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Home My WebLink AboutWPO201400066 Application 2014-08-061 WPO201400066Westgate Clubhouse and Office Renovation / Additi061000000042DVoid Albemarle Co4ty Community Development Department 40rIClntire Road Charlottesville,VA 22902-4596 c Planning Application Voice:(434)296-5832 Fax:(434)972-4126 PARCEL/ OWNER INFORMATION TMP 06100-00-00-042D0 Owner(s): WESTGATE/BARCLAY PLACE I LLC Application # WP0201400066 PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. lack Jouett Land Use Primary Residential -- Multi-family Current AFD Not in A/F District Current Zoning Primary Planned Residential Development APPLICATION INFORMATION Street Address 2623 HYDRAULIC RD CHARLOTTESVILLE, 22901 Entered By Todd Shifflett Application Type Water Protection Ordinances 08/05/2014 Project !Westgate Clubhouse and Office Renovation / Addition Received Date 08/04/14 Received Date Final Submittal Date Total Fees 150 Closing File Date Submittal Date Final Total Paid 150 Revision Number Comments Ai)/dam) �U G r5'rt� Legal Ad (. (/// pvv- „,„ SUB APPLICATION(s) Type Sub Applicati( Comment e Erosion and Sediment Control.Plan;.: ;;? 'APPLICANT/ CONTACT INFORMATION ContactType I Name Address CityState 1 Zi' Phone J PhoneCell Owner/Applicant =WESTGATE/MARCLAYPLACE I;LLC ;P 0 BOX 5526 CHARI:OTTESVLLL 122901: Primary Contact DAVID MITCHELL P.O. BOX 5526 CHARLOTTESVILL 22901 4342964141 Signature of Contractor or Authorized Agent Date Virginia Erosion and Sediment Control Program (VESCP) r, 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: W e a+ 611.4.h110,4,6 aJ �� "VC r 4 '/1"," (The name should be 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 yi County File Number: (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. ❑ A. 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. 6)-61'/2D Ga=- C IL iri /y Tax Map&Parcel Print Nam• of Property Owner Signwner Dat• /wIMHGfSw rvlfl2" 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 corr spondence: Q ` f Print Name P(,i,V L pr1) /w '&/�� y plot ez Address Po �f�p� 6-52(, City f✓�Cfsrla' 4eS Ite State Vii-- Zip ZZ/G/ Daytime Phone(-0 2 - WY/ E-mail j Mf 611e)) C 5'�y"G, GGH'J 7/1/14,Revised: 7/10/14 Page 1 of 2 *ow' Noose ❑ B. All Fees [Code section 17-207] Total acres proposed to be disturbed Acres to be disturbed Total Fee es tha $150 per review More than 1 $300 per review For amendments to an approved plan;$200 per review Exceptions;$240 Mitigation Plan;$150 Construction Record Drawing; $300 Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for c•• ;..ondence(usually the plan p epar- consultant or agent) Print Name 0A) Pt Vv' Address City State Zip Daytime Phone( ) E-mail *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ ` — Date Paid?414By who 4at 1 k L' I "'Receipt#Flit Ck# r I By: cage/ 7/1/14,Revised: 7/10/14 Page 2 of 2 'o'° ,,,pi Screening Form Number cit.1/.44, A5 PoN,,,_Zi,r %IF COUNTY OF ALBEMARLE Department of Community Development 401 McIntire 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. WV 7W►.eL m,lc h e>( ie/&"/J,,. ( c-e X 46c -566- 9 Owner/Agent Name(Print) Home phone Office/Other Phone 2617 y�►�aQ<<G Qc. Address G kt iv ■J,IL VA-- 22.to2 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 3. Will the project require grading, excavating, clearing, filling,or other land disturbing activity of any kind? No Purpose of land disturbing activity: ^ -6 ( / 23 n P 6/-O'/2 D act 2 617 Directions to Property an. Location of Activity: Area to be disturbed: acres or< 25-60 sq. ft. Owner/Agent Signatu �4 Date /0ti � �. (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