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Home My WebLink AboutWPO201400073 Application 2014-08-19 Albemarle CoL, ty Communit y Develo p ment Department 40fi" IIntire Road Charlottesville,VA 22902-4596 Voice: (434)296-5832 Fax:(434)972-4126 ----- Planning Application 'PARCEL/ OWNER INFORMATION TMPI 04500-00-00-068B0 I Owner(s): Application # WP0201400073 RIVANNA WATER & SEWER AUTHORITY PROPERTY INFORMATION Legal Description ACREAGE RIVANNA RESERVIOR Magisterial Dist. Rio Land Use Primary Public Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address 2385 WOODBURN RD CHARLOTTESVILLE, 22901 Entered By Application Type Water Protection Ordinances Todd Shifflett 108/19/2014 Project 'South Rivanna WTP Improvements Received Date 08/12/14 Received Date Final Submittal Date Total Fees 1350 Closing File Date Submittal Date Final Total Paid 1350 Revision Number Comments Legal Ad SUB APPLICATION(s) Type I Sub Applicati f Comment Erosion and Sediment Control Plan Stormwater Management/BMP Plan. 'APPLICANT/ CONTACT INFORMATION ContactType I Name Address f CityState Zip Phone PhoneCell owner/Applicant !MANNA WATER&SEWER AUTHORITY 1695 MOORES CREEK LANE ;CHARLOTTESVILL 122902-90 Primary Contact BRET EDWARDS C/O HAZEN AND SAWY 4011 WESTCHASE BLVD.,SUI RALEIGH, NC 27607 9198337152 Signature of Contractor or Authorized Agent Date Amore "%we Virginia Stormwater Management Program (VSMP) for Albemarle County ®e Project Name: South Rivanna WTP Improvements (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No MI Is this a revision or resubmission for review? Yes ❑ No IN County File Number: (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. 45-68B Rivanna Water and Sewer Authority py S 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 Doug March C/O Rivanna Water and Sewer Authority Address 695 Moores Creek Lane Charlottesville VA City State Zip 919 833-7152 dmarch @rivanna.org Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14 Page 1 of 2 v.r Nose e B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 1.96 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; $150 N C. Registration Statement on the official DEQ form. N D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. N E. Stormwater Management Plan satisfying the requirements of code section 17-403. IN F. Pollution Prevention Plan satisfying the requirements of code section 17-404. N G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Bret Edwards C/O Hazen and Sawyer Address 4011 WestChase Blvd., Suite 500 Raleigh City 9 State NC Zip 27607 Daytime Phone(919) 833-7152 E-mail bedwards @hazenandsawyer.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ /56.4? Date Paid%)TLIJ t//By who? #g vGr✓1 a► WQlt( Receipt#9 47 3(0 Ck# Q L$$37 By: t.5e wet A tri1,0 rd.y 7/1/14,Revised:7/10/14 Page 2 of 2 Noe pF \l./,, Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: South Rivanna WTP Improvements (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No II Is this a revision or resubmission for review? Yes IR No ❑ County File Number: WPO201400073 ty (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. NI 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. 45-68B Rivanna Water and Sewer Authority ( 4c /0— 7-/it Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 1 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 Doug March C/O Rivanna Water and Sewer Authority Address 695 Moores Creek Lane Charlottesville State VA Cit y Zip 919 833 7152 dmarch @rivanna.org Daytime Phone( ) E-mail 7/1/14, Revised:7/10/14 Page 1 of 2 C B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 1.75 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;$150 I C. Registration Statement on the official DEQ form. PI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. PI E. Stormwater Management Plan satisfying the requirements of code section 17-403. PI F. Pollution Prevention Plan satisfying the requirements of code section 17-404. • G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. PI I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Bret Edwards C/O Hazen and Sawyer Address 4011 WestChase Blvd., Suite 500 City Raleigh State NC Zip 27607 919 833-7152 bedwards hazenandsaw er.com Daytime Phone( ) E-mail @ y *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$/So•0Q Date Paid l By who?. 1 V ■19Y1Cp Werktie Receipt# 7 5(9 3 Ck#9,3 2 7 Z. B Y� t Stwe c url •I'y 7/1/14,Revised:7/10/14 Page 2 of 2 l pF.1Lg,.1 Virginia Stormwater Management Program (VSMP) ®ter Application for Albemarle County Project Name: South Rivanna WTP Improvements (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No U Is this a revision or resubmission for review? Yes IN No ❑ County File Number: WPO201400073 tY (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. e 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. 45-68B Rivanna Water and Sewer Authority ;r I U /1-ZC r 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 Doug March C/O Rivanna Water and Sewer Authority Address 695 Moores Creek Lane Charlottesville City State VA Zip 919 833 7152 dmarch @rivanna.org Daytime Phone( ) E-mail 7/1/14, Revised: 7/10/14 Page 1 oft Noe N•0•9 PI B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 1.53 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;$150 ▪ C. Registration Statement on the official DEQ form. I D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. P E. Stormwater Management Plan satisfying the requirements of code section 17-403. IP F. Pollution Prevention Plan satisfying the requirements of code section 17-404. PI G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. e I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Bret Edwards C/O Hazen and Sawyer Address 4011 WestChase Blvd., Suite 500 City Raleigh State NC Zi p 27607 919 833-7152 bedwards @hazenandsawyer.com Daytime Phone( ) E-mail *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14, Revised:7/10/14 Page 2 of 2