HomeMy WebLinkAboutWPO201700017 Application WPO VSMP 2017-02-27 Albemarle ç,_unty moCommunity Development Departrr
401 McIntire Road Charlottesville,LSA 22902-4i
Voice:(434)296-5832 Fax:(434)972-4
11 -- Planning Application
PARCEL/OWNER INFORMATION
T11113 {),55E0-'01,-I17406 ". ; Owner(s): EAST VILLAGE LLC
Application * W 17OOO1
PROPERTY INFORMATION
Legal Description I OLD TRAIL BLK 17 LOT 3
Magisterial Dist. [White Half Land Use Primary Unassitpled
Current AFD Not in A/F Uistrlct Current zoning Primary Nei rhood l District
[APPLICATION INFORMATION
Street Address Entered
Judy Martin
Application Type Water Pra�teCtio�t Ordinances 2116/2817
Project QId Trail ocks 17,18&27-VSMP
Received Date 02/16/17 Received Date Final Submittal Date 03/02/17 Total Fees 27
Closing File Date Submittal Date Final Total Paid 27
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Type w, t Sub i __ Comment
Stormwater Management/BMP Plan 03/02/17
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APPLICANT/CONTACT INFORMATION y/f
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Applicant FRANK BALLIF 170 SOUTH PANTOPS DRIVE CH'VILLE, VA. 22'411 43424513394
Primary Contact KEITH LANCASTER 170 SOUTH PANTOPS DRIVE CH'V1LLE, VA. 22911 4342450394
Signature of Contractor or Authorized Agent Date
Virginia Stormwater Management Program (VSMP)
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Application for Albemarle County
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Project Name: OSSI(-AS i-i,
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes ❑ No kr
Is this a revision or resubmission for review? Yes 0 No kr-
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.
/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.
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Tax Map&Parcel Print Name of Property lecaner _ ature of Owner Date
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Tax Map&Parcel Print Name of Propert weer S'gnature of Owner Date
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Tax Map&Parcel Print Name of Property wner Si i.. ur 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 FcowA.(30.11ii"
Address l'20 S mac,.' L Pc S J;1ve-
City c‘1\ kr74$2.su State 'A Zip 22-9l\
Daytime Phone(1.139) 24 S-(S8 4 4 E-mail G'r hIra). &Scuc' t-n--dez,eic�lmcw�` . c�vv�
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16 B. All Fees [Code section 17-208]
For new or modified plans;Total acres proposed to be disturbed 3 ;—r72 AT___
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.
Ar 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.
Pollution Prevention Plan satisfying the requirements of code section 17-404.
G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
O 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 Ke L C $-Ear--
Address I Z 0 S J3A, Pwr.kme% C\!`y v-e
City c 1.+w-lo g+l (� State (fig Zip 2_2Gi I I
Daytime Phone(c/3y) 2' ..0 gq4i E-mail k(c)..-.c".. t‘y--P r:a'Rtes^n—dlp u-e. olcyv4C.ci vv
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months
from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY (� WPO# /� CoI '�j
Fee Amount$ 7 UZ Date Paid 2-/() � .1 uy who?,'1 I I ROVe ¢etP# f( ✓3- k#V 3�j lI By`3
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