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Home My WebLink AboutWPO201700041 Application WPO VSMP 2017-05-26 Albemarle arl e CC - (nCommunity DerrelopmentDep artmerrt t h4clntire Road Charlottesville;VA 22902-4591 Voice:(434)29£-5832 Fax:(434)972-4125 1 Planning Application PARCEL/ OWNER INFORMATION TMP 07500-00-00-05200 Owner(s): FORGE FARM LLC Application# WPO201700041 PROPERTY INFORMATION Legal Description lAcREAGE Magisterial Dist Samuel Miller Land Use Primary Residential Single-family(incl. modularme5 Ii Current AFD [Not in A/F District 2 Current Zoning Primary R4 Residential APPLICATION INFORMATION Street Address 1179 SUNSET AVENUE EXT CHARLOTTESVILLE,22903 Entered By Type I Judy Martin ApplicationyP Water Protection Ordinances 52601 - Project Sunset Overlook Amendment- VSMP Received Date 05/26/17 Received Date Final Submittal Date Total Fees 200 Closing File Date Submittal Date Final Total Paid 200 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Applicatio Oxnment Stormwater Management/BMR Plan 05/26/17 Erosion and Sediment Control Pian 05126/17 APPLICANT /CONTACT INFORMATION CantactType Nage Address CityState Zip Phone PhoneCell OraneriApprmwd RAISE FARM LLC i 195 RIVERSEND DRIVE CHARLOTTESVILL :22911 ?nrnary Curtsct +SCOTT COLLINS-COLLINS ENGINEERING 200 GARRETT ST.,STE.K +CHARLOTTE SVILL +22902 4342933719 Signature of Contractor or Agent Date DocuSign Envelope ID:FCC3A7FC-5D21,014.009-84B7-E5FBOA313495 '`/l OVA Virginia Stormwater Management Program (VSMP) Application for Albemarle County AO", crRcar��r Project Name: SUNSET OVERLOOK (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ® No ❑ Is this a revision or resubmission for review? Yes ❑ No WI County File Number: WPO-2016-4 (to be provided by the County for new applications) The following are required elements of new applications[from code section 17-4011 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. c—DocuSigned by: 76-52 FORGE FARM, LLC QIaVr,W 66,4Lw,14, 5/26/2017 Tax Map&Parcel Print Name of Property Owner S ignahrre3YPEPAEr1Fte45B... 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 FORGE FARM, LLC Address 195 RIVERBEND DRIVE City CHARLOTTESVILLE State VA Zip 22911 Daytime Phone( ) E-mail 7/1/14,Revised:7/10/14, 1/7/14 Page 1 oft DocuSign Envelope ID:FCC3A7FC-5D219-84B7-E5FBOA313495 / ® 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 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;$150 ❑ C. Registration Statement on the official DEQ form. 1 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. • E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name SCOTT COLLINS-COLLINS ENGINEERING Address 200 GARRETT ST, SUITE K City CHARLOTTESVILLE State VA Zip 22902 Daytime Phone(434) 293-3719 E-mail scott@collins-engineering.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY !/, WPO# 3 O l b ` OC�[� I Fee Amount$d0 0 Date Paid (, 2-By who?C CJ/!��S `/!i •4....4lecelpt#` Ck#3 S By: 176f/17 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of2