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Home My WebLink AboutWPO201700034 Application 2017-08-25 Virginia Stormwater Management Program (VSMP) 1 ''a - . Application for Albemarle County Y�ACdr�' Project Name: West View Farm Driveway,Addition,and Property Improvements (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 0 County File Number: WPO201700034 (to he 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 fir 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. 06000-00-00-002A1 &A2 Mr. Tim Davis D5/0 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 Mr. Tim Davis Address 501 Lexington Avenue City Charlottesville State VA Zip 22902 Daytime Phone( ) E-mail tdavis@guardianpointlp.com 7/1114,Revised: 7/10/14, 1/7/14 Page 1 oft _ t O B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 23.01 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) Previously Paid Mitigation Plan;$150 • C. Registration Statement on the official DEQ form. O D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. E. Stormwater Management Plan satisfying the requirements of code section 17-403. 0 F. Pollution Prevention Plan satisfying the requirements of code section 17-404. 11 G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. O H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. N/A 0 I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. N/A 0 J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Draper Aden Associates(Campbell Bolton) Address 110 Avon Street City Charlottesville State VA Zip 22902 Daytime Phone(434) 295-0700 E-mail cbolton@daa.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By. REUEIVbU AUU28 2017 COIV1MUNITY 7/1/14,Revised:7/10/14, 1/7/14 Page 2 oft DEVELOPMENT Albemarle Counj fit► Community QevelopmentDepartment �i: 401 M��ntire Road Charlottesville,VA22982-4596 soide:(434)296-5832 Fax:(434)972-4126 Planning Application vstarie PARCEL/ OWNER INFORMATION TMP 06000-00-00-002A1 y �r A +Owner(s): RMC7 LIC . Application# WPO2YI700034 PROPERTY INFORMATION Legal Description I RCHERGE TRACT 2I1 Magisterial Dist. Jack Jouett Land Use Primary Unassigned Current AFD Not in A/F District Current Zoning Primary[Rural�Areas APPLICATION INFORMATION Street Address 1495 INGLERIDGE FARM CHARLOTTESVILLE,22901 Entered By Application Type ,Water Protection Ordinances ..:._ Jennifer Pritch 1 4/712017 Project West View Farm Driveway,Addition,&Property Improvements Received Date 04/07/17 Received Date Final Submittal Date 04/07/17 Total Fees 2400 Closing File Date Submittal Date Final Total Paid 2400 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sib:Applicatio Comment Stormwater Management/BMR Plan 04/07/17 Erosaon i44;: enrtr.ontrot Plan §04/01/17 APPLICANT/CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCell overieiosicticiint i RMC7 tiC 501 LEXINGTON AVE CHARLOTT ;.22902 �. �... Prrimary C''-lact TIM DAMS 501 LEXINGTON AVE CH.ARLOTTESVILL 22902 Signature of Contractor or Authorized Agent Date pE ALS Virginia Stormwater M ement Program (VSMP) Application for Albemarle County . Project Name: West View Farm Driveway,Addition, and Property Improvements (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: (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. 06000-00-00-002A1 &A2 Mr.Tim Davis j1j '' ( I1 Tax Map&Parcel Print Name of Property Owner Signature of Owner Dath 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 Mr. Tim Davis Address 501 Lexington Avenue City Charlottesville State VA Zip 22902 Daytime Phone( ) E-mail tdavis@guardianpointlp.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 oft ® B. All Fees [Code section !' 208] `✓ For new or modified plans; Total acres proposed to be disturbed 23.01 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;$150 .er request) Mitigation Pl. • '.150 ® C. Registration Statement on the official DEQ form. ▪ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ® G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ® H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. N/A ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. N/A ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Draper Aden Associates (Campbell Bolton) Address 110 Avon Street City Charlottesville State VA Zip 22902 Daytime Phone(434) 295-0700 E-mail cbolton@daa.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# ar'o/7-- Fee Amount$ MVDate Paid 1 ! 7 By who? I (, Receipt# ,OgDD/iCk# By: ip 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 T • of n Virginia Stormwater Management Program (VSMP) Application for Albemarle County 47,10 Project Name: West View Farm Driveway,Addition, and Property Improvements (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes ❑ No 121 Is this a revision or resubmission for review? Yes ❑ No 10 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. ® 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. 06000-00-00-002A1 &A2 Mr.Tim Davis /fj L' (3( 1-7 Tax Map&Parcel Print Name of Property Owner Signature of Owner Dat t 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 Mr. Tim Davis Address 501 Lexington Avenue City Charlottesville State VA Zip 22902 Daytime Phone( ) E-mail tdavis@guardianpointlp.com 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 Virginia Stormwater Management Program (VSMP) "`'i' • Application for Albemarle County �l ' 1 '�3 Project Name: West View Farm Driveway,Addition, and Property Improvements (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes D No Is this a revision or resubmission for review? Yes ® No ❑ 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. ® 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. 06000-00-00-002A1 &A2 Mr.Tim Davis t VD- Tax Map&Parcel Print Name of Property Owner Si ature of Owner e 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 Mr. Tim Davis Address 501 Lexington Avenue City Charlottesville State VA Zip 22902 Daytime Phone( ) E-mail tdavis@guardianpointlp.com 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 23.01 acres Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification ofpermit Less than I $290 $145 $20 I and less than 5 $2,700 $1,350 $200 5 and less than 10 $3,400 _ $1,700 $250 10 and less than 50 $2,250 (,25Q.. $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 ler request) Mitigation Pla '.150 ® C. Registration Statement on the official DEQ form. O 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. 1I H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O L 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 Draper Aden Associates(Campbell Bolton) Address 110 Avon Street City Charlottesville State VA Zip 22902 Daytime Phone(434) 295-0700 E-mail cbolton@daa.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 S Date Paid By who/__ Receipt# Ck# By: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 oft