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Home My WebLink AboutWPO201700058 Application WPO VSMP 2017-05-31 ofAL:. Virginia Stormwater Management Program (VSMP) +'' Application for Albemarle County 1ff, Rao Project Name: Sparrow Hill (The name should be the same as it appears on plans) Is this an amendment town approved plan? Yes 0 No Is this a revision or resubmission for review? Yes l' No 0 County File Number: W PO 2 0 17--000) '(io he 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. ® 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. 56-26A2 3.1144.11 S. Ntit R4 WI 5-3I-17 Tax Map&Parcel Print Name of Property Owner( Signature of Owner Date 56-108A Mitd: 'S, %Acm i1� tu�i , 5-31-I/ Tax Map&Parcel Print Name of Property OwneA Si turee 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 74,114.11. 5• Herta;oat Address •S y 4 Al 3 reunN s v;ll a Rena City L'11air16ftts,u:lls. State VA. Zip 12.903 Daytime Phone(H!y tit 52 23 E-mail it ssi tfri w`. AM. CAM 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 B. All Pecs [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed N.Q Z Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than I $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 P4:at $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; p 41 ® C. Registration Statement on the official DEQ form. It 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. 6a 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. ❑ .1. 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 Address City State Zip Daytime Phone( ) E-mail *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 of 2 Albemarle /dtin { Community Development Department `+ L jr 1 McIntire Road Charlottesville,VA22902 4596 err/ 161Pr Voice:(434)296-5632 Fax:(434)972-4126 --- " Planning Application PARCEL I OWNER INFORMATION TMP 05600--00-00-026A2 Owner(s) HERRING,JUDITH S Application# WPO2O1700058 PROPERTY INFORMATION Legal Description Magisterial Dist. !White Hall '+_ Land Use Primary Forest Current AFD Not in A/F District Current Zoning Primary;Rl Residential APPLICATION INFORMATION Street Address 5442 ROCKFISH GAP TPKE CHARLOTTESVILLE,22903 Entered By _ — Judy Martin _ARpfication Type Water Protection Ordinances 7r25/2013 Project Sparrow Hill- VSMP Received Date 07/21/17 Received Date Final Submittal Date Total Fees 2250 Closing File Date Submittal Date Final Total Paid 2250 Revision Number Comments Legal Ad SUB APPLICATION(s) Type Sub ARAicatio. Stormwater Management/BMP Plan 07/21/17 APPLICANT I CONTACT INFORMATION ContactType Name I Address CityState Zip Phone PhoneCeil i HERRING.7tJDITH S 5444 -i'++WNSVIILLE ROM) t RLO E ILI. 22443 Primary Contact JUSTIN SHIMP -SHIMP ENGINEERING 201 E.MAIN ST.,STE.M CHARLOTTESVILL 22902 4342078086 AapiK+re JUDITH S.HERRING 5444 BROWNSVILLE ROAD CHARLOTTESVTLL 229+03 4348235223 Signature of Contractor or Authorized Agent Date `01111111 ciA! Virginia Stormwater Management Program (VSMP) Application for Albemarle County r.et'"A Project Name: Sparrow Hill (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No PI Is this a revision or resubmission for review? Yes 0 No WA 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. 56-26A2 Sud;}h S. t ; uLaL 1b. )I2A L:, 5-3I-17 Tax Map&Parcel Print Name of Property Owne Si ature of Owner Date 56-108A Itch S. Nettie,ty q4t 4_ er 5.31-17 Tax Map&Parcel Print Name of Property OwneA Signature of OwnDate 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 MAMA. S S. Metae:ary Address sS14 Brom)NSVift Ristrij City C.IlsrlpiN.Su1114. State Vst. Zip 'Vida Daytime Phone(y3y Q23 5223 E-mail Skenacri tr ilP etel. cern 7/1/14,Revised:7/10/14,1/7/14 Page 1 oft Sure '*ftool WI B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 11.2 Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than i $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 Pla VI C. Registration Statement on the official DEQ form. 0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. l E. Stormwatcr Management Plan satisfying the requirements of code section 17-403. 1 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. . 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 Address City State Zip Daytime Phone( ) E-mail *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$2241 0 i5ate Paid 1444-4)4 who? 41 LJ.pi Receipt#fiv 4/C Ck# i li' B y: 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2 Virginia Stormwater Management Program (VSMP) 4" Application for Albemarle County _ eW,. �1R�tN�P Project Name: Sparrow Hill (The name should be the same as it appears on plans) Is this an amendment to an approved plan? Yes 0 No Is this a revision or resubmission for review? Yes si No WI County File Number: 'il/PO 2,017 0 ase (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. ® 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. 56-26A2 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date of Property Own,- ire of Owner Date 4 e of Pr ' ' owner Date c of Pro}. ,ure of Owner Date (s)to receive. .nce: State Zip E-mail 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 11.2 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 GZI C. Registration Statement on the official DEQ form. El D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. I1 E. Stormwater Management Plan satisfying the requirements of code section 17-403. WI F. Pollution Prevention Plan satisfying the requirements of code section 17-404. WI 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 Address City State Zip Daytime Phone( ) E-mail *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# 10 1 — O D6 i ! f r/ C� � 1 Fee Amount$1S'a Date Paid/D/f 7'y who?1`► - �'y(ia £17•-v peipt# 1` JO( CId#�C co By: 0141 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 Virginia Stormwater Management Program (VSMP) Application for Albemarle County Ittof Project Name: Sparrow Hill (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 WI County File Number: WPO 2017-000**60 (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. 56-26A2 Adelaide C-ville LLC Z ( 1 S7 Tax Map&Parcel Print Name of Property Owner Signature of Owner Date 56-108A 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 Shimp Engineering, P.C. Address 201 E Main St Ste. M City Charlottesville State VA Zip 22902 Daytime Phone(434) 227-5140 E-mail justin@shimp-engineering.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 ® B. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 14.92 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 planAlligniiiMP Variances;$150(per request) Mitigation Plan;$150 D C. Registration Statement on the official DEQ form. O D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. ❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Address City State Zip Daytime Phone( ) E-mail *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. 11 Tq cj5S(e/fe FOR OFFICE USE ONLY WPO# n ,/ Fee Amount$ 0) Date Paidq4 I)1'' A By who?SIAL YVL, V n Receipt# CO �01U )�/ By: 3-•\YCJ)i /4/2 7/1/14,Revised:7/10/14, 1/7/14 Page 2 of 2