HomeMy WebLinkAboutWPO201200087 Application 2012-11-01 Albemarle Coity40001 Community Development Department
0401 McIntire Road Charlottesville,VA 229024596
Planning Application Voice:(434)296-5832 Fax:(434)972-4126
PARCEL/ OWNER INFORMATION
TMP 09100-00-00-01200 Owner(s):
ALBEMARLE HEALTH CARE CENTER LLC
Application # WP0201200087
PROPERTY INFORMATION
Legal Description ACREAGE PARCEL A
Magisterial Dist. Scottsville Land Use Primary Residential --Single-family(incl. modular homes)
Current AFD Not in A/F District Current Zoning Primary Planned Development Mixed Commercial
APPLICATION INFORMATION
Street Address 91 GALAXIE FARM LN CHARLOTTESVILLE, 22902 Entered By
Jennifer Durrer
Application Type Water Protection Ordinances 11/01/2012
Project ALBEMARLE HEALTH &REHABILITAION CENTER
Received Date 10/29/12 Received Date Final Submittal Date 10/29/12 Total Fees 600
Closing File Date Submittal Date Final Total Paid 600
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Erosion and Sediment Control Plan 10/29/12
Nalb-
o APPli 'i#n ypes for S .fid ►t i
wwww4wwwwwwrwiiiJ✓"dMwwwwwrwd.lilddK wwwyiwMiidw.wwwwW wwwwwwwwddwLwwrwyJ d rwrwwwww wtwwwdwwr4 wwwwwkwwu�w wwwwwwwwr dJdrww.r wdwwdwwu wwwwwwww wwwwwwdww wwwwwwwv wdww.wwrdwwwwwww�„i
APPLICANT/ CONTACT INFORMATION
,conType Sr ,i ', Tamp. »c2 c rr, x x AddreS, r; , ,, x 9It Mate � j, ZIQ'
J Phone F PhoneCel
;Owne/A art t�-MAi HEATH CAFE ENTER LLC2917 PENN STBLVD ROANOKEVA 24018CF w wuVwPrlmaryContacJUTIN SHIMP w201EMAINSTREETSUITE CHARLOTTESVILL 22902 434207808
Signature of Contractor or Authorized Agent Date
Application for Review of
Erosion & Sediment Control Plan & Stormwater Management/BMP Plan &
Stream Buffer Mitigation Plan
® Erosion& Sediment Control Plan ®Stormwater Management/BMP Plan 0 Stream Buffer Mitigation Plan
❑ E&S Plan Amendment ❑SWM Plan Amendment
(Previous Plan# ) (Previous Plan# )
❑ E&S Plan with Variance ❑Request for Exception
#of Variances 0 SWM Plan Resubmittal
O E&S Plan Resubmittal WPO Application#
WPO Application#
Submit 2 copies each of applicable plans/narrative/computations
"When a WPO plan is 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county comments,the application will be deemed withdrawn.
Project Name: Albemarle Health and Rehabilitation Center
Tax map and parcel: Tax Map 91, Parcel 12Zoning; PD-MC
Amount of Land Disturbance: 7.73 Acres
Location of property tlandmarks,intersections,or other): Between Galaxie Lane and Albemarle Fire and Rescue Station
Contact Person(Who should t.'e call/write concerning this project?): Justin Shimp
Addrec, 201 E Main St, Suite M city Charlottesville State VA zip 22902
Daytime Phone(434) 207-8086 Fax a~(._,......__.).__._.._._._._.. _i-mail Tustin@shimp-engineering.com
Owner of Record Albemarle Health Care Center. LLC
Address 2917 Penn Forest Blvd City Roanoke State VA /ip 24018
Daytime Phone( ) ._..—_ . Fax 7 E-mail B-mail
Contractor
Address City —...__ State — Zip
Daytime Phone( )— - Fax s( ) l trail_
Plan Preparer Shimp Engineering, PC
Address Same as Contact Person City. State_-. Zip
Daytime Phone( .......) _._ Fax r( )._...._._. E-mail
•
Owner/Applicant Must Read and Sign
By signing this application as owner,I hereby certify that all requirements of the approved Erosion Control Plan,Stormwater
Management/BMP Plan,and/or Mitigation Plan 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 Albemark the right to enter upon the property as required to ensure
compliance with th • ", - ved plan.
#4 I
ne ir lot/? 5F-�—
Signature of 6wDate
��✓__ LiC C�tEo� 77Cv- TYSY
NamePrint —.- _
�'l ,c-, CQ ����,•— Daytime phone number of Signatory
FOR OvriCE )SE()j.Y WP5)t: w
�A , ,^ A n�the�� !� (1 5g41a �'l��h SCC
Fee Amount$ r Date Paid 1Q'2R'' y who? "1 1 1�RJ�faux"feei.f.,m,t}; U�„ Ck 5014 t }
of
Revises!November 14.2011 Pare 1 of.,