HomeMy WebLinkAboutWPO201600045 Application 2016-06-21 Albemarle County r-mmunityDevelopment Department
401 WI nti ra, Vic!Charlottesville,VA 22902-4596
Planning Application Voice:` {)296-5832 Fax :(434)972-4126
PARCEL f OWNER INFORMATION'
TM PI 055E0-01-O0-000H0 I Owner(s): COUNTY OF ALBEMARLE,VIRGINIA
Application* I WPO2OI 600045 I
PROPERTY INFORMATION
Legal Description I DID TRAIL OLD TRAIL PARK
Magisterial Dist, White Hall Land Use Primary Unassigned
Current AFD Not in A/F District Current Zoning Primary Neighborhood Model District
IAPPLICATION INFORMATION
Street Address Entered By
I Judy Martin
Application Type
Water Protection Ordinances
16/21/2016
Project Old Tril Village-Paris Greenway Path- VESCP
Received Date 06/20/16 Received Date Final ( I Submittal Date 06/20/16 Total Fees 300
Closing File Date Submittal Date Final
Total Paid 300
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Type ISub Applicatio I Comment
Erosion and Sediment Control Plan 06/20/16
Boundary Line Adjustment 06/20/16
APPLICANT /CONTACT INFORMATION
ContactTypre I Name
ownerthvocant CO 0F'AL EM VIRGINIA �40i sa E Address I LOIttate l 1 Zip I Phone ► t
Tv DAVID M. ROBINSON, P,E.rROUDABUSH, 914 MONTICELLO ROAD CHARLOTTESVILL 2902 4349770205
Signature of Contractor or Authorized Agent Date
Virginia Erosion and Sediment Control Program (VESCP)
Application for Albemarle County
(This application is only to be used for projects exempt from the Virginia
Stormwater Management Program,VSMP,and the DEQ General Permit)
Project Name: Old Trail Village- Park Greenway Path - Erosion Control Plan
(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
County File Number: (to be provided by the Cou
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.
055E0-01-00-000HO County of Albemarle
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
Address
City State Zip
Daytime Phone( ) E-mail
7/1/14,Revised: 7/10/14, 1/7/15 Page 1 of 2
® B. All Fees [Code section 17-207] NIS
Total acres proposed to be disturbed 4.58
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
Variances;$150(per request)
Exceptions;$240
Mitigation Plan;$150
Construction Record Drawing; $300
® C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
❑ D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ E. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ F. 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 Roudabush, Gale&Associates Attn: David Robinson
Address 914 Monticello Road
City Charlottesville
State VA Zip 22902
Daytime Phone(434) 977-0205 E-mail drobinson@roudabush.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# h
Fee Amount$30D cc Date Paid(D1 ' b B who? n rop tS ff 'y /� p L�
Y ( e Receipt# 1 U 19 O Ck# 1 99 By:
7/1/14, Revised: 7/10/14. 1/7/15 Parr. ��