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Home My WebLink AboutWPO201500013 Application 2015-03-03 Albemarle Coun' - 401 M -e Community Development Department Road Charlottesville,VA 22902-4596 Wap06:(434)296-5832 Fax:(434)972-4126 14. Planning Application PARCEL/ OWNER INFORMATION TMP 076M1-00-00-002A0 Own e r(s): 5TH STREET STATION VENTURES 1.1C Application# WP0201500013 PROPERTY INFORMATION Legal Description I ACREAGE .& Nr. Magisterial Dist,I ScattWitie Land Use Primary Forest E s Current AFD : Not in A/F District ril Current Zoning Primary, Planned Development Shopping Center 1:1 APPLICATION INFORMATION Street Address Entered By anielle Rothn A application Type ' W ter Protection Ordinances II 31 /20T5 Project 5th Street Station Design Amendment-VSMP Received Date 03/03/15 Received Date Final Submittal Date Total Fees 200 Closing File Date Submittal Date Final Total Paid 200 Revision Number Comments .4. Legal Ad A SUB APPLICATION(s) Type Sub 4.plicatio Comment Erosion and Sediment Control Plan Stormwater Managenie..nt/BMP Plan ' 1 APPLICANT /CONTACT INFORMATION ' ContectType I Name address I CityState Zip Phone I PhoneCell OlivowiAppkont 5TH STREET STATION VENTURES LLC 5 WEST BROAD STREET STE B FAIRBURN GA 30213 Prirnary Contact DANIEL R HINES,P.E, ' 28 BLACKWELL PAILK LANE, WARRENTON VA 20186 ' 5403494500 Signature of Contractoror Authorized Agent Date tw-Virginia Stormwater Management Program (VSMP) . Application for Albemarle County 4wf .''(v Project Name: WPO - E&S Phase H 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: WP02013-00079 (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 die 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 `rj ^eo`�rNs f! 3/3/15 Tax Map&Parcel Print ame of Property Owner �gna of Owner Date 076M1-00-00-002B0 dcA �ol(ov,,s r 3/3/15 Tax Map&Parcel Print ame of Property Owner igna of Owner Date 076M1-00-00-004A0 4� I � `t riffs �p 3/3/15 Tax Map&Parcel Print ame of Property Owner 'gm of Owner Date 07700-00-00-011 E0 4S—001(644$ C�► ''� 3/3/15 Tax Map&Parcel Print ame of Property Owner 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(770) 692-8300 E-mail steve @sjcollins.com 7/1/14,Revised:7/10/14,1/7/14 Page 1 of 2 Noe Noe ❑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 S 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. El D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. 181 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. ❑ 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 Name Daniel R. Hines, P.E. Address 28 Blackwell Park Lane, Suite 201 Cm, 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# Foe Amounts ZOO.vo Data Paid 3)11i S By who? 10614 if/ C ns, r�;7x«eipc#Cq 9 3a# 22 By: —DA VA , �c e 7/1/14,Revised:7/10/14,1/7/14 Page 2 of 2