HomeMy WebLinkAboutWPO201400099 Application WPO VSMP 2017-03-17 Virginia StormwaVianagement Program(VSMP)
Application for Albemarle County
Project Name: Commonwealth Apartments
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes VI No 0
Is this a revision or resubmission for review? Yes 0 No 0
County File Number: WPO201400099 (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.
0 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>44)42., 3
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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
Tax Map&Parcel Print Name of Property Owner Signature of Owner Date
Contact Informati/on for the Owner(s)to receive correspondence:
Print Name /�/Gy n e �/v✓t/r ("—
Address /lCJ 2-v t�/(�Gr�• \ • �'+ C 4-
City
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City L hGH/.) r7rr -. //� State Zip 22,
'Daytime Phone(k3k) f a- g E-mail f"e / 460d^e/ ai 5.hr,U'. I .GC:H"1
7/1/14,Revised:7/10/14,1/7/14 Page 1 of 2
air, Albemarle Cent Community Development Department
t 401 McIntire Road Charlottesville,VA 9 -4596
Planning ApplicationAtrw
Voice (434)296-5832 Fax:(4342)97202 4126
PARCEL/ OWNER INFORMATION
TMP 061W0-03-00-01400 Owner(s):
MOORES CREEK LAND LLC
Application # WP0201400099
PROPERTY INFORMATION
Legal Description ACREAGE
Magisterial Dist. Jack Jouett Land Use Primary Open
Current AFD Not in A/F District Current Zoning Primary R15 Residential
APPLICATION INFORMATION
Street Address Entered By
Danielle Roth
Application Type Water Protection Ordinances 12/02/2014
Project Commonwealth Office Building -VSMP
Received Date 12/01/14 Received Date Final Submittal Date Total Fees 145
Closing File Date Submittal Date Final Total Paid 145
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Type Sub Applicati Comment
Erosion and Sediment Control Plan
Stormwater Management/BMP Plan
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1APPLICANT / CONTACT INFORMATION
ContactType Name Address CitState ZipJ Phone PhoneCell
�e :i r4'Nt.t :i -om 'Si ..�i 11 ._ . * `�I , P; Imo_ ., ;
Primary Contact JUSTIN SHIMP, P.E. [201 E MAIN-ST,SUITE M i CHARLOTTESVILL i 22902 4342078086
Signature of Contractor or Authorized Agent Date
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S111,
Virginia Stormwater Management Program (VSMP) 1411' (t
Application for Albemarle County ,,
Project Name: Commonwealth Apartments
(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 WI
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 ent upon the property as required to ensure
compliance with the approved plans and permits.
61W-3-14 Positive LLC --) -41(-1 (
Tax Map&Parcel Print Name of Property Owner Signature of Owner Date
Man •s. /►��,.,, S�
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 Lane Bonner
Address 620 Plantation Court
City Charlottesville
State VA Zip 22903
Daytime Phone( ) E-mail
7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2
' • +'
66 B. All Fees [Code section 17-208]
For new or modified plans;Total acres proposed to be disturbed 0.99
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;$150
❑ C. Registration Statement on the official DEQ form.
21 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
▪ E. Stormwater Management Plan satisfying the requirements of code section 17-403.
• F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)
Print Name
Address
City State Zip
Daytime Phone( ) E-mail
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months
from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY WPO#
Fee Amount$ Date Paid By who? Receipt# Ck# By:
7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2
OFA
` - '.r.r+ COUNTY OF ALBEMARLE
_� Department of Community Development
• 01 401 McIntire Road
11RGINIP
Charlottesville,Virginia 22902
VSMP Application Completeness Check
Project Title:C cMM64\w 1A��►�
File Number: eo,),A t-11-
Date: l -; -t'1
Reviewer:
Your application has been checked for completeness per section 17-409 of the County Code. All
items must be received and correct for the application to be deemed complete.
❑ This application is complete and plan review has begun
❑ This application is not complete. Please provide the missing items
checked below.
Received Correct
Y N Y N N/A
l�za Completed application -[2 -0 0
�>�' ❑ Signatures of the Property Owners for each parcel affected 0 0 0
❑ Correct Fees Paid ❑ ❑ ❑
O t7 Registration Statement on the official DEQ form, with correct LDA 0 0 0
2( 0 Erosion and Sediment Control Plan satisfying the requirements
/ of code section 17-402. 0 0 0
d ❑ Stormwater Management Plan satisfying the requirements of code
section 17-403.
0 0 ❑
❑ Pollution Prevention Plan satisfying the requirements of code
section 17-404. The EPA template should be used. 0 0 0
❑ Stormwater Pollution Prevention Plan satisfying the requirements
of code section 17-405. The EPA template should be used. 0 0 0
O 0 Mitigation Plan satisfying the requirements of code section
17-406 for any proposed disturbance of stream buffers. ❑ ❑ ❑
❑ ❑ Requested Variations or Exceptions as provided in code sections
17-407 and 408, if applicable. (SSF,MMT,etc) 0 0 0
❑ ❑ Construction Record Drawings (as-builts) for any existing facilities
in the proposal satisfying the requirements of code section 17-422. 0 0 0
Comments:
■
Virginia Stormwater Mgement Program (VSMP) -AlrA
Application for Albemarle County 114 f ''•
Project Name: COM*iowe4 'tii 6( eeckfAq
(The name should be the same as it appears on plans)
Is this an amendment to an approved plan? Yes 0 No 18f
Is this a revision or resubmission for review? Yes 0 No
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.
XA. 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.
Obito o-o3-co-o/Koo 1-awe. nem C q�lJ�2aL�
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
Tax Map&Parcel Print Name of Property Owner Signature of Owner Date
Contact Information for the Owner(s)to receive correspondence:
Print Name Mao re 5 evee k LLC.
Address ?D. . op< 538 Li
City Cav1B9-1SV Ute State V f Zip 2201°5--
Daytime
2°1 3Daytime Phone( ) E-mail
7/1/14,Revised: 7/10/14 Page 1 of 2
`tir,
'B. All Fees [Code section 17-208]
For new or modified plans; Total acres proposed to be disturbed O.q(c)
Acres to be Total Fee Fee Due with this Fee with Transfer or
disturbed A.• ication 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 $6,100 $3,050 $450
100
100 and more $9,600 $4,800 $700
For(minor)amendments to an approved plan;$200 per review
Variances;$150
Mitigation Plan;$150
i.C. Registration Statement on the official DEQ form.
'D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
N.E. Stormwater Management Plan satisfying the requirements of code section 17-403.
X F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
X G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
ki I. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
16. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent)
Print Name J u 641'✓)
Address "20 2 /Actl n �t� 5�,'- ✓N
City Clq.✓SO 1!519;t1 . State V Zip 2Z4Y0 2
Daytime Phone(113 2O 7-90g 6 E-mail ::5-6 S fin 614:4,0-e .`Y1ee., r'tay.com
*When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months
from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY `�WPO# U
Fee Amount$I t"� l c ,OU Date Paid j 2.)I 1 1 )By who?_1 civl e.. L�jc ,c,,�' Receipt#9 7 eic Ck# 152.7 By:
)1)