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Home My WebLink AboutWPO201500060 Permit 2016-02-25 pF AI i,1,111F aft" 1jR�GI13��' COUNTY OF ALBEMARLE Community Development 401 McIntire Road Charlottesville,Vriginia 22902-4596 (434)296-5832 EROSION CONTROL PERMIT Date of Application: 08/31/2015 Permit Effective Date: 02/25/2016 Number: WPO-2015-00060 LANDOWNER: Tap Investments,LLC Phone: 5408855181 2903 N.Augusta St. Staunton,VA24401 CONTRACTOR: Kjellstrom and Lee Phone: (540)885-9980 2815-A N.Augusta St. Staunton,VA24401 REPONSIBLE LAND Tom Jones Enterprises,Inc. Phone: (540)825-4789 DISTURBER: P.O.Box 595 Culpeper,VA22701 Certification/License#: 20991 Type: Responsible Land Disturber Plans Prepared By: Balzer and Associates Inc Plans Dated: 07/26/2010 Last Revised: 10/02/2015 Plans Entitled: Town&Country Shopping Center Location: VSMP/WPO201500060 Dist. 1.24 Acreage: Tax Map: 07800-00-00-009C0 Hydrological JR14 Unit: Issued By:Kenny Thacker Title:Erosion Control Officer Signature Date Notice of Termination General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10) (Please Type or Print All Information) 1. Construction Activity Operator: Name: ,T rtp :N V i;z,r 1Y?;gin c 1- (- L. (AiContact: p -�e_r t,�.J a) ff Mailing Address: 2<10 3 ikot ,s-fa ._(-)-.4-. City: J. r.l r. ,^ State: V A Zip: 2440 l Phone: ‘10 - EX.!..;-.-:)._r'fi I 1. E a Ail address(if available): 1...); :�,,/, tom? ,L(-'")r I . < 0'--"- 2. Name and Location of the Construction Activity:(As listed on the Registration Statement.) Name: I l.�c`"• } (e�•.., ,�'4'' . 1 S �,,;,)ap i.,. ("-A�e' Address(if available): ' ,-)Ci [>1�f/7�i`� D `'`` . City: (. k7iv l.,He). ,�7l r State: i1A Zip: County(if not located within a City): A 1 L,r""'/el-I" -c Si. 10 337 Longitude(decimal degrees): ` 7 g.`'f 1V 7 Latitude(decimal degrees): / 3. General Permit Registration Number: JMf-.AQ t4 ` Q 14 4. Reason for Terminating Coverage Under the General Permit: (The operator shall submit a Notice of Termination after one or more of the following conditions have been met.) A.Necessary permanent control measures included in the SWPPP for the site are in place and functioning effectively and final stabilization has been achieved on all portions of the site for which the operator is responsible. When applicable, lone-term responsibility and maintenance requirements for permanent control measures shall be recorded in the local land records prior to the submisslon of amotice of termination; ❑ B.Another operator has assumed control over all areas of the site that have not been finally stabilized and obtained coverage for the ongoing discharge; ❑ C.Coverage under an alternative VPDES or state permit has been obtained;or ❑ D. For residential construction only,temporary soil stabilization has been completed and the residence has been transferred to the homeowner. The notice of termination should be submitted no later than 30 clays after one of the above conditions being met.Authorization to discharge terminates at midnight on the date that the notice of termination is submitted for the conditions set forth in subsections B through D above, unless otherwise notified by the VSMP authority or the Department. Termination of authorizations to discharge for the conditions set forth in subsection A above shall be effective upon notification from the Department that the provisions of subsection A have been met or 60 days after submittal of the notice of terminations,whichever occurs first. 5. Permanent Control Measures Installed: (When applicable, a list of the on-site and off-site permanent control measures (both structural and nonstructural)that were installed to comply with the stormwater management technical criteria.Attach a separate list if additional space is needed.) Permanent Control Measure#1 ilAType of Permanent Control Measure: Ai Date Functional: Address(if available): - City:- State: Zip: County(if not located within a City): Latitude(decimal degrees): Longitude(decimal degrees): _ Receiving Water. Total Acres Treated: Impervious Acres Treated: Page 1of2 01/2014 Permanent Control Measure#2 Type of Permanent Control Measure: Date Functional: Address(if available): City: State: Zip: County(if not located within a City): Latitude(decimal degrees): Longitude(decimal degrees): Receiving Water: