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Home My WebLink AboutWPO201500088 Application 2015-11-02 Albemarle CluntyCommunity Development Departn• 401 McIntire Road Charlottesville.VA 22902-4: Nome Nal" Voice:(434)296-5832 Fax:(434)972-4 Planning Application PARCEL/ OWNER INFORMATION TMP 05700-00-00-067A0 Own er(s): CARTER, WEYMAN C OR KRISTEN A Application # WP0201500088 PROPERTY INFORMATION Legal Description LONGACRE FARM 1 Magisterial Dist. White Hall Land Use Primary Residential -- Single-family(incl. modular homes) Current AFD Not in AjF District v Currert Zoning Primary Rural Areas [APPLICATION INFORMATION Street Address 4175 LONGACRE FARM LN CHARLOTTESVILLE, 22901 Entered Judy Martin Application Type Water Protection Ordinances I11n/2015" Project Longacre Farm- Mitigation Received Date 11/02/15 Received Date Final Submittal Date Total Fees 1 Closing File Date Submittal Date Final Total Paid 1 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Application Comment Erosion and Sediment Control Plan Stormwater Management/BMP Plan APPLICANT CONTACT INFORMATION ContactType I Name Address CityState Zip Phone I PhoneCt Owner/406m CARTER,WEYMAN C OR KRISTEN A 4175 LONGACRE FARM LN CHARLO II t$VILL 22901 Primary Contact NAT PERKINS 680 IVY FARM DRIVE :CHARLOTTESVILL 22901 4345317287 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County nI !` Project Name: Longacre Farm (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No 0 Is this a revision or resubmission for review? Yes 0 No 0 County File Number: WP0200400100 (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. Il 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. 57/67A1 Lawjan LLC /-/l 11/2/15 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 Nat Perkins Address 680 Ivy Farm Drive City Charlottesville State VA Zip 22901 Daytime Phone(434) 531-7387 E-mail nat.perkins@gmail.com 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 Nay 'fir ® B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 0.14 ac 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;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. 0 H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. /Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Nat Perkins, Bend Properties LLC Address 680 Ivy Farm Drive City Charlottesville State VA Zip 22901 Daytime Phone(434) 531-7387 E-mail nat.perkins@gmail.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# a Fee Amount$ ( Sd. Date Paid VW'S By who') y) Rape,*ej Receipt# l U c)030 f�Ck# 11 0 B: �L LCC- 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2