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Home My WebLink AboutWPO201600011 Application 2016-02-22 • rt Albemarle 'ounty401 McIntire Community Development Departrr Road Charlottesville,VA 22902-4; *41'` Voice :(434)296-5832 Fax:(434)972-4 Planning Application PARCEL/ OWNER INFORMATION TMP 04500-00-00-11260 Owner(s): HG LAND LLC Application # WP0201600011 PROPERTY INFORMATION Legal Description!ACREAGE PARCEL X Magisterial Dist. Rio Land Use Primary, Commercial Current AFD I Not in A/F District Ej Current Zoning Primary Cl Commercial [APPLICATION INFORMATION Entered Street Address Application Type LWater Protection Ordinances ' Judy Martin 12/2272016 Project Harvest Moon -VSMP Received Date 02/19/16 Received Date Final Submittal Date 02/22/16 Total Fees 13 Closing File Date Submittal Date Final Total Paid 13 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Application Comment Erosion and Sediment Control Plan 02/22/16 Stormwater M a n a ge m e n t / B M P Plan 02/22/16 APPLICANT / CONTACT INFORMATION ContactType Name I Address I CityState I Zip Phone I PhoneCi Owner/Applicant HG LAND LLC 109 BLUEBERRY RD CHARLOTTEBV1LL 22901 Primary Contact MARK HAHN 109 BLUEBERRY ROAD CHARLO it LSVILL 22901 4342969091 Signature of Contractor or Authorized Agent Date .Ac Virginia Stormwater Management Program (VSMP) Application for Albemarle County -`,tom?' ��RGIN�P Project Name: Harvest Moon (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 WI County File Number: Not applicable (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. 45-112G HG Land, LLC dee:ti ‘,/,‘O ,/ .2/J.20/..‘ Tax Map&Parcel Print Name of Property Owner Signature of 0 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 Mark Hahn Address 109 Blueberry Road City Charlottesville State Va Zip 22901 Daytime Phone(434) 296-9091 E-mail mark@hmcatering.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 l B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed_ Z•3t 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;$150 ® C. Registration Statement on the official DEQ form. 0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. ® F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ® G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. NlAH. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ® I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. 14/1 J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Dustin Greene Address 172 South Pantops Dr City Charlottesville State Va Zip 22911 Daytime Phone(434) 979-8121 E-mail dgreene@dominioneng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ °. 0 to DatePaic4,')(1 !(u ' Bywho? ■( 4 11/16 it Receipt 14 )030.37 Ck# 1.3iNkli By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 oft vole rC`.te I'oi Dominion 172 South Pantops Drive e y i� Engineering Charlottesville, VA 22911 o C , ffj- 434.979.8121 (p) P000�i ear' 434.979.1681 (f) '>e - DominionEng.com Transmittal Cover Sheet To: John Anderson Date: 02.19.16 Civile Engineer II Address: Albemarle County Community Development Transmitted: EJ By Mail 401 McIntire Road Charlottesville, VA 22903 By Hand From: Michael Myers, P.E. By Email Application: VSMP Plan Project: Harvest Moon For Pick-up Project#: not yet assigned Quantity Item Description 1 Initial VSMP Application 2 VSMP plans(includes E&SC and Stormwater Management plans) 2 E&SC Narrative 2 Stormwater Pollution Prevention Plan (includes Registration Statement and PPP) 1 Check for$1,350 Comments: All Hydraulic/Hydrologic Calculations and CN Calculations are shown on the VSMP plan Delivered by: 0 Dominion Engineering Client Received By: Other Date: For Pick-up: At Dominion cc: Mark Hahn Engineering Kevin O'Brien Virginia Stormwater Management Program (VSMP) � � Application for Albemarle County '' I e' V�RC;ICIIP Project Name: Harvest Moon-Phase 1 (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No WI Is this a revision or resubmission for review? Yes ® No D County File Number: WPO 2016-00011 (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. 45-112G HG Land, LLC i tom` .y 5/17/16 Tax Map&Parcel Print Name of Property Owner Signature of 0 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 Mark Hahn Address 109 Blueberry Road City Charlottesville State Va Zip 22901 Daytime Phone(434) 296-9091 E-mail mark@hmcatering.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of2 ,A1 rQ i.cik F ' int t,sijiic All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed '-3 1 A 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;$150 ® C. Registration Statement on the official DEQ form. ® D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. F. Pollution Prevention Plan satisfying the requirements of code section 17-404. • G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. fosi*I. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ® I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. 11J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Dustin Greene Address 172 South Pantops Drive City Charlottesville State Va Zip 22911 Daytime Phone(434) 979-8121 E-mail dgreene@diminioneng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 \ ,._._..._....._\) ) /// ' 1 II / / / / / i I I \\l------ i ID 7 ,..... \ / / I / /i �/1! ® A\ \\V \ \\\ '�" • A 1 11 i 1 1 • • I xi 1 ' 11 �\ \\J \\ \ \ ' 1 I i \ \ i . 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Engineering RIO DISTRICT, ALBEMARLE COUNTY, VA J R+ +, 1.7?South Panmps ornre SHEET TITLE Q� C m S.. ,. 4:.111" ..% SWPPP EXHIBIT y �Far1o434 9/ H 11911 FILE NAME' r � e 434 9/9 1691((9 iiiiiiiii. IS SHOW DID DOG IfFN SCALE: DESIGNED BY: DMWN BY: CHECKED BY: t'( \� o••�� ++=i�9.1 sn p)