Total Acres Treated: Impervious Acres Treated: Permanent Control Measure#3 C Type of Permanent Control Measure: Date Functional: Address(if available): City: State: Zip: County(if not located within a City): Latitude(decimal degrees): Longitude(decimal degrees): Receiving Water: Total Acres Treated: Impervious Acres Treated: 6. Participation In a Regional Stormwater Management Plan: (When applicable, Information related to the participation in a regional stormwater management plan.Attach a separate list if additional space is needed.) Regional Stormwater Management Facility , Type of Regional Stormwater Management Facility: G r A"t_V ,(, oe/4/44"4 Oa RC/ Address(if available):�L f['�/ _ ff�i4X. aft ,0/6r.-W/1. £'t to0I"'n 12. // City: ahl� GJ State: 1)A Zip: an29!/ County(if not located within a City): 7 /?//7,0P p !q '. Latitude(decimal degrees): JJ � b. D 3�'n —7 Longitude(decimal degrees): Total Site Acres Treated: Impervious Site Acres Treated: Q. 9( 7. Perpetual Nutrient Credits: (When applicable, information related to perpetual nutrient credits that were acquired in accordance with§62.1-44.15:35 of the Code of Virginia.Attach a separate list If additional space is needed.) Nonpoint Nutrient Credit Generating Entity Name: NIA Perpetual Nutrient Credits Acquired(Ibs/acre/year): 8. Certification:"I certify under penalty of law that I have read and understand this Notice of Termination and that this document and all attachments were prepared in accordance with a system designed to assure that qualified personnel property gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the Information, the Information submitted Is to the best of my knowledge and belief true, accurate,and complete. I am aware that there are significant penalties for submitting false information including the possibility of fine and imprisonment for knowing violations." 1 r Printed Name: • t'. ' Title: T icr T I Y! Signature: Date: (Please sign in INK. This Certification must be signed by the appropriate person associated with the operator identified in item#1.) 01/2014 Page 2 of 2 Separate permits may be required for Electrical,Plumbing,Heating,Ventilating,and Air Conditioning. This permits becomes null and void if work or construction authorized is not commenced within 6 months,or if construction or work is suspended or abandoned for a period of 6 months at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct.All provi- sions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. By signing this building permit,the owner and/or their agent hereby grant employees of the Albemarle County Community Development&Real Estate Departments the right to enter and inspect the subject property Monday through Friday between the hours of 8:00 a.m.and 5:00 p.m.,holidays excepted. If you are not the owner of record,please check which applies: I certify that I am the agent for TAP Investments, LLC The Owner,and am authorized to submit this application on behalf of the Owner under the agency I am neither the Owner nor the Owner's agent.I certify that written notice of this application, by pro- viding a copy of this application,will be mailed to the Owner at the following address: Within 10 days of today's date as required by Virginia Code§15.2-2204(H).1 understand that,if I do not provide the notice to the Owner as provided herein,the building permit application and every other subsequent approval,permit or certificate related thereto could be determined to be void. • Signature of Owner,Con ac r Authorized Agent Date I Signature of Owner,Contractor,or Authorized Agent Date ELECTRONIC RECORDS STATEMENT:Albemarle County is creating and using electronic records and electronic signatures as allowed by the Uniform Electronic Transactions Act(Virginia Code§ 59.1-479 et.Seq.).As an applicant to the Building Permit process,you may consent to receive,or have online access to,electronic records and receive and create records having electronic signatures related to Building Permits,Correspondence,Inspection Tickets and Certificates of Occupancy(the Building Permit transactions). • 1 • Initials of Owner,Contractor or Authorized Agent Date Your agreement to conduct Building Permit transactions by electronic means does not prevent you from refusing to conduct other transactions by electronic means.