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Home My WebLink AboutWPO201500058 Application 2015-08-25 , lbemarle County Community Development Department f 401 htclntire P^ad Charlottesville.VA22902-4596 Noloe Voice: 296-5832 Fax:(434)972-4126 tr Planning Application PARCEL j OWNER INFORMATION TMP 07700-00-0Q-040A0 Owner(s): RIVANNA WATER&SEWER AUTHORITY Application# W 0201500058 PROPERTY INFORMATION Legal Description I ACREAGE Magisterial Dist. SCottsviile + Land Use Primary Public Current AFD !Not in A/F District Lal Current Zoning Primary! Light Industry .. APPLICATION INFORMATION Street Address 1194 N MOORES CREEK LN CHARLOTTESVILLE,22902 Entered By Application Te ! EmilyLantz YP Water Protection Ordinances Project Moores Creek Recovery Facility,Odor Control Project Received Date 08/19/15 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 Sub Applicatio Comment Stormwater Management/BMP Plan • Erosion and Sediment Control Plan Stream Buffer Mitigation Plan APPLICANT j CONTACT INFORMATION ContactTypeName Address CityState Zip Phone PhoneCell chyntriApoi.t RIYANNA WATER&SEWER AUTHORITY 695 MOORES CREEK LANE CHARLOTTESVILL 22902- ;-nmary Car-tact �BRET EDWARDS a 4011 WESTCHASE BOULEVARD `RALEIGH NC a 27607 9197558568 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program SMP i''a Application for Albemarle County Project Name: Moores Creek Advanced Water Resources Recovery Facility-Odor Control Project (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No El Is this a revision or resubmission for review? Yes 0 No El County File Number: (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. ® 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. 77-40A Rivanna Water and Sewer Autho edu t _at I 0115 Tax Map&Parcel Print Name of Property Owner Signatu e of Owner Dat; 77-38B Rivanna Water and Sewer Authority t C / f'�q ' 5 Tax Map&Parcel Print Name of Property Owner Sign ture of Own 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 Michelle Simpson Address 695 Moores Creek Lane City Charlottesville State VA Zip 434 Daytime Phone(N.) 977-2970 E-mail msimpson@rivanna.org 7/1/14 RPvicerl• 7/10/14 1/7/14 Paap 1 nf� Nwit L B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 2.10 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;$150 RI C. Registration Statement on the official DEQ form. CI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. Ig E. Stormwater Management Plan satisfying the requirements of code section 17-403. RI F. Pollution Prevention Plan satisfying the requirements of code section 17-404. EI G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. El l H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. 0 I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. 0 J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Bret Edwards Address 4011 Westchase Boulevard City Raleigh State NC Zip 27607 Daytime Phone(919) 755-8588 E-mail bedwards@hazenandsawyer.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ I.7,5-6•00 Date Paid$-t 9-i 5 By who? ,F n'" t4i"4-e,r- Receipt# I Dl Ck#eiS 3 1 By:-4 ? Sev- A-1-1,Gtr, 7/1/14 RPvicpri• 7/111/14 1/7/14 Pa RP of 9