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Home My WebLink AboutWPO201400074 Application WPO VSMP 2015-01-20 u,y Virginia Stormwater Management Program (VSMP) Application for Albemarle County '. ®Q�`'•` i ` Project Name: Riverside Village (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes El No 0 Is this a revision or resubmission for review? Yes m No ❑ County File Number: 2014-00074 (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. 78-58 Riverside Village Properties `�� 20IS Tax Map&Parcel Print Name of Property Owner .• I ...- )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 Chris Henry Address 200 Garrett St, Suite P City Charlottesville State VA Zip 22902 434 466-9426 chenry@pbmcap.com Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14 Page 1 of 2 Fees paid directly to DEQ Prior to 7/1/2014. B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 12.11 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;$150 ❑ C. Registration Statement on the official DEQ form. DEQ Registration on File. 171 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. VI E. Stormwater Management Plan satisfying the requirements of code section 17-403. Ci'F��. Pollution Prevention Plan satisfying the requirements of code section 17-404. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Shimp Engineering Address 201 E Main St, Suite M City Charlottesville State VA Zip 22902 Daytime Phone(434) 207-8086 E-mail Tustin @shimp-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# CIO By: 7/1/14,Revised:7/10/14 Page 2 of 2 Virginia Stormwater Management Program (VSMP) , Matt Application for Albemarle County 44,031":- Project Name: Riverside Village (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No la Is this a revision or resubmission for review? Yes m No 0 County File Number: 2014-00074 (to be rovided by the County( p y ty 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. m 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 perty as required to ensure compliance with the approved plans and permits. 78-58 Riverside Village Properties Tax Map&Parcel Print Name of Property Owner 1111. ;,,," ;� D e 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 Chris Henry Address 200 Garrett St, Suite P Qty Charlottesville VA 22902 State Zip 434 -488-9426 chenry@pbmcap.com Da ytune Phone( ) E-mail "540 353 "O f3 7/1/14,Revised:7/10/14 Page 1 oft New Fees paid directly to DEQ Prior to 7/1/2014. uJ B. All Fees[Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 12.11 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;$150 ❑ C. Registration Statement on the official DEQ form. DEQ Registration on File. O D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. O E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Skimp Engineering Address 201 E Main St, Suite M City Charlottesville State VA Zip 22902 Daytime Phone(434) 207-8086 E-mail justin@shimp-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments Is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Cldt By: 7/1/14,Revised: 7/10/14 Page 2 oft Virginia Stormwater Management Program (VSMP) Application for Albemarle County , ., ;,PinGisv- Project Name: Riverside Village (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No L - Is this a revision or resubmission for review? Yes m No ❑ County File Number: 2012-00074 (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. 21 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. 78-58 Riverside Village Properties I6A■■ (0-7/PI Tax Map&Parcel Print Name of Property Owner Sig - re 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 Chris Henry Address 200 Garrett St, Suite P City Charlottesville State VA Zip 22902 434 466-9426 chenry@pbmcap.com Daytime Phone( ) E-mail 7/1/14,Revised:7/10/14 Page 1 of 2 Nor Noe Fees paid directly to DEQ Prior to 7/1/2014. Vi B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 11.64 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;$150 ❑ C. Registration Statement on the official DEQ form. DEQ Registration on File. 171 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Shimp Engineering Address 201 E Main St, Suite M City Charlottesville State VA Zip 22902 Daytime Phone(434) 207-8086 E-mail justin@shimp-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By 7/1/14,Revised:7/10/14 Page 2 of 2 y` OFA Virginia Stormwater ManaOlnent Program (VSMP) ® ' Application for Albemarle County Project Name: i\)ICSic e \/i1)4 (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 4 No ❑ County File Number : 2,614-" "714 (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 • : .erty as required to ensure compliance with the approved plans and permits. Cjr:S 0en,y "� I�'< - ��0CI•," Tax Map&Parcel Print Name of Prop rty Owner Sign. re of Ow.> 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 Address City State Zip Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14 Page 1 of2 ,.r ❑ B. All Fees [Code section 17-r8] For new or modified plans;Total acres proposed to be disturbed 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;$150 ❑ C. Registration Statement on the official DEQ form. 10. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. kr E. Stormwater Management Plan satisfying the requirements of code section 17-403. El F. Pollution Prevention Plan satisfying the requirements of code section 17-404. El G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name i1(� ,iy ) Address 201 E 7 "n l,4 5 '- t S F A \ City C1(1 14oH SVi1f('t, State VA Zip Z2.9U2_ Daytime Phone((431/4/) q 3 6 (1(, E-mail J V S\ 2 SLt i wle- Eanrlekrn. (ovh *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14. Revised' 7/10/14 Noe 2 of 2 Albemarle Corrnepr Community Development Department 401 McIntire Road Charlottesville,VA 22902-4596 R 11 Planning Application Voice: (434)296-5832 Fax:(434)972-4126 (PARCEL/ OWNER INFORMATION TMP) 07800-00-00-05800 Owner(s): Application # WP0201400074 RIVERSIDE VILLAGE PROPERTIES INC PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. Rivanna Land Use Primary Forest Current AFD Not in A/F District Current Zoning Primary Neighborhood Model District APPLICATION INFORMATION Street Address Entered By Application Type Water Protection Ordinances Todd Shifflett 108/19/2014 Project (Riverside Village Received Date 08/19/14 Received Date Final I I Submittal Date Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments Application rcvd 8/5/14. Info to complete application (reg. statement and proof of DEQ payment) rcvd on 8/19/14 Legal Ad SUB APPLICATION(s) Type I Sub Applicati I Comment Erosion and Sediment Control Plan Stormwater Management/BMp Plan 'APPLICANT/ CONTACT INFORMATION ContactType Name Address CityState I Zip I Phone j PhoneCell r Owner/Applicant ;RIVERSIDE VILLAGE PROPERTIES INC ;200 GARRETT ST STE S F.CHARLOT'TESVILL:'-122902 Primary Contact ._rE.._._IL.... ....._.434207....08..........:.........:............... �' SHIMP ENGINEERING 201 E. MAIN ST,SUITE M CHARLOTTESVILL 22902 4342078086 Signature of Contractor or Authorized Agent Date 'gee' Ord `rte ',..e Virginia Stormwater Management Program (VSMP) Application for Albemarle County , , Project Name: Riverside Village (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No WI 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. 2 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 propert . required to ensure compliance with the approved plans and permits. r 78-58 Riverside Village Properties Tax Map&Parcel Print Name of Property Owner Si . . 0 .j s 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 Chris Henry Address 200 Garrett St, Suite 0 City Charlottesville State VA zi P 22902 Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14 Page 1 of 2 Fees paid directly to DEQ Prior to 7/1/2014. ❑ B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 11.64 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;$150 ❑ C. Registration Statement on the official DEQ form. DEQ Registration on File. D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. VI E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Shimp Engineering Address 201 E Main St, Suite M City Charlottesville State VA Zip 22902 Daytime Phone(434) 207-8086 E-mail justin @skimp-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By 7/1/14,Revised: 7/10/14 Page 2 of 2