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Home My WebLink AboutWPO201700033 Application WPO VSMP 2017-04-04 Albemarle Community DeveloprnentDepartrr )` 401 McIntire Road Charlottesville,VA 229002-4 Voice:(434)296-5832 Fax:(434)972-4 n 4 Planning Application PARCEL I OWNER INFORMATION TMP 056A3-00-00-00900 Owner(s): NOTCH'D LLC Application # WPO2O1700033 PROPERTY INFORMATION Legal Description I ACREAGE Magisterial Dist. l White Hall Land Use Primary Residential--Single-family (incl.modular homes) Current AFD Not in A/F District Planned veto _ t.___ ,� Current Zoning Rrimary ? Development Shopping Center (APPLICATION INFORMATION Street Address 5368 THREE NOTCH`D RD CROZET, 22932 Entered �.._ _._ Judy Martine Application Type 1 Water Protection Ordinances 14/4/2017 Project Three Notch'd Center-Auto Laundry-Amendment-VSMP Received Date 04/04/17 Received Date Final Submittal Date 04/04/17 Total Fees 2 Closing File Date Submittal Date Final Total Paid 2 Revision Number Comments Legal Ad SUB APPLICATION(s) Type I Sub Application Comment Stormwater Man ent/8MP Plan 04/04/17 • Erosion and Sediment Control Plan 04/04/17 APPLICANT/CONTACT INFORMATION ContactType ticYne Ackbess CityState Zip Phone PltoneCe dwner/Appikait MOTCH`D'LLC 190 STOCKTON RIDGE PL GREENWOOD VA i 22943 Primary Contact JEFFREY S. SPROUSE P. O. BOX 910 aCROZET, VA. 22932 434514673 Signature of Contractor or Authorized Agent Date fire \nI` Virginia Stormwater Management Program(VSMP) ` Application for Albemarle County 1P '' Project Name: -1-14R-E€ ALorc4 1? ChAJT4R. -- 4fro Le uu (The name should be the same as it appears on I plans) r Is this an amendment to an approved plan? Yes No ❑ Is this a revision or resubmission for review? Yes I No ❑ County File Number: U1.R,2o13—QOY>&4 (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.— t�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. 5( A3 --41ii%�"s.� -Lb p Tax Map&PC-cel Print Name of PropertyL Owner •lie: ure o • er 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 V e,, ` ` r t . . C V M Address PO 192 04 - 1 (D City CXVT Statd/�1 Zip ;� Daytime Phone ` 1 LI (ME-mail 1 SS )1 (O @ Com/ 7/1/14,Revised:7/10/14,1/7/14 Page 1 of 2 ❑B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 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 revte Variances;$150(per request) Mitigation Plan;$150 ❑ C. Registration Statement on the official DEQ form. tl/D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ql/E Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ 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. ❑ J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the requirements of code section 17-422. %AProvide 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 Air- 1:74.2441/4-#1..t � &IP E)6.1ut.& 2•i^1to% Address &SO ivy rAMA . D(_ • City CMA0.-La)7)) ?VIM State 14 Zip �Z.jD Daytime Phone(4S`1)531./387 E-mail Ala.-• (e-4416 e7b rn A! .C`. no,, *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 S Date Paid /ilf �y who? /1/-1* I <<Rece #ipt#(uff 3 "3B7 ' 7/1/14,Revised:7/10/14,1/7/14 Page 2 of 2