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Home My WebLink AboutWPO201500093 Application 2015-11-13 Community DevelopmentDepartrr Albemarle Clunty 401 McIntire Road Charlottesville.VA 22902-4! ..' • .., Nor' lore Voice : (434)296-5832 Fax:(434)972-4 Planning Application PARCEL / OWNER INFORMATION TMP 05600-00-00-05300 Owner(s): LICKINGHOLE CREEK LLC Application # WP0201500093 PROPERTY INFORMATION Legal Description 1 ACREAGE Magisterial Dist. ' White Hall v Land Use Primary Forest Current AFD l Not in AIF District v Current Zoning Primary ; RI Residential .m., [APPLICATION INFORMATION Entered Street Address . _ . _ . Judy Martin Application Type ; Water Protection Ordinances [v111. _ii 2/2015 Project Westlake Hills Ph. 1 - VSMP-Amendment Received Date Received Date Final Submittal Date Total Fees 2 Closing File Date Submittal Date Final Total Paid 2 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Application Comment Erosion and Sediment Control Plan APPLICANT/ CONTACT INFORMATION ContactType Name Address CityState 43 Phone Phortee own er/Applicant LICKINGHOLE CREEK LLC P a BOX 1467 CHARLOTTESVILL 22902 . ,. Primary Contact COLLINS ENGINEERING 200 GARRETT ST., STE. K CHARLOTTESVILL 22902 4342933719 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle CountyA ! ' Project Name: WESTLAKE HILLS PHASE I WPO AMENDMENT#2 (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 0 No LK County File Number: WP02013-16 (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. Cg/ 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. 56-53 LICKINGHOLE CREEK, LLC 11/12/15 Tax Map&Parcel Print Name of Property Owner nal uie h1 n r 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 LICKINGHOLE CREEK, LLC Address PO BOX 1467 City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 Now 0 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 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 plar($200 per review Variances;$150(per request) Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. I2g D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. O F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. O H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name COLLINS ENGINEERING Address 200 GARRETT ST, SUITE K City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434) 293-3719 E-mail scott@collins-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# eUl�iY1S Fee Amount$ LOU Date Paid I 11131 i5 By who? Cpvtlrui_0f/ nC4 Receipt# ‘1)LZb lF Ck# Z9 M By: o„L, 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 Virginia Stormwaters. anagement Program (VSMP) Application for Albemarle Countyotte Project Name: WESTLAKE HILLS PHASE I WPO AMENDMENT#2 (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No I%I Is this a revision or resubmission for review? Yes El No 0 County File Number: WP02013-16 (to be provided bythe County ry 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. al 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. 56-53 LICKINGHOLE CREEK, LLC Tax Map&Parcel Print Name of Property Owner ~,gnat u„�e.?1iumv. • 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 LICKINGHOLE CREEK. LLC Address 2421 IVY ROAD City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 oft ❑ B. All Fees [Code sectiofr17-208] 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 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;$150 ❑ C. Registration Statement on the official DEQ form. IXI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. El F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name SCOTT COLLINS - COLLINS ENGINEERING Address 200 GARRETT ST, SUITE K City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434) 293-3719 E-mail Scott@ collins-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 oft