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Home My WebLink AboutWPO201600041 Application 2016-06-07 J AlbCty Community Development Departmelt emare oun 401 Ntrintire P,,.d Charlottesville,VA 229024696 • in. Voice: ,296-6932 Fax:(434)9724126 .st 4 Planning Application PARCEL I WNER INFORMATION TMP 06100-40-06-126e0 Own e r(S).• HILLTOP PARTNERS LI Application* WP0201600041 PROPERTY INFORMATION a* Leg al D e sc r i p t i o n A C R E AGE Magisterial Distmad utar ttarrilm_1,,,, Land Use Primary„ Current AFD LNot inA/FDistr-tct Current Zoning Primary R2 Residential - APPLICATION INFORMATION Street Address 1411 HILLBItOOK CT CHARLOTTESVILLE,22901 Emily ELnatiiterzed:y, Application Type Water Protattto' n ordifiances 7207 Project litithrenk eSt'IP Amendment Received Date 06/116/16 Received Date Final Submittal Data Total Fees 200 Closing File Date Submittal Date Final Total Paid 200 Revision Number comments Legal Ad SUB APPLICATION(s) Type Stib Appdiceat19Ccmment Stormwater Management/BMP Plan Erosion and Sediment Control Plan APPLICANT CONTACT INFORMATION ee c . L Zip Phalle L,Phoz1,4cei1 c.,11-itactType ntitn < tff E'.•: fT 646 Lt*--7:Ufali 14314114USTIT1N'StIR t4-C .'CHARLOTTES‘ilLL 41.34277.1.4? ..... . ----‘ . Date Signature of Contractor or Authorized Agent of At Virginia Stormwater Manage; ti t Program (VSMP) Tr.. Application for Albemarle County p'Thm Project Name: Hilibrook (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 ❑ No County File Number: WPO 2015-00033 (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. 61-126 Hilltop Partners, LLC r/0 Tax Map&Parcel Print Name of Property Owner gnature 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 Jess Achenbach Address P.O. Box 645 City Charlottesville State VA Zip 22902 Daytime Phone( ) E-mail 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 I RI B. All Fees [Code section 17-208 ``" For new or modified plans; Total acres proposed to be disturbed 1.94 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 QF (minor)amendments to an approved plan;$200 per review ariances;$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. ❑ 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 Justin Shimp Address 201 E Main St, Suite M City Charlottesville State VA Zip 22902 Daytime Phone(434) 227-5140 E-mail justin@shimp-engineering.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# Ob f r tt,Q Fee Amount Date Paid b j3l i 1 �r By who? i h 6('p PQIkY\ (j S Receipt# 4 v Ila Ck# 101,5 ByC UP 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2