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Home My WebLink AboutWPO201700050 Application WPO VSMP 2017-07-12 Albemarle Cnty Community Development Department ‘111i 1 Mclntire Road Charlottesville,VA 22902-4596 Voice:(434)296-5832 Fax:(434)972-4126 --- a Planning Application PARCEL/ OWNER INFORMATION TMP 03200-00-00-009C0 Own er(s)c CRUTCHFIELD CORPORATION Application# WPO2OI 700050 PROPERTY INFORMATION Legal Description I ACREAGE Magisterial Dist.'Rio ::,®! Land Use Primary Commercial Current AFD !Not in A/F District El Current Zoning Primary L ht Industry APPLICATION INFORMATION Street Address 1540 QUIET ACRES LN CHARLOTTESVILLE,22911 Entered By Judy Martin Irj Application Type `Water Protection Ordinances Project Crutchfield Corporation- VSHP Received Date 06/29/17 Received Date Final Submittal Date Total Fees 2700 Closing File Date Submittal Date Final Total Paid 2700 Revision Number Comments A Legal.Ad SUB APPLICATION(s) Type Sib Applicatio Comment Stormwater Management/BMP Plan 06/29/17 Erosion and SedtmentCo P i 06/29/17 APPLICANT /CONTACT INFORMATION Contaetlype Name Address CityState Zip Phone PhmeCell owneriAppScant CRUTCHFIELD CORPORATION j*1 CRUTCHFIELD PARK CHARLOTTESN1LL 22901 Primary Cantn t ERIC WOOLLEY,PE 220 EAST HIGH STREET CHARLOTTESVILL 22902 4349730045 Signature of ContractororAuthorized Agent Date Virginia Stormwater Management Program (VSMP) h "°2;$1 Application for Albemarle County litroft Project Name: Crutchfield Corporation (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: t .1 � ''EO (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. PI 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 1 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. 1CD TMP 32-9C Crutchfield Corporation �NJ�7l�r� ,s ,. \�, \Z11`2 11 Tax Map&Parcel Print Name of Property Owner Signature of wner 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 Bill Crutchfield Address 1 Crutchfield Park City Charlottesville State Virginia Zip 22911 Daytime Phone(434) 817-1000 E-mail 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 Oure El B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 4.90 ac. Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than l 5290 $145 $20 1 and less than 5 $2 70Q,..' $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;$150 0 C. Registration Statement on the official DEQ form. O D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. O E. Stormwater Management Plan satisfying the requirements of code section 17-403. O F. Pollution Prevention Plan satisfying the requirements of code section 17-404. O G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Eric Woolley, PE Address 220 East High Street City Charlottesville State Virginia Zip 22902 Daytime Phone(434) 973-0045 E-mail ewoolley@woolley-eng.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ 2�UV°--'Date Paid 67-2447 By who? Mlkelj Receipt# !G Zlg Ck#335�7�By:Jee k.., 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 Stormwater Pollution Prevention Plan (SWPPP) Crutchfield Corporation CERTIFICATION AND NOTIFICATION I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and ' priso ent for knowing violations. Name: \\\VN.r r.. , ��S. c ‘t:\ Title: Signature: Date: IA \ "Z 0 \s-A I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name: Title: Signature: Date: ii