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WPO201600006 Application WPO VSMP 2016-01-26
CommunitvDe�FelopmentDepartn (47 Ali ` Albemarle Dunty 401 McIntire Road Charlottesville,VA 22902-4! J Voice:(434)296-5832 Fax:(434)972-4: 4 Planning Application PARCEL / OWNER INFORMATION TMP 07800-00-00-020M0 Owners): MARTHA JEFFERSON HOSPITAL Application # WP0201600006 ;PROPERTY INFORMATION Legal Description rACREAGE 11 MARTHA JEFFERSON HOSPITAL Magisterial Dist. Rivanna H 1 Land Use Primer. Commercial Current AFD Not in A/F District [:1 Current Zoning Primer,; Planned Development Mixed Commercial APPLICATION INFORMATION Street Address 500 MARTHA JEFFERSON DR CHARLOTTESVILLE, 22911 Judy Nla-tir: Application Type Water Protection Ordinances is 016 Project Sentara Martha Jefferson Hospital - Helipad - VSMP Received Date 7 01/25/16 I Received Date Final Submittal Date 01/26/16 Total Fees 2 Closing File Date Submittal Date Final Tckal Paid 2 Revision Number Comments Legal Ad [SUB APPLICATION(s) _ T,P Sub Application Comment Erosion and Sediment Control Plan 01/26/16 Storntwater Management/BMP Plan 01/26/16 APPLICANT / CONTACT INFORMATION Contact Ty Name crews CityState Zip Phone PhoneCe ,,,ner,r.pplicant VARTI-'A )EFFER=OF. HOSPITAL PCE _"__ CHARLOYIESVILL 22902 -pplicant !..f,=-1- 1, I D- .:1 1:: ..F—F= _EFPEA; _:i, DF:'. _! E :=:TESVILL 22911 4346547300 Prm,r;Contact DANIEL MICl-'EL PE .. LLE. El =:I.EEFF-', 1.:Ir. cE::FLE HARRISONBURG, 22801 5404346365 iiimmi Signature of Contractor or Authorized Agent Date Virginia Stormwater Management Program (VSMP) -AL �� ' Application for Albemarle County , Project Name: z-)evrtigA 1iAPr 14" 3 Ep.4:01,,) tr,iR t f'4 (The name should be the same as it appears on plans) VkQA1 9n ,W!�. Is this an amendment to an approved plan? Yes of No 0 Is this a revision or resubmission for review? Yes 0 No County File Number: , I)P 2.00q- coo* (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. g zn) Zia 11144 -5- Davi AP Tax Map&Parcel Print Name of Property Owner ignature o"t1 • er 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)L/ to receive correspondence: Print Name N J Lt / A/2 S J)(1`i 3 /! Address T QU i !c 1htt J �`�t'�S, 4/'f City aldr6i/eS✓r l4C ,._ State VA zip 4.2?-2/ Daytime Phone(% ) .5 y- 7 3 (10 E-mail S DA VIS [ Ci.s r?r1 7 cccti • 6_0 7/1/14 RPvice.ri• 7/1(1/14 1/7/14 Paar 1 nf2 1604 ©B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed L ,, IAcres to be 1 Total Fee Fee Due with this Fee with Transfer or disturbed A ,lication modification of•ermit Less than 1 $290 $145 $20 1 and less than 5 $2,700 $1,350 $200 5 and less than 10 J $3,400 $1,700 $250 10 and less than 50 $4,500 $2,250 $300 SO 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) 4 4gation Plan;$150 I R5 C. Registration Statement on the official DEQ form. VC). Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. 41E. Stormwater Management Plan satisfying the requirements of code section 17-403. W4. Pollution Prevention Plan satisfying the requirements of code section 17-404. VG. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. u/A t{H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of r stream buffers. Nip 64 I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. v A y J. Construction Record Drawings(as-builts)for any existing facilities in the proposal satisfying the ( requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents, Professional seals must have original signatures. Additional information if not provided on plans and documents.' Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name -. tL1`1a- Address V hMi-ey Et. 11JC-1 A)t kG -••••• State Ok- Zip..._224301 Daytime Phone( ) 4 -6A25 E-mail a m 1 Cin a e.(i va.t tey e e•cols too *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid 1 o n-14 By who? -,Ail r� -NO fiLICCei 116 Receipt# /9 9S4o_ /361 Y 1 _ Ck# B ' -- 7/1/14 Revi.cerl. 7/10/14 1/7/14 Page 2 of 2 County of Albemarle - GI' Web - Property Information Page 1 of 2 Parcel ID: 07800-00-00-020M0 1 .x t 7 f • Parcel Assessment Data (CAMA) Last Updated On: 01/09/2016 Other Parcel Data Last Updated On: 01/10/2016 GIS/Mapping Data Last Updated On: 01/10/2016 Summary Information Parcel Information Total Acres 65.52 Primary Prop.Address 500 MARTHA JEFFERSON DR Other Address N/A Property Card(s) 2 Lot 11 Property Name MARTHA JEFFERSON HOSPITAL Subdivision N/A Notes 1/16/14 Deed of Boundary Line Adjustment&Combination DB4454/527 65.740 ac - .223 ac to TM 78-20C =65.517 ac 09/23/2011 - Certificate of Plat per DB:4077 PG:311 72.663 ac - 6.919 ac to VDOT =65.744 ac 08/26/2011 - Boundary Line Adjustment per DB:4069 PG:267 72,663 ac - 1.694 ac to TM 78-20M1 + 1.694 ac fr TM 78-20M1 =72.663 ac Owner Information Owner MARTHA JEFFERSON HOSPITAL Address PO BOX 2606 CHARLOTTESVILLE VA, 22902 Owner as of Jan 1st MARTHA JEFFERSON HOSPITAL Most Recent Assessment Information Year 2015 Assessment Date 01/01/2015 Assessment Reason Reassessment Land Value $13,698,800 Land Use Value $0 Improvements Value $203,951,400 Total Value $217,650,200 Most Recent Sales History Previous Owner MJH FOUNDATION Owner MARTHA JEFFERSON HOSPITAL Sale Date 09/23/2009 Sale Price $0 Deed Book/Page 3799/734 Other Tax Information as of Jan 1st State Code Other httre.