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Home My WebLink AboutWPO201600040 Application WPO VSMP 2016-06-06 AlbemAlbemarle County r--ImunityDevelopmentDepartment arle 409 Mclntir Charlottesville,VA22902.4596 Voice 296-5832 Fax:(434)972-4126 4 -- ' Planning Application ar/ PARCEL/OWNER INFORMATION - TMP 058A2-OO-0o-01 Owner(s): LENVIC LLC Application# WP02O1>60004E PROPERTY INFORMATION Legal Description I ACREMX Magisterial Dist.ILSamuei Miller ❑' Land Use Primary Open Current AFD Not in A/F District Current Zoning Primary Cl Commercial APPLICATION INFORMATION Street Address Entered By Emig Lantz Application Type Water Protection Ordinances 6/2016 Project Ivy Water Main Extension Project-VSMP Received Date 06/02/16 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 Cement Stormwater Management/BMP Plan Erosion and Sediment Control Plan stream„soffer„, Ibn�n I APPLICANT/CONTACT INFORMATION NameAdchees xatte itp fiA[��ti PbcoaCell ownettoopfgiot titNyittle :1006 RLSE vo1R ..a....e.............q„....a .,...w..e..:..................... .......,: .......... .P::..:., ....., . n.,.5«. .........: ....:i:.i ..u...ab (a ..u.esu' ........... ...,...:. a........:....# Primary Contact JEREMY LYNN 168 SPOTN.AP RD a CHARLOTTESVILL 22911 4349774511 Signature of Contractor or Authorized Agent Date stool Virginia Stormwater Management Program (VSMP) _:17 _. Application for Albemarle County Natal' Project Name: Ivy Water Main Extension Project (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes El No Is this a revision or resubmission for review? Yes ❑ 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. El 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. t-,•5•y; x,,,;11 (� I rc�r . 58A2-14 &58A2-20 Lenvic, LLC Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 58A2-20A Joseph W. Richmond, Jr. Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 58A2-21 Roger L. Gibson Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 58A2-24 Louis S. Eaton Tax Map&Parcel Print Name of Property Owner Signature of Owner Date Contact Information for the Owner(s)to receive correspondence: Print Name Jeremy Lynn Address 168 Spotnap Road City Charlottesville State VA Zip 22911 Daytime Phone(434) 977-4511 E-mail jlynn@serviceauthority.org 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 0 B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 0.75 Acres 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;$150 ❑ C. Registration Statement on the official DEQ form. ❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Charles Luck, P.E. Address 9030 Stony Point Parkway Suite 220 City Richmond State VA Zip 23235 Daytime Phone(804) 272-8700 E-mail cluck@wrallp.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# n // /� �t, � Fee Amount$/45°° Date Paid 6".7t7Z/° By who?Alk-mA- f1 Cac.,...r/ Receipt# d TCPa13 Ck# 50 V07 By: -"ee l -6 ER-0 lee Au relotery 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2