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Home My WebLink AboutWPO201500101 Application 2015-12-03 Community Development Departrr Albemarle 1 lunty 401 McIntire Road Charlottesville.VA 22902-4! t4.* -Noe Voice:(434)296-5832 Fax (434)972-4 Planning Application PARCEL / OWNER INFORMATION IMP 03200-00-00-017A1 Owner(s): CHURCH OF JESUS CHRIST OF LATTER-DAY SAINTS C/O LDS Cl Application # WP0201500101 PROPERTY INFORMATION Legal Description I ACREAGE A Magisterial Dist. Rio Land Use Primary Forest Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address 1275 TIMBERWOOD BLVD CHARLOTTESVILLE, 22911 Entered Judy Martin Application Type Water Protection Ordinances 12/3/2015 Project LDS Church -VSMP Received Date 12/02/15 Received Date Final Submittal Date 12/07/15 Total Fees 13 Closing File Date Submittal Date Final Total Paid 13 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Application Comment APPLICANT/ CONTACT INFORMATION ContaotType Name Address I CityState Zip j Phone PhoneCt Owner/Applicant CHURCH OF JESUS CHRIST OF LATTER-DA 50 E NORTH TEMPLE ST FLOOR SALT LAKE CITY U 64150 Primary Contact ED BLACKWELL 566 EAST MARKET STREET HARRISONBURG, 22601 5404329555 Signature of Contractor or Authorized Agent Date .4p Virginia Stormwater Management Program (VSMP) 4 Application for Albemarle County Project Name: LDS CHURCH- AKE (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ® No 0 Is this a revision or resubmission for review? Yes 0 No County File Number: WPO 2006 00055 (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. 61 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 17A1 CHURCH OF JESUS CHRIST OF Tax Map&Parcel Print Name of Property Owner Signature of Owner Date LATTER-DAY SAINTS 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 Address City State Zip Daytime Phone( ) E-mail 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of2 tame ® B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 4.75 Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than I $290 $ $20 --� 1 and less than 5 $2,700 ( 1,35 $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. O G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. O H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O 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 Ed Blackwell Address 566 East Market Street City Harrisonburg State VA Zip 22801 Daytime Phone(540) 432-9555 E-mail ed@blackwellengineering.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$1 3 SO,ciDate Paid i n J 3By who? 'S t OLl<A,e-I/ Receipt# 1 Ck# 3 070 LI By: ASIC PL- 7/1/14, 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2