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Home My WebLink AboutWPO201500001 Application 2015-02-02 Community Development Department i Albemarle County 401 M^entire Road Charlottesville,VA22%2-4595 :(434)296-5832 Fax:(434)972-4126 11 Planning Application New' Nowe PARCEL I OWNER INFORMATION IMP 03200-00-00-07000 Owner(s): HALL, LARRY B Application# WP0201500001 PROPERTY INFORMATION Legal Description I NORTRSIDEINDUSTRIAL PARK II i Magisterial Dist.I Rio Land Use Primary Open Current AFD [Not in A/F District El Current Zoning Primary I Heavy Industry __._'�1] APPLICATION INFORMATION Street Address Entered By Application Type LWaterProtection Ordinances ..___.____. ._.._�_ _ _ 2/2/2o1Lantz Project Northside Drive Stockpile Area Received Date 01/30/15 Received Date Final Submittal Date Total Fees 145 Closing File Date Submittal Date Final Total Paid 145 Revision Number Comments Legal Ad A SUB APPLICATION(s) Type I Sub App4icatio Comment Stream Buffer Mitigation Plan Stormwater Management/BMP Plan Erosion andSediimen<tControl Plan APPLICANT /CONTACT INFORMATION ContactType Name address I CityState l Zip I Piton I PhoneCell I Ow,xrrAppeca t HALL LARRY 8 1949 NORTHSIDE DRIVE `CHARL4iTESV1.L 1 22911 Rrtrrsry r,rt •ct LARRY HALL o-1749 NORTHSIDE DRIVE ACHARLOTTESVILL 22911 Signature of Contractor or Authorized Agent Date Virginia Stormwater Ma agement Program (VSMP) _Ai-3 Application for Albemarle County Project Name: Northside Drive Stockpile Area (The name should he 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 ❑ No 0 County File Number: (to he provided hr the Countv,for new applications) The following are required elements of new applications Lf'onl code section 17-401]. For revisions or amendments,please indicate which items are being amended. Signatures mast 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. 1 hereby grant the County of Albemarle the right to enter upon the property as required to ensure compliance with the approved plans and permits.32-70 Larry Hall �. 411/' /b74 -- Tax Map&Parcel Print Name of Property Owner Si i lure of Owner Date 32-71 Larry Hall 74(.�� b171 Tax Map& Parcel Print Name of Property Owner Signf tore 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 Larry Hall Address 1949 Northside Drive City Charlottesville state VA Zip 22911 Daytime Phone( ) E-mail 7/1/14, Revised: 7/10/14 Page 1 oft VI B. All Fees [Code section7-208] For new or modified plans; Total acres proposed to be disturbed 0.97 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;$150 C. Registration Statement on the official DEQ form. {Z1 D. Erosion and Sediment Control Plan satisfying the requirements of code section 1 7-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ 1. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Brent Hall Address 1949 Northside Drive City Charlottesville State VA Zip 22911 Daytime Phone(434) 996-5911 E-mail brent @greenstonematerial.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE,USE ONLY WPO# Fee Amount$ 19 '.W Date Paid 434141S By who?LA f l y g N q r I Receipt# D%' 7/1/14,Revised: 7/10/14 Page 2 of 2 " Registration Statement General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10) (Please Type or Print All Information) 1. Construction Activity Operator: (General permit coverage will be issued to this operator. The Certification in Item #12 must be signed by the appropriate person associated with this operator.) Name: Larry Hall Contact: Brent Hall Mailing Address: 1949 Northside Drive City:Charlottesville State:VA Zip:22911 Phone:434.996.5911 Email address(if available): brent@greenstonematerial.com Indicate if DEQ may transmit general permit correspondence electronically: Yes. No n 2. Existing General Permit Registration Number(for renewals only): 3. Name and Location of the Construction Activity: Name: Northside Drive Stockpile Area Address(if available): Northside Drive, Albemarle County city:Charlottesville State:VA Zip:22911 County(if not located within a City):Albemarle Latitude(decimal degrees):38d8'36.0"N