _ z/(//A)// Signature of wn• (font a urchaser Date y��ICN E r__ 6AFI✓IiJt/ Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY WPO# Fee Amount$_ _Date Paid' (4By who? I er Ares, LUL Receipt# 144 52 Ck# a 2 By: t Y x • Revised November 14,2011 Page 1 of 3 kfto *me 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 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 EACI-I SUBMITTAL THEREAFTER UNTIL APPROVAL) 17. Variances $150/per request (TO BE PAID AT TIME OF APPLICATION) 18. SUBTOTAL EROSION CONTROL PLAN $ 150 Revised November 14,2011 Page 2 of 3 Nov New STORMWATER MANAGEMENT/BMP 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 $ l5 0 TOTAL APPLICATION FEE: (Add lines 18 and 25) S 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