HomeMy WebLinkAboutFDP201800004 Application 2018-02-23Phone (434) 296 -5832
COUNTY OF ALBEMARLE
Department of Community Development
401 McIntire Road
Charlottesville, Virginia 22902-4596
FLOODPLAIN DEVELOPMENT PERMIT
Fax (434) 972-4126
This form is intended to aid the Department in documenting and characterizing the nature of development proposed in the
floodplain. Development includes buildings or other structures, mining, dredging, filling, grading, paving, excavation or
drilling operations or storage of equipment or materials. The form responses will be used to determine whether a
floodplain impact plan or special use permit is required.
Please check one: [;' New Submittal with no anticipated floodplain impact (no floodplain impact plan)
❑ New Submittal with an anticipated floodplain impact. Please include a floodplain impact
plan. FEE required with submittal: $323 (Code 18-35.1g)
FEMA Letter of ❑ Map Change (LOMA, LOMR) Please include a complete copy of all
material to be submitted to FEMA. Include any computer models (HEC-RAS files) on a disc.
FEE REQUIRED WITH SUBMITTAL: $161
(TOPOGRAPHIC INFO ONLY), OR $323 (FLOODPLAIN
MODELING)
New Submittal ❑ with a Zoning Special Use Permit. Please include a floodplain impact plan.
❑ FEE REQUIRED WITH SUBMITTAL: $323
Resubmittal (Floodplain Development Permit Number ) Please include your response form from the
original submittal. FEE as above required with each resubmittal.
A Floodplain Impact Plan, Special Use Permit, or FEMA Map Change will need to follow Zoning Floodplain Overlay
District requirements (County Code 18-30.3), found at
http://www.albemarle.org/upload/images/Forms Center/Departments/County Attorney/Forms/Albemarle County Code
Ch18 ZoninLY30 Overlay Districts.pdf
Section 4 of the Design Standards Manual provides a list of required items to be included in a Floodplain Impact Plan.
This can be found at tt://www.albemarle.or de artent.as ? artment=cdd&rel =4447.
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Owner Name (Pri
Home Phone Office / Other Phone
F
Pt) 1
Address
CITY STATE ZIP CODE TAX
MAP & PARCEL NUMBER
--p 1
PROJECT NAME (IF APPLICABLE)
BUILDING PERMIT OR PROJECT NUMBER (IF APPLICABLE)
1 1 /1/2015
Please describe the nature of the development activity proposed within the floodplain (e.g. new structure, grading for a
playing field, driveway stream crossing, installation of a fence, etc.):
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(Pl a e Ji5d y pCans or photos to this application)
1. If a structure is proposed, is the structure accessory to a recreational or agricultural use? Yes No N/A
2. Does the proposed activity involve a stream crossing for a pedestrian trail or driveway
serving a single family dwelling? Yes Now N/A
3. Does any proposed fencing cross a stream channel? Yes o� N/A
4. If any fill is proposed, please approximate the proposed amount of fill in the floodplain
OWN[
DATE
(FOR OFFICE USE ONLY)
Checked By
(for resubmittals) Fee Amount $ Date Paid By Who?
Receipt # Check #
Date
l l/l/2015