Loading...
HomeMy WebLinkAboutWPO201400019 Application 2014-09-04 Virginia Stormwater Managt.dent Pro ram VSMP) (i " Application for Albemarle County Project Name: ° not ko\ Uia-kr C©•-rec 4'o� Q�il�e�+ (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No Et' Is this a revision or resubmission for review? Yes C' No ❑ County File Number : W PO.1 l 00019' (to be provided by the County for new applications) The following are required elements of new applications [from code section 17-4011 For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. EA. 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. Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 59A-01-CR-14 Rekr bacc S�t_ Tax Map&Parcel Print Name of Property Owner Signature of Owner Date C(.c c(es Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 59 -a3 Geoc- t �r� c13re Cc-4r Tax Map&Parcel Print lame of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name .lei eo-- L� n Address i(j$ Spt*f o*cf City o 5y; State VA Zip a-6V i Daytime Phone(IP-1) 9'77-9 xI lo{ E-mail ri-YJA)C 7/1/14,Revised: 7/10/14 Page 1 of 2 G "B. All Fees [Code section 17-2,11] For new or modified plans; Total acres proposed to be disturbed krier Q.Se( Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $290 $145 $20 1 and less than 5 $2,700 $1,350 $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;$150 19'C. Registration Statement on the official DEQ form. CAD. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. "G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name `Sep e.t L ,S■ Address (6S S4 c-n' Qoo.i City ttt State VA Zip X9)1 Daytime Phone(q3`1) 97 7-'AC IN 4-1l 4 E-mail 3L YNA)e yet✓,ceaA-oc: ,073 *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# 5 Fee Amount$' ,(�/V Date Paid Itti__By who?tit gvQ. ho Receipt#g700-9 Ck# c I3 By: 7/1/14, Revised: 7/10/14 Page 2 of 2 Albemarle Coc>`.,ty Community Development Department 4014Intire Road Charlottesville,VA 22902-4596 U Planning Application Voice: (434)296-5832 Fax:(434)972-4126 PARCEL/ OWNER INFORMATION TMP 059A0-01-OB-001A0 Owner(s): Application # WP0201400019 KANG, MONICA H & HAN MO KANG C/O 3EMO KANG PROPERTY INFORMATION Legal Description FLORDON B 1A Magisterial Dist. Sack 5ouett Land Use Primary Residential --Single-family (incl. modular homes) Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address 606 FLORDON DR CHARLOTTESVILLE, 22901 Entered By Todd Shifflett Application Type Water Protection Ordinances 03/10/2014 project (Ivy Road -Flordon Water Connection Project Received Date 03/05/14 Received Date Final Submittal Date Total Fees 150 Closing File Date Submittal Date Final Total Paid 150 Revision Number Comments Legal Ad SUB APPLICATION(s) Type : . I Sub Applicati l Comment Erosion.and.Sedlntent ConlErol P[a 'APPLICANT/ CONTACT INFORMATION ,ContactType, I, Name I Address CityState I Zip Phone PhoneCell Owner/Appllcaint .'1CANGr;P!{?fl'I AtI2i;HAN'MO;KANG'C/£?.;,-;P0BOX";7139, ;PiitNCETC3NNJ: ;0854 ::. Primary Contact CHIP VOTAVA, P.E. 272 BENDIX ROAD, SUITE 40 VIRGINIA BEACH 23452 7576315404 Plan Preparer MICHAEL BAKER FR.,INC. 272 BENDIX ROAD, SUITE 40 VIRGINIA BEACH 23452 7576315404 Signature of Contractor or Authorized Agent Date A *Autio/ "wile Application for Review of 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 ❑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: Ivy Road-Flordon Water Connection Project Tax map and parcel: 095,059A,060E1 Zoning: Amount of Land Disturbance: 0.47 Acres Location of property(landmarks,intersections,or other): Ivy Road and Broomley Road Intersection Contact Person(Who should we call/write concerning this project?): Chip Votava,P.E. Address 272 Bendix Road,Suite 400 City Virginia Beach, State VA Zip 23452 Daytime Phone(757) 631-5404 Fax#(757) 463-0503 E-mail cvotava @mbakercorp.com Owner of Record Albemarle County Service Authority Address 168 Spotnap Road City Charlottesville State VA Zip 22911 Daytime Phone(434) 977-4511 Fax#( ) E-mail jlynn @serviceauthority.org Contractor To be determined Address City State Zip Daytime Phone( ) Fax#( ) E-mail Plan Preparer Michael Baker Jr.,Inc. Address 272 Bendix Road,Suite 400 City Virginia Beach, State VA Zip 23452 Daytime Phone(757) 631-5404 Fax#(757) 463-0503 E-mail cvotava @mbakercorp.com 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 complia ce with the approved plan. •�'� -SISfa-vI9 Sign re of 0 ner,Contr ct�aser Date �e �.�• i (L 1-() ) - 4S-11 N+ IN y Print Name Daytim phone number of Signatory FOR OFFICE USE ONLY f WPO# t U Iii - i q Fee Amount$ Z1-6 u Date Paid3/�'I By who? nib CO U i 1"I 1 ,Receipt rig if7! 3 Ck# '7'4 s 6 By:_iTh7 1 �J iCR. I u/loon Revised November 14,2011 Page 1 of 3 `arr r,v EROSION CONTROL PLAN: (SUBMIT 2 COPIES) Land disturbing activity pertaining to single family dwelling unit: 1. Plan Review $i58-per review (TO BE PAID AT TIME OF APPLICATION AND EACH SUBMITTAL THEREAFTER UNTIL APPROVAL) \ 2 Permit and First Year Inspection Fees I $150 1 (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 $ ( CO Revised November 14,2011 Page 2 of 3 `rare '.41444" 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 $ TOTAL APPLICATION FEE: (Add lines 18 and 25) $ ( SIC) 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 Screening Form Number fRCi141. COUNTY OF ALBEMARLE Department of Community Development 401 Mclntire Road,Room 227 Charlottesville,Virginia 22902-4596 Phone(434)296-5832 Fax(434)972-4126 LAND DISTURBANCE EROSION AND SEDIMENT CONTROL SCREENING FORM This form is intended to aid the Department in classifying a land disturbance. The form responses will be used to determine whether a disturbance is subject to the County's Water Protection Ordinance. Failure to respond or to fully complete the screening form within 72 hours may require the Department to stop all land disturbing activity. The Stop Work Order will remain effective until the classification of the disturbance and/or obtainment of all required permits associated with the disturbance. Albemarle County Service Authority 4349774511 Ext. 114 Owner/Agent Name(Print) Home Phone Office/Other Phone 168 Spotnap Road Address Charlottesville VA 22911 City State Zip Code 1. Are there any streams on the property? Yes No 2. If so,will land disturbing activity be within 100' of the stream? Yes No o 3. Will the project require grading,excavating,clearing, filling,or other land disturbing activity of any kind? No Purpose of land disturbing activity: 8" and 12"water main installation Directions to Property and Location of Activity: The project will start on Ivy Road at the entrance of the Christian Mission Aid and running west along Ivy Road. It will turn north across the railroad at a location 1000 feet west of Ivy Road and Broomley Road intersection. It will turn east on Old Ballard Road and turn north and end on Broomley Road 215 feet north of the intersection of 0 Ballard Road and Broomley Road. _ Owner/Agent Signature ?-7 Date Sts 1/ ./y (FOR OFFICE USE ONLY) Tax Map/Parcel: - - - Checked By Date Requires an Erosion and Sediment Control Plan Requires an Agreement in Lieu of an Erosion and Sediment Control Plan Exempt Activity October 9,2006