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Home My WebLink AboutWPO201500003 Application 2015-02-03 „*':'rf,24'''t• Albemarle County 401 Community Development Department ,'.-1 ntire Ro ad Charl ottesville,VA 22902-4596 ce:(434)296-5632 Fax : (434)972-4126 Ati:177:,:ile, Planning Application Avow- ,loof IFTARcEL/OWNER INFORMATION IMP 09 DAD-(10-OD-00300 WTIOPN0201500003 PROPERTY INFORMATION Owner(s): COMMONWEALTH OF VIRGINIA DEPT OF CONSERVATION &RE Application# Legal Description ACREAGE PARCEL B A A Magisterial Dist, ' Scottsville 1r Land Use Primary Forest I ' i Current AFD ' Not in A/F DistrictEl Current Zoning Primary l Neighborhood Node! District :E7 !APPLICATION INFORMATION Street Address Entered By ApplicationType Water Protection Ordinances 7, ' ---- i Emily Lantz ---• r 32O15 Project Oak Hill Phase 2 Sanitary Sewer Project Received Date 02/02/15 Received Date Final Submittal Date 02/02/15 Total Fees 150 Closing File Date Submittal Date Final Total Paid 150 Revision Number Comments ' A Legal Ad A IS-D-0 APPLICATION(s) Type .,, 1,S4b,Apt icatio Comrrient „.:,,W1,9A0.--vM,A,'4,i',:,'T-FA-,i-,,411,74 ., ::-,NIV.,43,/,,71.,,-...., '!'t;'.,:zi2;1!AL:,::'..L.I:h,':iSr:'-gl1a2:;fs:L'e,gONf,'-J APPLICANT / CONTACT INFORMATION ContactType Name d4 ciles,p CityState Zip 1 f,',I.torte Phonerrell I 45.34444*.tit ' i caimtwieirt*EA:T#b,i,14RotAtA,t,Etr.t#,,o:;1,o.i.q4Ct.#d:,-,T.'r'"::.'P,,it,,,',7v, iioNf,vii,, - ,Nev,:,,,,,- _,........-.,,_,..—,_........:1,....,..., ...,.....„.. Prim 3 nr C zrnt a e JEKE-11Y NI LYNN P.E. 168 SPOTNAP ROAD CHARLOTTESVILL 22911 4345774511 Signature of Contractor or Authorized Agent Date *41000, ALRn!l Virginia Erosion and Sediment Control Program (VESCP) Application for Albemarle County t �7RGjN�P (This application is only to be used for projects exempt from the Virginia Stormwater Management Program,VSMP,and the DEQ General Permit) Project Name: Oak Hill Phase 2 Sanitary Sewer Project (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: (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. 0 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. A_�4a4 j, v+i-r _ E.i~'SS 5t e-�,.. c.5C o„,-`►);e 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 Jeremy M. Lynn, P.E. -Albemarle County Service Authority Address 168 Spotnap Road City Charlottesville State VA Zip 22911 Daytime Phone(434) 977-4511 E-mail jlynn@serviceauthority.org 7/1/14,Revised: 7/10/14 Page 1 of 2 ❑ B. All Fees [Code section 17-207] Total acres proposed to be disturbed 2.77 (LOD)0.40(AOD) Acres to be disturbed Total Fee Less than 1 $150 per review More than 1 $300 per review For amendments to an approved plan;$200 per review Exceptions;$240 Mitigation Plan;$150 Construction Record Drawing;$300 Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Maggie Hopkins Address 4435 Waterfront Drive, Suite 205 City Glen Allen State VA Zip 23060 Daytime Phone(804) 270-3515 E-mail maggie.hopkins@obg.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# f Fee Amount$ I�/V Date Paid?-2-I 5 By who?Ii) aV\ U 16 lJJJ�� } �• Receipt#"I F 10 Ck# 1--3C1 By: 0./ \Ii✓. P,;khori 7/1/14,Revised: 7/10/14 Page 2 of 2 pS 1Lj Virginia Stormwater Management Program (VSMP) E' zr Application for Albemarle County Project Name: Oak Hill Phase 2 Sanitary Sewer Project (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 WI County File Number: W CC)0kS""3 (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) 7 ° oist cej 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. 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 Jeremy M. Lynn, P.E. -Albemarle County Service Authority Address 168 Spotnap Road City Charlottesville State VA Zip 22911 Daytime Phone(434) 977-4511 E-mail jlynn@serviceauthority.org 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 ❑ B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 3.35 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;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Maggie Hopkins, P.E. Address 4435 Waterfront Drive, Suite 205 City Glen Allen State VA Zip 23060 Daytime Phone(804) 270-3515 E-mail maggie.hopkins@obg.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# _seog` A Fee Amount$ t i Z� Date Paid 5)) By who? Receipt# '/0 Ck# I.3) G By: 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 Todd Shifflett From: Todd Shifflett Sent: Wednesday, February 11, 2015 11:38 AM To: 'jlynn@serviceauthority.org' Cc: Max Greene Subject: Oak Hill Phase 2 Sanitary Sewer Project(WPO201500003) Jeremy, Based on the acreage,you all were supposed to pay$300 for this application. You have already paid $150, so please provide us with either a check or cash for the additional $150. Thanks, Todd Todd Shifflett Community Development Engineering Division (434)296-5832 ext. 3072 tshifflett@albemarle.org 1