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Home My WebLink AboutWPO201600036 Application WPO VSMP 2016-06-06 .. . , Community DeveloiamentDetaartri Albemarle 'ounty ,....,, ,,,,4. ,.... ,,...9 401 McIntire Roar!Charloftesville,VA 22902-4! Voice:(434)296-5832 Fax:(434)972-4' Planning Application PARCEL/ OWNER INFORMATION TMP 05900-00-00-037C7 Owner(s): WINSLOW,JENNIFER&FRANKLIN, TRS 11/F JENNIFER H liVINSL Application * WP0201600036 PROPERTY INFORMATION Legal Deacriptian IVY CREEK 9 i _ , Magisterial Dist. 12ack JoUett . Land Use Primary Residential-- Single-family (incl, modular homes) r-- — 1-- Not in A/F District lr, Current AFD APPLICATIONCurrent Zoning Primary RUral Areas INFORMATION Street Address 1421 PALLAS HILL LN CHARLOTTESVILLE, 22901 Entered -- - ------.. __Jutiv Martin Application Type tWater Protection ordinances .g74 5/312016 Project Carver Bridge-VSMFt Received Date 05/03/16 Received Date Final Submittal Date 05/09/16 Total Fees 2 Closing File Date Submittal Date Final Total Paid 2 Revision Number Comments I Legal Ad SUB APPLICATION(s) Type Sth Aplicaton Comment Erosion and Sediment Control Plan 05/09/16 '...-;''''.t.:'''.1,,,;:_:;:,-t.:"jit'::;'::::::!'''''.:4::tii':,-:!.1::;.:7:1'P'-','t:;:'r:'1,ii'4tPet.,:;!.,:,;,:,i'i-:'-:':;::j.;''.i•''g,if:::..1-.'1,'-'-'4,'!:7:' ";':.:i,'I'ir':':(:;:;.itt,il:1!j'-7.!''':41,T.-1,,t.i.i..::':j':-::;-:';:--if,i4:5;:.'k.._.',,,IL;,i'-*14,ip.-k;:...,?.:,l:i,-'j.',,,a'''---,,.::..'flia:'.fa,..•'-',t.IN:','IZ-'ec:'2;i:i-!.'A.:':,:',.il-'2iiL2:-,:z. , APPLICANT/ CONTACT INFORMATION s ! 1 ContaciType , ,., Namee., , ... , , , resCi State I Zip Phone PhorteCt A''''''..`_::,;:l..i'..4•Sli**,;A"';...--;.,,,:-ii,. .i 17:',.'.'"':,,,::=44,F v , .'..,,', “*..44. ,--t,,t,,,q,''"-,44.1Ezt. '',V0,11,''':'411,1,*,b9.1,,$,._._ :,?;,',e',.r.,4,,.',,,,, .;',.,.!, ",,,,I.,-.,:r4s,';''''''-',,,.."1A1,,,A`4,7j=r,',.',5,.rz,"]-4,-,,,,.:,.i.,,,',.,,,',.-q-r.th-,i'4 i„.',4''... Applicant THOMAS A. CARVER 200 GARRET ST., STE. FC/0 H CHARLOTTESVILL 22901 4342455800 Primary Contact CLARK GATHRIGH 100 10TH ST., NE, STE. 200 CHARLC)TTESVILL 22902 434971848 MIIIIIMINIMMIIIIMINI=1111111=111= Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County tico oft Project Name: C4v V QY. (Sy N bsL (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 NoN6.1 Is this a revision or resubmission for review? Yes El No ❑ County File Number:V.(f4?, \'Looa3 (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. NIT 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. T1^/\ SCJ '37� / T�ov.�o�g A C0.4vc i/ ��217s L-- c, _ 6 . Tax Map&Parcel Print Name of Property Owner Sign ure 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 o C0.Y'V ty Address 20O C avve S� , 51n; F c/o No.r✓Q,._ City 0_\o.„`o esV t\I-( State X M Zip -2--Z9o) ) Daytime Phone et3J ZaS -S? E-mail t P1Le c\-.e°I V.t �I Com 7/1/14,Revised:7/10/14 Page 1 of 2 *Iwo' Lr/ B. All Fees[Code section 17-208] For new or modified plans;Total acres proposed to be disturbed ' 11 AG 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 $6,100 $3,050 $450 100 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150 --Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. "IS1 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. 1 E. Stormwater Management Plan satisfying the requirements of code section 17-403. D F. Pollution Prevention Plan satisfying the requirements of code section 17-404. G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. • H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name GLYK eaLf Address\\\ t j ' ¶ �� SvA\ 2�0 City Gy-\t,vAi `sv State Zip 2-Zi0 Daytime Phone( ) E-mail-71'g246V8 4c"1 - Y 1 ,�L0194 hs. <�,•,� *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised:7/10/14 Page 2 of 2 Virginia Stormwater Management Program(VSMP) J ® itt Application for Albemarle County Project Name: �..s'"tVCt,ie (The name should be the sari&as it appears on plans) Is this an amendment to an approved plan? Yes 0 Nodi Is this a revision or resubmission for review? YeS\11 No 0 County File Number: opo t th '36) (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. ""113 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. PA s9 e�(Cc1 7 Ti hvMcLs A Ccc,nt6 Tax Map&Parcel Print Name of Property Owner Si• : ure 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 Tc;M Car V e Address S 2–CO G f v e t- SiS'v iF C/O 1.&r en fy City—C &V t b il2='V t.1 t e State \", Zip 2.1 Ct Of Daytime Phone(434)_.._ 0-'4S Sf3,0Oa_._,._.__.E-mail Charvein ec u i t olr. 7/1/14,Revised:7/10/14 Page 1 of 2 ISZ B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 0 a 3 ki‘G Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $290 45 $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 $6,100 $3,050 $450 100 100 and more $9,600 $4,800 $700 For(minor)amendments to an approved plan;$200 per review Variances;$150 --Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. N. D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. -\IYI E. Stormwater Management Plan satisfying the requirements of code section 17-403. 0 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. h G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Q.d6Y\C„ Address V=1"‘ SA-N.\ r�j City C\ Aa'`QT'r t State q , z v..}� Zip 2.z.,10 Daytime Phone( ) 1�x''80-8 e�� 1�Y l�l.�� 3 r( -E-mail C. *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# irG (� ''1`,,__ i �^t 1,0°1 Fee Amount$ (?q5' Date Paid /3/)t f By who? f5. (Jour k Gct4r',g eceipt# `l�'t 4i CP Ck#L t)°1\ By: E ltd 7/1/14,Revised:7/10/14 Page 2 of 2