HomeMy WebLinkAboutWPO201500065 Application 2015-09-08 ��, Albemarle Cour -/
E
•
z
, Planning Application
PARCEL ir OWNER INFORMATIOI+I v
"''`t 07700-00-00-O11E,t0 t� :...,:e• ...:': AVON HOLDINGS LLC
t# fir■
Application P0201501�0065
PROPERTY INFORMATION
..E:;a•:,e1::.--,.,,:,- :ACREAGE
...._..__�._
='a: .:r,ai 2 't. Scottsville _ _. rr3,. Commercial
Not in A j F District ` < Planned Development Shopping Center
APPLICATION INFORMATION
:.;•„ :st,:..—.., Water Protection Ordinances an li F:nth
P :; :t 5th Street Station - Landfill Capping Amendment - VSMP
-a-e d -, 09/03/1s ` a' 'C'3•.• 2(.
..._ eC. ..3c^ ..E_P:.e, C�a7FY:n 7L:�^"�..e�? { T,t� GEF 200
‘'..,:,sing t` ::ate za• :at. ,na T:"a 200
P.eois.-:n t urnt,er
,
SUB APPLICATION(s):11IPA'F'= _. _ _.._ . Svc ` plicatt: C..c€rfrert 1
Erosion and Sediment Control Plan
Stormwater Management/BMP Plan
i
:Strfain Buffer Development Request
APPLICANT / CONTACT INFORMATION
C• rt ct'ix•l ge .. _
::re:; CitiState h-I:vi*. is.oreCell
_- ._ ._Cirl'._ _L:_ _ 4 . �i . a-,_, rE.s.i_L _.. 9 z
.__ - _.-',,• 'JIE_F .4E- E _. .L D. ..c... »Fr L,:-NE =r. . :+,:°. :_ j4:;,_
`,..,`.. _t:_-0-,r<;y;_t-,. _t'h'e Ze:.' g," :ate.
Nary A of A ;
Virginia Stormwater Management Program(VSMP)
Application for Albemarleation fzolide
Project Name: 5th Street Station - Landfill Gapping WPO Amendment
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes IZI No 0
Is this a revision or resubmission for review? Yes ❑ No 0
County File Number: (to be provided by the County for new applications)
The following are required elements of new applications[from code section 17-401J. For revisions or
amendments,please indicate which items are being amended. Signatures must be provided for any
submission.
El 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.
77-11E Avon Holdings, LLC
Tax Map&Parcel Print Name of Property Owner ignature of er 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 Alan Taylor
Address P.Q. Box 1467
City Charlottesville State VA Zip 22902
Daytime Phone(434) 245-4932 E-mail alae.taylor@redlightmanagement.com
7/1/14,Revised:7/10/14, 1/7/14 Page 1 oft
New New,
El 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 plan;$200 per review
Variances;$150(per request)
Mitigation Plan;$150
❑ C. Registration Statement on the official DEQ form.
El D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403.
❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)
Print Name Daniel R. Hines, P.E.
Address 28 Blackwell Park Lane, Suite 201
City Warrenton State VA zip 20186
Daytime Phone(540) 349-4500 E-mail dhines@bohlereng.com
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months
from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY WPO#
Fee Amount$ .°JO Date Paid ) By who? 1301, k I V i ne','Receipt#I a 1 a4 6 Ck#"2 D'S By: AS IL
LLC
7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2