//rticisrol, nrlca 1 it fl inn 061062 - 1 r ^ r t ®® fit-_29A1 62-87'N./ E cn f4.3 „vL.nn,�"78-57 '� 62 23 �c • -', tea¢^ .c ® F f �,,till,.,.f SRI .. �eel i ,< l''''''--- -- 59 �GO-4.0•La �o i�. Er'rf058A R <�j° � � 1 �fl 58 as 78 Part,1 f> 7;� 78B r`a`t•,--tibFLORE \', O ' � c9, P-di • /' i 786 Part.1 a�� •- i l iwQWA 4 - -��.7- /.., Par? m� • h�° 58(11 ( , \iaLL5G‘" 6 /7LE C<YliplA {/ C l (j UQ i®j Y'� ' 16 11 .-/.;4""'"( 3 .. v vs, ' X1 +4 a ti H•T '� n 1 \. Allt 12 78 fife 4 4 7?A11y �t --1, �Q ,--a . e r} •s •�. ar * 40 • 151c;, ,74.021 J,,, .`l i .� it_,, ,,' 55A6 ( r t t -�`-,1'20`i"` '` r �,`r'ii1• �' ,s„ /, of f 51 ttesville t �, oa _ 1 ..,.. , 20F1 / 20K '�� �. v q' r �: ',/ ,"'7. \ ,/' 3 1r :,.0 C 201;1 � ` mar.2 rr 53 at i I f ' i I • 'J �� . 311 ' � i r .! � .�' — `e ,%1 �.,�( 2u' X31 J ����-� 1 � aA a •rte'' /'/ 31F "31 cc fes, -----'..--..-----".:::7,--..--..: .�� : ;�'q% •\ 20J 31H 45 ~`� -�_ , 218 IsomViii SOC _ 1 � 201v41 %" `a 4�r fir e. ,' � 22A 4` --- _ \324 1 ^�� 48 49 '%r�9� f �- - '�� y \ ., 47A ) o ,I 33 "17t. %; Q ti4 aZ__ � r __ 33D ���� - __��/ R, P 79-7A 76.21, ELt,�L.t+� \ 4., 78-22 `•, ti'"'eR, ryvH ,, 78-288 a 8� 00 �P ReL,uyyA RIVER � 78-26 6 / 92-16 ,\ J '23 27A �\ Tee NQO OIRANC,y 1 . 1pY 1 1 7 77-31 .. �`ti 278 �� .iti` .--".:*9.---' i hl ACS''e92-1 1 ,GGP_____-----8""cH------, A ,• 9z-4 \1 v. 091 092 Tax Map: 093 Scale Albemarle County 1 -- -z-r---/4/ 0 800 1.600 2.400 078 .<,,,,,:,. Feet II Note This map is for display purposes only '" and shows parcels as of 12/31/2014. .r- ' -,,,,;, ' See Map Book Introduction for additional details. Albemarle County Engineering Erosion and Sediment Control Plan checklist for plan reviewers Updated 1 Dec 2014 An erosion and sediment control plan is a document which illustrates the measures used to control erosion and sedimentation during construction. All measures follow the Virginia Erosions and Sediment Control Handbook. Reference key; [Square Brackets] are County Code references, {Curved Brackets} are policy references, and(regular parenthesis) are explanatory. Links to reference documents are provided where possible. Application information: x Completed WPO application and fees, with owners signature [County Code 18-32.4.3.2, 18-32.3.9, 17 Article II] Erosion Control plans require a Water Protection Ordinance (WPO)application and original owner's signature. No review is provided without application, owner signature and fees. This is true even for revisions. It is important that the owner be aware of comments and re-submittals, and this is the county assurance. N/A Copies of federal and state permits for any wetland or stream disturbance. (Army Corps, VDEQ, etc) [17-604, 18-32.1.2, 14-311] VSMP: x SWPPP, PPP, SWMP approvals obtained where necessary. In most cases, the erosion control plan will not be submitted independently, but will be part of a Stormwater Pollution Prevention Plan (SWPPP). Unless exempt, it will be approved with the SWPPP. Title information: x Project title. Titles should be appropriate. It should be an erosion control plan, not a stormwater plan, or site plan, etc. In some cases a WPO package will contain a stormwater plan and a mitigation plan, but they should be on separate sheets with keys and page titles. x Professional seal, with original signature and date for professionally prepared plans. x Content: The erosion control plan must not contain information regarding permanent improvements that do not also appear on other plans. Erosion control plans are temporary documents that are discarded after projects are complete. Existing conditions plan view information: x accurate current existing topography at the time of submittal, including all existing site features, and any recent disturbances, all at a legible scale x date and source of the topographic information: All topography should be at least visually field verified by the designer within the last year. Adequate erosion control cannot be designed without accurate topography and drainage areas. x WPO buffer limits; 100' from stream or wetland bank, 200' from reservoirs, or floodplain limit if greater. N/A No buffer disturbances