The URL can be used to link to this page

Home My WebLink AboutWPO201400070 Application WPO VSMP 2014-11-05 \“\ AV 0 'ter► "Vol/ tioe.arty Virginia Stormwater Management Program (VSMP) "? Application for Albemarle County iT Project Name: Faith Christian Center International (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No IE Is this a revision or resubmission for review? Yes IK No ❑ County File Number: WPO201400070 (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. VI 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. 78-47A Faith Christian Center International X AY I /r( 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)to receive correspondence: Print Name Wayne A. Frye, Pastor Address P.O. Box 2306 City Charlottesville State VA Zip 22902 Daytime Phone(434) 979.1700 E-mail pastor @fccintl.org 7/1/14,Revised:7/10/14 Page 1 of 2 Kl B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 6.20 acres 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 E7 C. Registration Statement on the official DEQ form. ICI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. Z7 E. Stormwater Management Plan satisfying the requirements of code section 17-403. 1{7 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. $7 G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. 11 H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. n/a ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. n/a ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Brian P. Smith, PE Address 4835 Three Chopt Road City Troy State VA zip 22974 Daytime Phone(434) 296.3644 E-mail bpspe @embarqmail.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised:7/10/14 Page 2 of 2 'Ot At-N:1' Virginia Stormwater Management Program (VSMP) 9 - Application for Albemarle County 1 7 O'' Project Name: Faith Christian Center International (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No IE Is this a revision or resubmission for review? Yes No ❑ County File Number: WPO201400070 (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. l l 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. 78-47A Faith Christian Center International X Tax Map&Parcel Print Name of Property Owner Signature of Owner ' ate 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 Wayne A. Frye, Pastor Address P.O. Box 2306 City Charlottesville State VA zip 22902 Daytime Phone(434) 979.1700 E-mail pastor @fccintl.org 7/1/14,Revised:7/10/14 Page 1 of 2 Now' ,ftsve /0 B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 6.20 acres 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;$150 J C. Registration Statement on the official DEQ form. K7 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. 1 E. Stormwater Management Plan satisfying the requirements of code section 17-403. E F. Pollution Prevention Plan satisfying the requirements of code section 17-404. J G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. Kl H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. n/a ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. n/a ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Brian P. Smith, PE Address 4835 Three Chopt Road City Troy State VA Zip 22974 Daytime Phone(434) 296.3644 E-mail bpspe @embargmail.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised:7/10/14 Page 2 of 2 • Albemarle Cot,,,,,tv Community Development Department 40ctntire Road Charlottesville,VA 22902 4596 # �v 41. Planning Application Voice:(434)296-5832 Fax:(434)972-4126 'PARCEL/ OWNER INFORMATION TM P' 07800-00-00-047A0 ' Owner(s): Application # WP0201400070 FAITH CHRISTIAN CENTER INTERNATIONAL INC PROPERTY INFORMATION Legal Description ACREAGE SLEEPY HOLLOW TRAILER PARK Magisterial Dist. Scottsville Land Use Primary Residential -- Mobile home Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address 2184 RICHMOND RD CHARLOTTESVILLE, 22911 Entered By Todd Shifflett Application Type Water Protection Ordinances 08/14/2014 Project 'Faith Christian Center International Received Date 08/13/14 Received Date Final Submittal Date Total Fees 1700 Closing File Date Submittal Date Final Total Paid 1700 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applicati l Comment I 'APPLICANT/ CONTACT INFORMATION ContactType Name J Address Ci State Zip Phone PhoneCell Owner/Applicant 1 FAITH:CHRISTIAN CENTER INTERNATIO 1P O.BOX 2306 CHARLOTTESVILL ;22902 Primary Contact BRIAN SMITH, PE :4835 THREE CHOPT ROAD TROY,VA 22974 4342963644 Owner/Applicant WAYNE A. FRYE, PASTOR P.O. BOX 2306 CHARLOTTESVILL 22902 4349791700 Signature of Contractor or Authorized Agent Date +..r• Virginia Stormwater Management Program (VSMP) _ Application for Albemarle County Project Name: Faith Christian Center International (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No XI Is this a revision or resubmission for review? Yes ❑ No KI 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. LZI 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. 78-47A Faith Christian Center International X . �L 0 c�/j' Tax Map&Parcel Print Name of Property Owner Signature of Owne 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 Wayne A. Frye, Pastor Address P.O. Box 2306 City Charlottesville State VA Zip 22902 Daytime Phone(434) 979.1700 E-mail pastor @fccintl.org 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 6.20 acres 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 C$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 .YJ 6. Registration Statement on the official DEQ form. ,J2(D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. 127E. Stormwater Management Plan satisfying the requirements of code section 17-403. lir F. Pollution Prevention Plan satisfying the requirements of code section 17-404. f(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. 61 t n ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. 014 ❑ 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 Brian P. Smith, PE Address 4835 Three Chopt Road City Troy State VA Zip 22974 Daytime Phone(434) 296.3644 E-mail bpspe @embarqmail.com *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$1 7 to.06 Date Paid$)/3)11 By who? 7 e i-t i Cr rReceipt#9(.797 Ck# 7)T es, By DR Ce.44 e.f I el r'v►ci 4 a r , 7/1/14,Revised:7/10/14 Page 2 of 2