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HomeMy WebLinkAboutWPO201400067 Application Minor Amendment 2014-08-07 Albemarle Coi. t 7'-.1.,, Community Development Department 40 Mk4lntire Road Charlottesville,VA 22902-4596 Planning Application Voice: (434)296-5832 Fax: (434)972-4126 PARCEL/ OWNER INFORMATION 1 TMP 06100-00-00-15500 Owner(s): CHURCH OF GOD; THURMAN HENRY, RAY D HENRY & HAROLD L HAGA TRUSTEES HENRY & HAROLD L HAGA Application# WP0201400067 TRUSTEES PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. Rio Land Use Primary Public Current AFD Not in A/F District Current Zoning Primary Commercial Office APPLICATION INFORMATION Street Address 1025 RIO RD E CHARLOTTESVILLE, 22901 Entered By Todd Shifflett Application Type Water Protection Ordinances 08/07/2014 Project Covenant Church Amendment Received Date 08/06/14 Received Date Final Submittal Date Total Fees 145 Closing File Date Submittal Date Final Total Paid 145 Revision Number Comments Legal Ad 'SUB APPLICATION(s) Type Sub Applicati Comment 'APPLICANT / CONTACT INFORMATION ContactType 1 Name _ l Address CityState Zip I Phone 1 PhoneCell I Owner/Applicant ,���OFSCS,."�Mlil11�€li'klEl�l�',;1 y 1025 E RIO RD iidiiiiiititeregiatihi 22901 Primary Contact 42MERIDIAN PLANNIN GROUP 1413 SACHEM PLACE,STE. 1 CHARLOTTESVILL 22901 4348820121 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County �. Project Name:', won- S)fh PC.Ai✓ iami aME"h'T- pet co✓'c'1✓, Air (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,® 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. 0-/53- Cove( / Go • r. � e- -Gu 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 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s) • receive correspondence: e u.4CJ s Print N. e _ - / - , --A 1..5/ tJ • Address / S The? /Q©A--3 —Q . City CI j>6 t/asL/;/l 1 e/� / State j/,Ll u Daytime Phone ?53 %O Gn �E-mai 4.574.02.4//2 �' ite,t/,4',L 'C uz el. 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 O, '(AC12 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;$150 ❑ C. Registration Statement on the official DEQ form. 1$'D. 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. ❑ 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/WAX/a// A/ PG,Jil//V1AJG (/Jaye Address /q/J S iQC/J -"1C 6 ) STC_? City Cgs%LL 7 ,5-1/// 6 State V/ Zip 2l9 / Daytime Phone(V3q) 8$Z-01 Z i E-mail TIC/L(,E r,j 4ErzIo 13iJw''/cam *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY I/ WPO# ) Q/ / �j 9 Fee Amount$ )9c,00 Date Paid �J01'T By who? MP(tC1 1 C Y1 ngt)/7(1.eceipt#9 6673 c,dIt7 2 / By. L J 7/1/14,Revised:7/10/14 Page 2 of 2