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HomeMy WebLinkAboutWPO201600048 Application 2016-06-27 lbemarle -ounty Community DevelopmentDepartn ":f" 401 McIntire Road Charlottesville.VA ssIv - 4,1 Voice :(434)296-5832 Fax: (434;972-4 Planning Application PARCEL / OWNER INFORMATION TN1P 03200-00-00-019D0 c. 11,1,.•,.;. UNIVERSITY OF VIRGINIA REAL ESTATE FOUNDATION Application # WP0201600048 PROPERTY INFORMATION Legal Description ACREAGE B9.1 Magisterial Dist. Rio Larc Use Primary Office Current AFD Not in A/F District ',. : current zerirz Primal- Planned Development Industrial Park APPLICATION INFORMATION ----- street Addres.. 4040 LEWIS AND CLARK DR CHARLOTTESVILLE, 22911 ErtEnic Judy Martin Application Type Water Protection Ordinances .] 16/27/2016 Project Norh Pointe Sanitary Sewer Extension - VESCP Received Date 06/22/16 Received: Date Firal Submittal Date 07/05/16 Total Fees 2 Closing File Date Submittal Date FinalTotal Pic 2 1 Revision Number _J Comments Legal Ad 1 SUB APPLICATION(s) -..:._.L --44.142.Eli:r - _-_TT' it _ APPLICANT / CONTACT INFORMATION _crt-E-atType i Name 1 .4-i s,res s C Mi State 2ip 1 PI-one PherleCt : • ,.,.• Lpplicarit L'.:.v- :-. OF VIRGIN la REAL ESTATE F C : E= 40C=.1.= :"--7 :—EE .-___ Primar, Contact rF E-- E-E-EF I ''':,' — , - ::: !'_ _FE_ _E:: - ,_,,_,__,..... ,c, _.: _1---- __ ..,., ..LL __7:1 I I Signature of Contractor or L.I.utnonzed Agent Date - w rrr Virginia Erosion and Sediment Control Program (VE SCP) ( 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: NORTH POINTE SANITARY SEWER EXTENSION The name should he the same as it appears on plum i Is this an amendment to an approved plan? Yes 6i7 No U Is this a revision or resubmission for review? 1 es 0 No ❑ County File Number: WP0201200068 Ito he provided by the County for new applications) The following are required elements of new applications[from code section 1-4011 For revisions or amendments. please indicate which items are being amended. Signatures must he 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) 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. 03200-00-00-02211,10.10,EC. 0320000-00-07400. 03200-00-00-02000 GREAT EASTERN MANAGEMENT _ 6—Az f b Tax Map& Parcel Print Name of Property Owner Signature of Owner Date 32- 232-2ATSOWc1 Ll,ft 74.54-- Sec 4 4eiEac.erletAdit Tax Map& Parcel Print Name of Propert Ott ner Signature of Owner Date 3Z-221— )t 1 r 44 J Z"221 �J11 0. K�,,rxd(a. ��tn.i(� �'�•�-1— Sic ---- Tax Map& Parcel Print Name of Propert> Owner Signature of Ow ncr Date 32- zz f GLS 4'- Tax Map& Parcel int Name of Property Owner Signature of Owner Date Contact Information for the Owners)to receive correspondence: Print Name GREAT EASTERN MANAGEMENT - DAVID MITCHELL Address 2619 HYDRAULIC ROAD City CHARLOTTESVILLE State VA Zip 22901 Daytime Phone(434) 963-2670 E-mail DAVID@SOUTHERN-CLASSIC.COM 7/1/14, Revised: 7110/14, 1/715 Page I of 2 - *441•0' Noe B. All Fees [Code section 17-207] Total acres proposed to be disturbed Acres to be disturbed Total Fee Less than I S150 per revio% 1 More than 5300 per rev io% For amendments to an approved pla€7.00 per re%(e‘i Variances:$150(per request) Exceptions;$240 ' Mitigation Plan:$150 Construction Recdrd Drawing;$300 W1 C. Erosion and Sediment Control Plan satisfying the requirements of code section 17402. O D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O E. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O 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(usual!) the plan preparer.consultant or agent) Print Name TOWNES SITE ENGINEERING - BRIAN MITCHELL Address 9850 LORI ROAD. SUITE 20 City CHESTERFIELD State VA 7ip 23832 Daytime Phone( 804 748-9011 L-mail BMITCHELL@CGTOWNES.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 N1 ithdrawn. Applications without valid owner's signatures will not be considered valid. FOR OM( t I •I vk 1'0# lee Amount Al* ,00 1)ate Paid 6 (0 .! " %Ikbth'k cv\itig toom, ilq3 1 14. Revised: 7 10 14. 1:7 15 Page 2 of 2