Longitude(decimal degrees):78d25'51.13"W Name and Location of all Off-site Support Activities to be covered under the general permit: Name:n/a Address(if available): City: State: Zip: County(if not located within a City): Latitude(decimal degrees): Longitude (decimal degrees): 4. Status of the Construction Activity(check only one): Federal State P Public I I Private n 5. Nature of the Construction Activity(e.g., commercial, industrial, residential,agricultural, oil and gas,etc.): Soil and stone stockpile 6. Name of the Receiving Water(s) and Hydrologic Unit Code(HUC): Name:N Fork Rivanna River - Jacobs Run Name: HUC:020802040303 HUC: 7. If the discharge is through a Municipal Separate Storm Sewer System (MS4),the name of the MS4 operator: n/a 8. Estimated Project Start and Completion Date: Start Date(mm/dd/yyyy):03/01/2015 Completion Date(mm/dd/yyyy):03/01/2017 9. Total Land Area of Development(to the nearest one-hundredth acre):2.33 Estimated Area to be Disturbed(to the nearest one-hundredth acre):0.97 10. Is the area to be disturbed part of a larger common plan of development or sale? Yes I No Jul 11. A stormwater pollution prevention plan (SWPPP) must be prepared in accordance with the requirements of the General VPDES Permit for Discharges of Stormwater from Construction Activities prior to submitting this Registration Statement. By signing this Registration Statement the operator is certifying that the SWPPP has been prepared. 12. Certification: "I certify under penalty of law that I have read and understand this Registration Statement and that this document and all attachments were prepared in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant penalties for submitting false information including the possibility of fine and imprisonment for knowin a vio a ions." Printed Name: - Title: e.: N-er- Signature: /� Date: r � (Please sign in INK.urhis Certification must be signed by the appropriate person associated with the operator identified in Item#1.) 07/2014 Page 1 of 1 `rie pFAL Virginia Stormwater Management Program (VSMP) Application for Albemarle County -*lot ii* -*lot Project Name: fUOr HIS de D. 3 cie_pi/e (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: \Ain 2O1,5 cycoo L (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. 32- -To Lairkk Ha 1I 6' Z Tax Map&Parcel Print Name of Property Owner Signatuy(o 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 t,111 JI&/ 41 ft- I Address 14 O k or-I I c e 1)1Y'. City C,haY tcr4--e,SvlIke- State V A Zip. 229 I I Daytime Phone E-mail(a13i Gt lQ 5q 11 Itcr erg- cle - 121•con-. 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of2 .r+o ❑ 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;$150 El C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. El I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name —Yu rk-iy c.JI ttr le Address 2O1 E. Mn 21 4'6k. v M City 0,Inar State VA Zip 2:2C10"2_ Daytime Phone(1 12.4 5 1 O E-mail uS-f tv, ry —e ztne iic c, .0 ar"-% *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 Virginia Stormwater Management Program (VSMP) Application for Albemarle County PP Project Name: of a r 4-145i e e ve. S+oe-k p;1e (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 l ' No ❑ County File Number: 1NPQ 2.0 I So 0 O(,I (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-4011. 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. T.M. 32-70 hA2'1 - -`/ Tax Map&Parcel Print Name of Property Owner Sign e of Owner /,/ Date T. 3 -71 „dant snit ( .� J -de • Tax Map&Parcel Print ame of'roperty Owner Signa 9 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, 1/7/14 Page 1 oft ❑ B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed I • q 7 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;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name TO S � Address 20 f LC ma"-s S>` St!r'1C_ /11 City C L,ar(O t fic5V,'l l c ,, State v'A Zip 2 Z/07 Daytime Phone(4/51,1) 2-2.7 S tip E-mail JVS f• Sh c vIto -ely;4 eel;,9, C Oe"n *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2