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Home My WebLink AboutWPO201500074 Application 2015-09-28 Albemarle County 401 M community Development Department cl nti rP13 o ad Charlottesville,VA 22902-4596 . - Voice 14)298-5832 Fax:(434)972-4128 !•-•-•tP Planning Application Awe *le 'PARCEL/ OWNER INFORMATION TMPI 0761,11-00-00-002A0 own e s 5TH STREET STATION VENTURES ILIC Application# WP0201500074 PROPERTY INFORMATION Legal Description I ACREAGE Magisterial Dist.'SCOUSViiie El Land Use Primary Forest . - . • • • - • • - Current AFD p Not in A/F District ■ Current Zoning Primary Planned Development Shopping Center - - - FA-PPLICATION INFORMATION Street Address Entered By Emily Lantz Application Type Water Protection Ordinances j91213/2015 Project 15th Street Station Phase II— Design Amendment Received Date 09/23/15 Received Date Final Submittal Date Total Fees 200 Closing File Date Submittal Date Final Total Paid 200 Revision Number I Comments Legal Ad SUB APPLICATION(s) Type Sub Applicatio Comment Erosion and Sediment Control Plan Stormwater Management/BMP Plan APPLICANT /CONTACT INFORMATION ContactType Name Address I CityState Zip Phone PhoneCell I a...1-wAPP4cerit 5TH STREET STATION VENTURES LLC 5 WEST BROAD STREET STE B FAIFtBURN GA 30213 'n""ari Czntact 'DANIEL R HINES 23 BLACKWELL PARK LANE WARREPITON VA 20136 5403494500 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) '. Application for Albemarle County Project Name: WPO - E&S Phase II and SWM/BMP Design Amendment (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: W PO2013-00079 (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. 076M1-00-00-002A0 `+u �^C.o11(s+V3 647— 9/18/15 Tax Map&Parcel Print ame of Property Owner igna of Owner Date 076M1-00-00-002B0 4.... 40 Coi(rvs ';°O '- 9/18/15 Tax Map&Parcel Print ame of Property Owner igna of Owner Date 076M1-00-00-004A0 1 ��m� , t / 9/18/15 Tax Map&Parcel Print ame of Property Owner igna' of Owner Date 07700-00-00-011 E0 `:r� 1 LLrfs C.o � 9/18/15 Tax Map&Parcel Print ame of Property Owner tgna of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Stephen Collins Address 5B Southwest Broad Street City Fairburn State GA zip 30213 Daytime Phone(I70) 692-8300 E-mail steve @sjcollins.com 7/1/14,Revised:7/10/14,1/7/14 Page 1 of 2 ❑B. All Fees [Code section 17-2081 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;$150 ❑ C. Registration Statement on the official DEQ form. ® D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ IL Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ L Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print N Daniel R. Hines, P.E. Address 28 Blackwell Park Lane, Suite 201 City Warrenton State VA 20186 Daytime Phone(540)349-4500 E-mail dhines @bohlereng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# R„(Cj 1 3 I j /�c Fee Amount$∎ob°(3 DatePaidC-a3- 5-Bywho? �h if r 1—�y,✓l ece # 1d/ �T�Ck1oZ336 Br_ 7C) Y� 7/1/14,Revised:7/10/14,1/7/14 Page 2 of 2