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Home My WebLink AboutWPO201500012 Application 2015-03-03 Community Development Department Albemarle County 401 P.'ontire Road Charlottesville,VA 22902-4596 3e:(434)296-5832 Fax:(434)972-4126 Planning Application PARCEL I OWNER INFORMATION TMPI 076M1-00-00-004A0 Owner(s): 5TH STREET STATION VENTURES LLC Application# WP0201500012 PROPERTY INFORMATION Legal Description 1ACREAGE PARCEL 4A Magisterial Dist.;ScOttsviiie Land Use Primary Industrial Current AFD Not in A/F District E Current Zoning Primary Planned Development Shopping Center APPLICATION INFORMATION Street Address 149 BENT CREEK RD CHARLOTTESVILLE,22902 Entered By Emily Lantzp Application Type i Water Protection Ordinances r3/1716-1-8- Project 15th Street Station 1-64 Treatment Facility-VSMP Received Date 02/27/15 Received Date Final Submittal Date 03/03/15 Total Fees 1350 Closing File Date Submittal Date Final Total Paid 1350 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applicatio Comment Stormwater Management/BMP Plan 03/03/15 Stream Buffer Mitigation Plan 03/03/15 Erosion and Sediment Control Plan 03/03/15 APPLICANT / CONTACT INFORMATION ContactType Name I Address CityState I Zjp Phone PhoneCell ow,r4Applicaot 5TH STREET STATION VENTURES LLC 5 WEST BROAD STREET STE B FAIRBURN GA 30213 zrtrIsry Czntt STEPHEN COLLINS WEST BROAD STREET STE B FAIRSURN GA 30213 7706928300 Signature of Contractor or Authorized Agent Date ✓ �.r Atcp"?a Virginia Stormwater Management Program (VSMP) '� Application for Albemarle County t=.w Project Name: 5th Street Station - 1-64 Treatment Facility WPO (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No Is this a revision or resubmission for review? Yes ❑ No MI 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 sung 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. 76M1-4A -.S—ftC iL v/-S 64r-- 2/26/15 Tax Map&Parcel Print Naof Property Owner igna 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 Stephen Collins Address 5 West Broad Street, Suite B City Fairburn State GA Tap 30213 Daytime Phone(770)692-8300 E-mail Steve @sjcollinsent.com 7/1/14,Revised:7/10/14,1/7/14 Page 1 oft ❑B. All Fees [Code section 17-208] 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 I00 $6,100 $3,050 $450 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150(per request) Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. ISl D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. X E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Daniel R. Hines, P.E., Bohler Engineering Address 28 Blackwell Park Lane, Suite 201, City Warrenton state VA zip 20186 Daytime Phone(540)349-4500 Email dhines @bohlereng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Pee Amount$ 13 Si•'4 Date Paid Z12 7 i‘By who?R 0V1)f Cie I rue. AD Receipt*S`�1 S'! cad#2I y ti _By: (C. 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 %or Noose Virginia Stormwater Management Program (VSMP) Application for Albemarle County �` Y Project Name: 5th Street Station - 1-64 Treatment Facility WPO (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No Is this a revision or resubmission for review? Yes CI No ❑ County File Number: W PO2015-00012 (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. IM 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. 76M1-4A �ov. 4/23/15 Tax Map&Parcel Print soar of Property Owner igna 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: PriatName Stephen Collins Amass 5 West Broad Street, Suite B city Fairburn state GA Zip 30213 Daytime Phone(770)692-8300 E-mail steve @sjcollinsent.com 7/1/14,Revised:7/10/14,1/7/14 Page 1 oft ❑B. All Fees [Code section 17-208] 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 100 $6,100 $3,050 $450 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150(per request) Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. Ili D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ 1. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Daniel R. Hines, P.E., Bohler Engineering Address 28 Blackwell Park Lane, Suite 201, City Warrenton state VA Zip 20186 Daytime Phone(540)349-4500 E-mail dhines @bohlereng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of minty comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY , WPO# Poe Amount$ Date Paid By who? Receipt# Cid By 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 ofA `�, COUNTY OF ALBEMARLE Department of Community Development ~ 401 McIntire Road Charlottesville,Virginia 22902 VSMP Application Completeness Check Project Title: us Co C -1a 5 5�r St�}� eu-trvaA. \�� File Number: ` Date: .a- t5 Reviewer: Your application has been checked for completeness per section 17-409 of the County Code. All items must be received and correct for the application to be deemed complete. ❑ This application is complete and plan review has begun ❑ This application is not complete. Please provide the missing items checked below. Received Correct Y /N Y N N/A t�//� Completed application ❑ ❑ ❑ ❑ Signatures of the Property Owners for each parcel affected ❑ ❑ ❑ V ❑ Correct Fees Paid ❑ ❑ ❑ ❑ Registration Statement on the official DEQ form, with correct LDA ❑ ❑ ❑ ❑ Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ ❑ ❑ ❑ Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ ❑ ❑ ❑ ❑ Pollution Prevention Plan satisfying the requirements of code section 17-404. The EPA template should be used. ❑ ❑ ❑ ❑ ❑ Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. The EPA template should be used. ❑ ❑ ❑ ❑ ❑ Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ ❑ ❑ ❑ ❑ Requested Variations or Exceptions as provided in code sections 17-407 and 408, if applicable. (SSF,MMT, etc) ❑ ❑ ❑ ❑ ❑ Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. ❑ ❑ ❑ Comments: •