without WPO Program Authority approval and a mitigation plan. x floodplain limits, including 100yr flood limits for any channel with a drainage area of 50+acres. %WO 11111) Albemarle County Engineering E&SC Plan Checklist Page 2 of 4 x Floodplain undisturbed. Disturbances require a Special Use Permit or Floodplain Development Permit. x all existing easements (access, drainage, sight, sanitary easements, etc.) with deed book references, locations and dimensions x all critical slopes (typically shaded) x Zoning Ordinance buffers shown and protected undisturbed. Disturbances require Planning approval of a waiver. Proposed plan view information: Grading: x proposed topography at minimum 2' contour intervals—tied into existing contours, as well as all proposed site features in later phases. (Sites with less than 6' of grade change should consider using smaller contour intervals.) These should agree with other final plans. x proposed slopes are all 2:1 (horizontal:vertical) or flatter {Design Manual, section 8} x proposed slopes steeper than 3:1 have low maintenance(not grass) ground cover specified on the plan (Design Manual, Section 8} x existing critical slopes are not disturbed, unless a waiver or exemption has been granted for the disturbance. [18-4.2, 14-304] N/A Retaining Wall Plans approved. Any walls supporting roads or necessary infrastructure require engineered plans (not generic manufacturer's details) and computations. }Design Manual, section 81 This will also be required where walls are close to property lines and there is the danger of affecting neighboring property, either during construction, with later failures, or with pedestrian or vehicle safety. x final contour shapes and slopes ensure no un-drained pockets or stagnant pools Narrative: x narrative and project title (Narratives are now optional, and not reviewed by the County, other than noting whether they are not seriously in error, like a boilerplate with another County's name on it.) Erosion and sediment control measures: x limits of clearing and grading encompassing all disturbances, entrances, staging and parking areas, areas where sediment laden runoff will cross, or any construction related activities. This must match any landscaping and conservation plans submitted with site plans . . Albemarle County Engineering E&SC Plan Checklist Page 4 of 4 N/A sized for total drainage area, including those for in-line upstream facilities N/A wet storage is 67cy or more N/A dry storage is 67cy or more N/A wet storage is 4' deep or less N/A wet storage side slope is 1:1 or flatter N/A dry storage side slope is 2:1 or flatter N/A stone weir is 6ft per acre of drainage area N/A embankment and stone weir height is 5' maximum from outside toe N/A embankment top width is adequate (see table 16 reference) N/A 2:1 length:width ratio for flow path For each basin; (GB 3.14) N/A sized for total drainage area, including those for in-line upstream facilities N/A wet storage is 67cy or more N/A dry storage is 67yr or more N/A wet storage side slope is 1:1 or flatter N/A dry storage side slope is 2:1 or flatter N/A embankment 15' high or less from downstream toe N/A principle and emergency spillways sized per handbook requirements N/A embankment has 1' freeboard during 25yr storm with emergency spillway N/A embankment has 2' freeboard during 25yr storm without emergency spillway N/A trash rack/anti-vortex device specified per handbook requirements N/A riser anchor size specified per floatation computation N/A dewatering device sized for 6+hr drawdown of dry storage: 3"dia. minimum N/A safety fence and signs stating"danger, quick sand, do not enter"provided if near any residential properties, or public access N/A structures and embankment match permanent design for facilities to be converted to permanent stormwater management facilities N/A embankment top width is adequate (see Design Manual reference details) N/A 2:1 length:width ratio for flow path. Baffles specified only on temporary structures (p.I11-79). Baffles are a big hassle in construction, and should not substitute for properly dimensioned design if at all possible. Details: N/A a paved construction entrance detail (see Design Manual reference details) for projects in the development areas over 10 acres N/A a typical section for each temporary channel or diversion,referenced from the plan sheets. Existing ground should be shown at the maximum cross-slope on the plan. N/A details and copies of Program Authority permissions for any variances. Mass or Early Grading: N/A mass grading Planning approval. (This is also called rough or early grading plans which contain only approximate finished grades and culverts necessary