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Home My WebLink AboutWPO201500063 Application Minor Amendment 2018-03-05 Virginia Stormwater Management Program (VSMP) f�;g Application for Albemarle County -11459607,-: Project Name: Virginia Asphalt Services (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ® No 0 Is this a revision or resubmission for review? Yes ® No 0 County File Number: WPO2015-63 (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. 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. 77-8 Bryan Heilman at IS ( l CJ 1 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 Alan Franklin, PE Address 427 Cranberry Lane City Crozet State VA Zip 22932 Daytime Phone(434) 989-5703 E-mail bryan_heilman@yahoo.co I. 7/1/14,Revised:7/10/14, 1/7/14 Page 1 oft ®B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed n/a 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;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. E1 E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ® J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Alan Franklin, PE Address 427 Cranberry Lane City Crozet State VA Zip 22932 Daytime Phone(434) 531-5544 E-mail alan@alanfranklnpe.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY )Q WPO#1 r 1 rn �//7, , ./ Fee Amount$�t Date Paid�' '1 0 By who? V C AS 2\,l k' Receipt#1 1(K Ck#\u�3 By:S '`-)(6(.(�A 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: Virginia Asphalt Services (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ® No 0 Is this a revision or resubmission for review? Yes ® No 0 County File Number: WPO2015-63 (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. 77-8 Bryan Heilman t" n Tax Map&Parcel Print Name of Property Owner 4-14# 6 tore of 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 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Alan Franklin, PE Address 427 Cranberry Lane City Crozet State VA Zip 22932 Daytime Phone(434) 989-5703 E-mail bryan_heilman@yahoo.co 7/1/14,Revised:7/10/14, 1/7/14 Page 1 oft ®B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed n/a 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. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. I E. Stormwater Management Plan satisfying the requirements of code section 17-403. O 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 Alan Franklin, PE Address 427 Cranberry Lane City Crozet State VA Zip 22932 Daytime Phone(434) 531-5544 E-mail alan@alanfranklnpe.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 r WPO#J Q 1 ic—`` [o((- G 3 1 i "� Fee Amount SAD Date Paid� g 2'I y who?\/� ► 1-p hLk Receipt#I {J a�l V acts 00 361 B1'12(421.0/ 7/1/14,Revised:7/10/14, 1/7/14 Page 2 oft T Albemarle Count)/ Community Development Department 401 MclntireRaadCharlottesville,VA22902-4596 Voice 1)296-5832 Fax:(434)972-4126 �- - =34 Planning Application „ iro PARCEL/ OWNER INFORMATION IMP Q7700-00-00-00800 Owner(s): VIRGINIA ASPHALT SERVICES INC Application# WP0201500063 PROPERTY INFORMATION Legal Description J ACREAGE Magisterial Dist,E Scottsville ..E Land Use Primary Residential-- Mobile home Current AFD , Not in A/F District �+ Current Zoning Primary Light Industry APPLICATION INFORMATION Street Address 1536 AVON STREET EXT CHARLOTTESVILLE,22902 Entered By •9E;m1/i2ly0Lantz Application TypeWater Protection Ordinances _._- Project Virginia Asphalt Services Received Date 08/26/15 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 Applicatio Comment Stormwater Management/BMP Plan Erosion and Sediment Control Plan Stream Buffer Mitigation Plan APPLICANT /CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCell owner/ M VIRGINIA ASPHALT SERVICES INC 439 BUACHS CREEK RD CRO.ZET VA 22932 Pn�s y Ccntsct ALAN FRANKLIN 427 CRANBERRY LN <CROZET VA 22932 4345315544 Signature of Contractor or Authorized Agent Date Near' IV Virginia Stormwater Management Program (VSMP) J''� Application for Albemarle County w Project Name: Virainia Asphalt Services (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No m 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. II 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. 77-R Rrvan Heilman•VA Asnhalt Servirec L 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 Bryan Heilman Address 493 Burches Creek Road City Crozet State VA Zip 22932 Daytime Phone (434) cm9=c7_Q3 E-mail brvan heilmant7a yahoo om 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 B. All Fees [Code section 17-2081 For new or modified plans; Total acres proposed to be disturbed 0.80 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; $150 l� C. Registration Statement on the official DEQ form. 0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. • E. Stormwater Management Plan satisfying the requirements of code section 17-403. 10 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ▪ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. O J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence (usually the plan preparer,consultant or agent) Print Name Alan Franklin Address 427 Cranberry Lane City Crozet State VA Zip 22932 Daytime Phone ( m) 31 55544 E-mail alanCa�alanfranklinoe.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# �[ Fee Amount$_t_DO__Date Paidg" 'i By who? i �;I 4 V (.1 Receipt# �{/y 1131 Ck# t) 146 B 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 °` ��•t, ►UNTY OF ALBEMARLE ► N✓ �,. Deepp artment of Community Development J ®�� 40] McIntire Road Charlottesville,Virginia 22902 VSMP Application Completeness Check Project Title: V',t r��^,: .� f �,�b. ,t � ;.:: cc 4) File Number: , , c';:-) 6'> Date: 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 til/-0 Completed application ❑ ❑ ❑ VP ❑ Signatures of the Property Owners for each parcel affected ❑ ❑ ❑ ❑ Correct Fees Paid o ❑ ❑ ❑ ia' Registration Statement on the official DEQ form, with correct LDA ❑ ❑ ❑ • ❑ Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ ❑ ❑ EY' 0 Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ ❑ ❑ ❑ ❑ 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. ❑ ❑ ❑ ❑ ❑ 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) ❑ ❑ ❑ ❑ ❑ Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. ❑ ❑ ❑ Comments: ■