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Home My WebLink AboutWPO201500098 Application WPO VSMP 2015-11-24 Till' Albemarle iurity 401 Mdntire Community Development Departn Road Charlottesville,VA 22902-4! *fter, Voice:(434)296-5832 Fax:(434)972-4- °. ---- Planning Application PARCEL/OWNER INFORMATION IMP 07600-00-00-049130 Owner(s): WINTERGREEN FARM LIZ C/0 RIVER BEND MANAGEMENT INC Application # liVP02015013098 PROPERTY INFORMATION Legal Description I ACREAGE WINTERGREEN FARM Magisterial Dist. Samuel Miller Land Use Primary Residential—Single-family(incL modular homes) Current AFD Not in A/F District Current Zoning Primary R1 Residential [APPLICATION INFORMATION Street Address 1134 SUNSET AVENUE EXT CHARLOTTESVILLE, 22903 Entered Judy Martin Application Type Water Protection Ordinances I 11/24/2015 Project Wintergreen Farm-VSMP Received Date 11/24/15 Received Date Final Submittal Date 11/24/15 Total Fees 30 Closing File Date Submittal Date Final Total Paid Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Application Comment Erosion and Sediment Control Plan 11/24/15 • APPLICANT I CONTACT INFORMATION Caitacifxpe Name, Adckess CityState Zip PhonePhoneCt ,NomelLBO: 74,41:-5,1"q°`.4N BEN 40's swoop sttt-tuntsabrAtaiS Rtcrtmwit, 122902, Primary Contact WINTERGREEN FARM LLC 455 SECOND ST., STE. 500 CHARLOTTESVILL 22902 4342454970 Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: WINTERGREEN FARM (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No Is this a revision or resubmission for review? Yes 0 No tffi. County File Number: (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-4011 For revisions or amendments,please indicate which items are being amended. Signatures must be provided for any submission. ISI 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 u required to ensure compliance with the approved plans and permits. 76-49B WINTERGREEN FARM, LLC O7 5t//5- Tax Map&Parcel Print Name of Pr operty Owner S ::,01" of s ,er ate Tax Map&Parcel Print Name of Property Owner S' ature o+ ,: Date ___71=51L WINTERGREEN FARM, LLC / 4 C----� �' /fs-- Tax Map&Parcel Print Name of Property Owner ignature of I ,er g� ate Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name WINTERGREEN FARM. LLC Address 455 SECOND ST SE, SUITE 500 City CHARLOTTESVILLE" / State VA Zip 22902 Daytime Phone(Y341) Z' ' 19 70 E-mail a a r- C4.0.—e0 7/1/14,Revised:7/10/14 Page 1 of 2 *4•110/ Neril LK B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 51.55 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 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 ($3,050D $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. ZI D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. El E. Stormwater Management Plan satisfying the requirements of code section 17-403. I%I 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 COLLINS ENGINEERING, LLC Address 200 GARRETT ST, SUITE K City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434) 293-3719 E-mail scott@collins-engineering.com d*When applications plant 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 ISE MIN, WPO# ` ( q. Fee Amount$30S0 bCODate Paid 114..�-EBy who? &' !ASA/. A& Ill li'1' eceipt# j.7 Ck# i t4 '(( By: ��' / 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 e, BOUNTY OF ALBEMARLE l Department of Community Development ,�'' �3$ s40l McIntire Road ' ;; � Charlottesville,Virginia 22902 VSMP Application Completeness Check Project Title: W'•&- ‘n-a-A Us.r.,\-Jae File Number: w V1). 6\5-9$ Date: \l_a4-15 Reviewer: Your application has been checked for completeness per section 17-409 of the County Code. All items must be received and correct for the application to be deemed complete. ❑ This application is complete and plan review has begun o This application is not complete. Please provide the missing items checked below. Received Correct Y N Y N N/A o Completed application ❑ ❑ ❑ Ij' o Signatures of the Property Owners for each parcel affected ❑ ❑ ❑ 1(/ oCorrect Fees Paid ❑ ❑ ❑ ❑ Registration Statement on the official DEQ form, with correct LDA ❑ ❑ ❑ II 0 Erosion and Sediment Control Plan satisfying the requirements / of code section 17-402. 0 ❑ 0 (� ❑ Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ ❑ ❑ d 0 Pollution Prevention Plan satisfying the requirements of code isection 17-404. The EPA template should be used. ❑ ❑ ❑ i ) 0 Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. The EPA template should be used. ❑ ❑ ❑ .d 0 Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ ❑ ❑ ❑ 0 Requested Variations or Exceptions as provided in code sections 17-407 and 408, if applicable. (SSF,MMT,etc) ❑ ❑ ❑ ❑ ❑ Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. ❑ ❑ ❑ Comments: ■