HomeMy WebLinkAboutWPO201600080 Application 2016-12-09 /' 1 ft Albemarle Coucy' •
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'fir:,.........1( Planning Application
7 i'l;' 07200-00-00-03200 Owner( ): MILLER SCHOOL OF ALBEMARLE THE
Application# WP0201600080
i PROPERTY INFORMATION ,
Lie,dal Dessription I ACREAGE
"a sterial Dist. Samuel Miller 1.
Land Use Primary Seatii-pUbik
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Current 4FD Not in A/F District ::1 Current Zoning Primary Rural Areas
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APPLICATION INFORMATION _1
street Ar
dreee 1b001 DICK WOODS RD CHARLOTTESVILLE,22903 Entered BY
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Jenmfer srmtiv
PPI'c3/,or,T'rPe Water Protection Ordinances i 129'2016
Project The Miller School New Entrance
Pecer„ed Date '12/07/16 Received Date Final ! i Submittal Date' Trital Fees 200,
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Closing Fiie Date 1 Submittal Date Final Total Paid , 200i
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Re,isic Number r
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SUB APPLICATION(s)
..T.A.P!„. 1 Su.0.4ppltoatioi Comment , 1
Stormwater Management/BMP Plan 12/07/16
Erosion and Sediment Control Plan 12/07/16 ' i
1
APPLICANT / CONTACT INFORMATION
Contac1Timi_ Name Address„ City$tate ! :Zt,p,. L,, Pjyope 1itonCeli 1
MILLER SCHOOL OF ALSEM4RLE THE 10,0`2 SAMUEL TIILLEF LOOP CHA'PLOTTESVILL 22903
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li.di9 ra•-t PATRICiL FRANCE 100C SAMUEL MILLER LOOP CHARLOTTESVILL 22903 434S2C4.835
:s-tvisr TIM MILLER 44.0 PREMIER CIRCLE CHARLOTTESVILL 229O1 434,362,0131
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::-",:. ,gnature of' ..7ontractor or A othonzed Agent Date
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Virginia Erosion and Sediment Control Program (VESCP)
Application for Albemarle County
(This application is only to be used for projects exempt from the Virginia
Stormwater Management Program,VSMP,and the DEQ General Permit)
Project Name: ��. ��te �no� Ap-r,,,l &L rpal( e.
(The name should be the same as it appears an plans)
Is this an amendment to an approved plan? Yes>k No ❑
Is this a revision or resubmission for review? Yes 0 NoX
County File Number: vipo (to he 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 providedfor any
submission.
j(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.
72 - 3 ZCn lcf��- rla� ?tit/7d( 0(' 1/.(2/1/<0
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 ?C,+I\K-111 F 4
Address /000 'vmite/ Mine, ,L&
h4," 1 s V i!( St
City ,�.� �........................_._..___._..__.___.__.__ ate VA-- Zip -a2g0 3
Daytime Phone( ' 8a32- _E-mail r' M f n l)1'eNiN !h(9® I o e)
D B. All Fees [Code section 17-207]
Total acres proposed to be disturbed_ 6:7.R? afire S
Acres to be disturbed Total Fee
Less than 1 S150 per review
More,than I S300 per review
For amendments to an approved plan;aMralpi
Variances;$150(per request)
Exceptions;$240
Mitigation Plan;$150
Construction Record Drawing;$300
C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
1,114x 0 D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
All 0 E. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
i\4\ 0 F. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the
N 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 -Tim_ /Pie" __
Address 446 Pre a r- (C:r d c....._..__.........__._._.._..__..___._._..___
City C/��o�,+-loT-�c5v41Ie.,...__..__._. State VA Zip 222901
Daytime Phone o1 f).._2► Z_.,`-. 121 `
�� ( ._ - E-mail� -�-irr,llt:,r mer;cti-a.4,wbe..Y 6044,.
*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 ttL7� //..�_......_.._.
Fee Amount ),00 S ),00 Date Paid�aC/� y who?A/4.4,6.t/ /'r d pi (J o ?r3('k# (/`_.....Ry: 0.("1-