to grade) Mass grading can only be permitted within planned developments where a concept grading plan was approved with the rezoning. The agent(Director of Planning) needs to formally determine that the grading plan is in general conformity with the approved rezoning plan. Otherwise, an initial site plan needs to be approved prior to issuance of a grading permit. Issuance of a grading permit at the initial site plan stage, as apposed to after final plan approval, requires specific approval from the County Engineer. ® • Albemarle County Engineering E&SC Plan Checklist Page 3 of 4 x a construction entrance (CE)draining to a sediment trap or basin x dust control symbols (DC) x temporary and permanent seeding symbols (TS,PS) x existing drainage divides x existing vegetation, with trees to be saved located by drip lines. This must match any landscaping and conservation plans. x protection provided for all stages/phases of construction,from initial land clearing to final grades and hardscapes. This is our most important item. Plans which show only inlet protection on proposed drainage systems,which are only possible to install upon completion of grading, may be denied without further review. x no erosion control measures in the way of construction access or grading. Diversion dikes or silt fence are not placed in the middle of the site, or through access or grading. Sediment traps are not under or on top of fill material or held up by retaining walls. Construction entrances are not on fill, etc.If the concept for site protection is not adequate in this regard,further review of the plan may not be possible. x existing soil boundaries are shown with labels. Areas already disturbed are indicated, with constructed fill depth or cut noted. x critical erosion areas are identified; areas of constructed slopes, areas near property lines N/A adjacent off-site disturbances are shown with erosion control facilities N/A a stockpile location. N/A where cut or fill balances have a 10,000 cubic yard deficit or more,plans should not be approved without a waste area identified. This must be on-site, or on another approved and permitted site. (Don't make the inspectors chase trucks to find the dump site violation.) x a staging and parking area, or other construction related areas N/A diversion dikes are used to direct drainage to traps and basins x silt fence is not used across contours in place of diversion dikes. x silt fence is limited to areas of sheet flow with I/4 acre per 100ft of level on-grade silt fence. Plans showing only silt fence,without sediment trapping measures, should not be approved unless they meet this criteria and fill dirt is minimal. x all swales and low points at the perimeter of the site have a sediment trap or basin. Silt fence in swales is typically not adequate. Check dams do not substitute for traps. Diversions which travel more than 100ft, or go in and out of swales, are usually not maintainable in the field. If the concept for site protection is not adequate in this regard, further review of the plan may not be possible. N/A temporary slope drains (TSD) or diversions are provided to prevent discharge over disturbed or fill slopes x inlet protection(IP) on all inlets N/A culvert inlet protection(CIP) on all culvert inlets N/A outlet protection(OP)on all outlets x all watercourses are protected and encroachments minimized N/A stream crossing(USC,SC) and diversions are provided at all stream crossings. x adequate channels(MS-19)provided for each outfall (see Design Manual for minimum content) WA all traps and basins are shown with proposed contours. Simple boxes or symbols are not sufficient, in most cases, to determine layout or bond amounts. For each trap; N/A drainage area is 3 acres or less VALLEY ENGIN E E R I N G IDEAS MADE REAL January 21, 2016 Matthew Wentland Civil Engineer II Engineering Division 401 McIntire Road, North Wing Charlottesville, VA 22902 Reference: SPD2015-62 Martha Jefferson Hospital — Minor Amendment Dear Mr. Wentland, I am forwarding revisions for the project referenced above. 1. Disturbances greater than 10,000sf are subject to the VESCP and VSMP and require a WPO submittal. RESPONSE:Please find herewith the Erosion& Sediment Control Plan and supporting documents for your review. Should you have any questions, please feel free to contact me at 5404346365 or email me at dmichael@valleyesp.com at your earliest convenience. Sincerely, Valley Engineering, PLC Tittak/A114/ Daniel K. Michael, P.E. Valley Engineering, PLC Partner/Principal-in-Charge 3231 Peoples Drive • Harrisonburg,VA 22801 Phone(540)434-6365 • Fax(540)432-0685 www.valleyesp.com • • RECEIVED JAN 2 5 2016 COMMUNITY DEVELOPMENT