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Home My WebLink AboutWPO201500064 Application 2015-09-08 COmmunity Dev elopment Department eerna 14Cit , Albrle our C •/ ,,,.., , ..a,e Road Charlottesville.VA 22902-4596 k4-'10ii: , "VI Se' (43,1)296-5632 Fax (434)972-4126 Planning AppiiCation -tiaitilLo:iii [PARCEL] OWNER INFORMATION IMP 434400-00-00-0213130 Owner(s): DAVIS, BENJAMIN NEIL Application# WP0201500064 iPROPERTY INFORMATION i Legal [teazription I ACREAGE PARCEL 3 tit a g,stertal Dist, Jack Jouett rivi LandUso Primary Forest ...-1 1..,. ,... L....,......, t---- :,rrent 4Fr) Ivy Creek ...t , Current Zoning Primary Rural Areas 1L1, ___ APPLICATION INTORMA I IONI 1--- E Street:Address iEntered Sy r--.1 .atmelie Roth i ei APPlication Type Water Protection Ordinances Id ....„.... _ Project Davis Residence Driveway - VESCP I Received Date 09/04/15 F.,e,:.r.'i ,..E.: :.11.t.'.i '''','...S: '3,.,:::----tta Date Total Fees 300 , Closing Fe __,„Date [N _,I Submittal Date Final! Total Paid 300j._ . ii ....1 Revision Number Comments — Legal 4 d y. 1 „ SUB APPLICATION(s) - - Type ., ''.-,;;:-....AppiK;atic, 'Erosion and Sediment Control Plan !APPLICANT i CONTACT INFORMATION L,-1 1 rf,-:..: ' Cit -Stte 4.„„--1-2.-.,thNkr ........ f.1.1.9.9.!e.c0 ,-.111E VA '2293-6 NP ENGINEE:2'.- D---,it:T-7i: `....i.t :22901 4345317387 Signature of Contractor or Authorized Agent Date s oe atg� Virginia Stormwater Malragement Program (VSMP) r Application for Albemarle County lkiett Project Name: Davis Residence Driveway (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 El County File Number: 0 101S-62 (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. I✓i 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. 44-20B Benjamin Davis 10•9.1s 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 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Ben Davis Address 452 Solace Lane City Earlysville State VA Zip 22936 st,-t Daytime Phone(434) 981-546- E-mail davisbnd@gmail.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 E B. All Fees [Code section/-208] For new or modified plans;Total acres proposed to be disturbed 1.77 ac Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $290 $145 $20 4e--1-0-e)1 and less than 5 $2,700` $1,350 $200 5 and less than 10 $3,400 $1,700 $250 MOA 0)1 10 and less than 50 $4,500 $2,250 $300 ?Ai D 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. E 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. El 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. O 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 NP Engineering (Nat Perkins) Address 680 Ivy Farm Drive City Charlottesville State VA Zip 22901 Daytime Phone(434) 531-73$7 E-mail nat.perkins@gmail.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# —(04 Fee Amount$i05-0." Date Paid l V1ny///c—By who? 'Be sn j c04-1,;n LA./. Receipt# l o a 13 3 Ck# J 03'1 By �Cnt1; � 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2