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HomeMy WebLinkAboutWPO201700066 Application 2017-08-24 Community Development Department ` ' � I I `-'rr NIS401 MclntireRoad Charlottesville,VA22902-4596 Voice:(434)296-5832 Fax:(434)972-4126 ••_SII Planning Application PARCEL I OWNER INFORMATION TMP 079A1-0O-0B-03000 Owner(s): VICTORIAN PROPERTIES LIC Application# WP0201700066 PROPERTY INFORMATION Legal Description I ROYAL ACRES $ 30 &31 Magisterial Dist. Scottsville 2rj Land Use Primary Residential-- Single-family(incl. modular homes] Current AFD Not in A/F District j Current Zoning Primary[Rural Areas APPLICATION INFORMATION Street Address 3782 RICHMOND RD KESWICK,22947 Entered By r Judy Martin Application Type -Water Protection Ordinances 024/2017 Project Received Date 08/24/17 Received Date Final Submittal Date Total Fees 150 Closing File Date Submittal Date Final Total Paid 150 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub Applio Comment APPLICANT /CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhcseCeil VICTORIAN PROPERTIES LLC =614 WEST RIO R© CHARLbTTE$VZLL ;r22901 Primary C.rtact JAMES MOSS 1799 AVON ST.EXT, CHVILLE,VA. 22902 4343536633 Signature of Contractor or Authorized Agent Date *141110 pY ALt„ Virginia Erosion and Sediment Control Program (VESCP) . Application for Albemarle County t Iq�wriA (This application is only to be used for projects exempt from the Virginia Stormwater Management Program,VSMP,and the DEQ General Permit) Project Name: 3 NZ i i-� li, d ROA (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 ❑ County File Number: UV YlJ QUI -669 (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 enter upon the property as required to ensure compliance with the approved plans and permits. /$1/ - 06— 27 ALI2y 249r4 Tax Map&Parcel Print Name of Property Owner Signa re of Owner Bate Tax Map&Parcel Print Name of Property Owner Sign ure o Owner ate 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 3cr'`.45 M o 55 Address 1 7/9 A%)P 5f Gyc.-- , City 01, V 'lit v% Z Z 4 0 Z State A Zip Z Z Q 01 Daytime Phone(`169 q 5.3 1,L 33 E-mail Jaseal)1 055 75-et(9 1.ci pi, 7/1/14,Revised: 7/10/14, 1/7/15 Page 1 of 2 'void 0 B. All Fees [Code section 17-207] Total acres proposed to be disturbed Acres to be disturbed Total Fee Less than 1 $150 per review More than 1 $300 per review For amendments to an approved plan;$200 per review Variances;$150(per request) Exceptions;$240 Mitigation Plan;$150 Construction Record Drawing; $300 fI C. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ D. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O E. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O F. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name 3.4,..K,e.5 M-ss Address 17?1 Au.", 5+ City CL ,% \L State V C, Zip 2- Z g O Z Daytime Phone(14311) qsj- C.C3 3 E-mail 5w.ien ir Ai 015 7S-6D3'0".`I .e Or. *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14,Revised: 7/10/14, 1/7/15 Page 2 of 2