HomeMy WebLinkAboutFDP201800006 Application 2018-04-17COUNTY OF ALBEMARLE
Department of Community Development
401 McIntire Road
Charlottesville, Virginia 2290245%
Phone 434 296-5832 Fax (43!9 9724126
FLOODPLAIN DEVELOPMENT PERMIT
This form is intended to aid the Department in documenting and characterizing the nature of development proposed in the
floodplain. Development includes buildings or other structures, mining, dredging, filling, grading, paving, excavation or
drilling operations or storage of equipment or materials. The form responses will be used to determine whether a
floodplain impact plan or special use permit is required.
Please check one: N( New Submittal with no anticipated floodplain impact (no floodplain impact plan)
❑ New Submittal with an anticipated floodplain impact. Please include a f loodplain impact
plan. FEE required with submittal: $323 (Code 18-35.1g)
❑ FEMA Letter of Map Change (LOMA, LOMR) Please include a complete copy of all
material to be submitted to FEMA. Include any computer models (HEC-R,4Sfiles) on a disc.
FEE required with submittal: $161 (topographic info only), or $323 (floodplain
modeling)
❑ New Submittal with a Zoning Special Use Permit. Please include a floodplain impactplan.
FEE required with submittal: $323
❑ Resubmittal (Floodplain Development Permit Number } Please include your
responseform from the original submittal. FEE as above required with each resubmittal,
A Floodplain Impact Plan, Special Use Permit, or FEMA Map Change will need to follow Zoning Floodplain Overlay
District requirements (County Code 18-30.3), found at
hM://www.albemarle.org6MIogdLimages/Fonns Center/Departments/County Attorney/Forms/Albemarle County Code
Chl8 Zoning30 Overlay Districts gdf
Section 4 of the Design Standards Manual provides a list of required items to be included in a Floodplain Impact Plan.
This can be found at http://www.albemarle.orgLCepgr ment.as ?de artlnent=cdd&rel a e=4447.
Owner Name (Print)
Home Phone Office / Other Phone
Address T"-
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City State Zip Code
Tax Map & Parcel Number T' � �. -C
Project Name (if applicable)
Building Permit or Project Number (if applicable)
11/1/2015
Please describe the nature of the development activity proposed within the floodplain (e.g_ new structure, grading for a
playing field, driveway stream crossing, installation of a fence, etc.):
iIV- FAcAr- n3F DAM is wiz' r gEA2s A-
(Please attach any plans or photos to this application)
1. If a structure is proposed, is the structure accessory to a recreational or agricultural use? Yes 113IN. ❑ N/A
2. Does the proposed activity involve a stream crossing for a pedestrian trail or driveway
serving a single family dwelling? Yes ❑ No N/A
3. Does any proposed fencing cross a stream channel? Yes El No N/A
4. If any fill is proposed, please approximate the proposed amount of fill in the floodplain
Owner / Agent Signature .. Date /Derly�z 1" iT 1g
A '►.-
1
a`7 1 L t 5q, i
(FOR OFFICE USE ONLY)
Checked By Date
(for resubmiUals) Fee Amount $ Date Paid By who?
Receipt # Check #
JI 20I5