HomeMy WebLinkAboutWPO201500056 Application 2015-08-25 0 ,
Albemarle County •
.: . Community Development Department
401 McIntire Road Ch arlottesv ille.VA 22 W2-4596
Voice '4)296-5832 Fax:(434)972-4126
Planning Application Noir, Name
'PARCEL/ OWNER INFORMATION
TMP 06200-00-00-. 071A0 Owner(s): TUERK,ADRIANA K,TRUSTEE OF THE ADRIANA K TUERK LIVIN'
Application# WP0201500056
PROPERTY INFORMATION
Legal Description I ACREAGE B A
Magisterial Dist.I Rivanna ,7 Land Use Primary Forest
Current AFD [Not in A/F District CI Current Zoning Primary: Rural Areas E
APPLICATION INFORMATION
Street Address 640 ROCKY HOLLOW RD CHARLOTTESVILLE,22911 Entered By
; Emily Lantz
Application Type I Water Protection Ordinances
Project !Rocky Hollow/Tuerk Stable-Amendment
Received Date 08/20/15 Received Date Final Submittal Date Total Fees 200
Closing File Date Submittal Date Final Total Paid 200
Revision Number
Comments A
Legal Ad A
:1-
SUB APPLICATION(s)
Type Sub Applicatio Comment
Stormwater Management/BMP Plan
Erosion and Sediment Control Plan
Stream Buffer Mitigation Plan
...
APPUCANT I CONTACT INFORMATION
ContactType I Name Address I CityState Zip Phone PhoneCell I
OwneriApprment TUERK,ADRIANA K,TRUSTEE OF THE P0 BOX 85 ISLA FL 33036
'
Primary Cc,ntact KAREN TUERK .2684 PADDOCK WOOD RD ,.
KESWICK VA ..
22947 4342956039
Signature of Contractor or Authorized Agent Date
Virginia Stormwater Management Program (VSMP) c.
Application for Albemarle County . �
Project Name: eZOr k-'' ' CEO /✓� (2.-L "
(The name should be the same as it appears on pens)
Is this an amendment to an approved plan? Yes It!' No ❑
Is this a revision or resubmission for review? Yes ❑ No ❑
County File Number: )z.7) 74- (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.
T{ i- 7 t4coi or Aoeicei T -
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
Tax Map&Parcel Print Name of Property Owner Signature of Owner Date
Contact Information for the Owner(s)to receive correspondence:
Print Name KCLA-"v a' A c 21 1-A'A -TU
Address a V""t ?Qt df - l 0 d Q6)
City Vsuu t C-- State �/ 1 , Zip-t___
Daytime Phone(` by a° S (4 OM-mail k'C U ;YZ-1� € a c) ■ . LQ11rv�
3cs 3q3 2s&-k A D_i_Ak -rueQ�
7/1/14,Revised:7/10/14 Page 1 of 2
Naar war'
[1} 3. All Fees[Code section 17-208]
For new or modified plans;Total acres proposed to be disturbed T -
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
VFor(minor)amendments to an approved plan;$200 per review
Variances;$150
Mitigation Plan;$150
❑ C. Registration Statement on the official DEQ form.
Ef D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
ED'E. Stormwater Management Plan satisfying the requirements of code section 17-403.
[-q'F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
EttG4Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
l2H^'Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ I.virRequested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ J.114,Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence
e (usu(allly the plaan(preparer,consultant or agent)
Print Name �U ++ 6hJO(._ 11 DC1►"3 LIRA �,f(��._.)E
Address #aQ.��c QU` C.k_. u} t1 Uc
City 14\01x3 Ck— State V(\ ,,� Zip 9 q 1
Daytime Phone) 2e S U2� CI E-mail 4--)E,tt -�!=v"�-�,•CiP& A-T i,�K 1U�i Q
3 s X93—2s-i� /
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months
from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY WPO#
Fee Amount$AV Date Paid g/20/15-By who?DD bSDY 1- /Pie Receipt# I U 1013 C1;712(4 By: /1 53`-
7/1/14,Revised:7/10/14 Page 2 of 2