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HomeMy WebLinkAboutWPO201700071 Application Minor Amendment 2018-08-06 4 • ALeti Virginia Stormwater Management Program (VSMP) Application for Albemarle County Project Name: OTV-BLOCK 22 SWM & ESC PLAN WP0201700071 (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 0 No ❑ County File Number: WPO201700071 (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. 55E-01-22-0 ‘1241 b woos. Tax Map&Parcel Print Name of Property O ner40, : .r•wner 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 Dave Brockman Address 1005 Heathercroft Cir. City Crozet State VA Zip 22932 Daytime Phone( ) E-mail dave@oldtrailvillage.com 7/1/14,Revised:7/10/14, 1/7/14 Page 1 of 2 1' O B. All Fees [Code section 17-208] 5.2� For new or modified plans;Total acres proposed to be disturbed, AC 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 an;$200 per review Variances;$150(per request) 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. • 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. 0 H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. O 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 Jeremy Fox Address 914 Monticello Rd City Charlottesville State VA Zip 22902 Daytime Phone(434) 977-0205 E-mail jfox@roudabush.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 J Q WPO# Fee Amount'4'L&ACC Date Paid VO-kg By who kith 121. Receipt# 114(61 Ck# , By 9 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 pF A14441 Virginia Stormwater Management Program (VSMP) „:- ''; Application for Albemarle County 1.14vOi Project Name: OW-BLOCK 22 SWM& ESC PLAN (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 ® No 0 County File Number: WPO201700071 (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. 55E-01-22-0 1C`,�. jam - l ' ,4/!V Tax Map&Parcel Print Na a of P .perty 0 er atur 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 Dave Brockman Address 1005 Heathercroft Cir. City Crozet State VA Zip 22932 Daytime Phone( ) E-mail dave@oldtrailvillage.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 5.87 AC Acres to be Total Fee Fee Due with this Fee with Transfer or disturbed Application modification of permit Less than 1 $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 $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;$150 O C. Registration Statement on the official DEQ form. 0 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. ® F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings(as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Jeremy Fox Address 914 Monticello Rd City Charlottesville State VA Zip 22902 Daytime Phone(434) 977-0205 E-mail jfox@roudabush.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: • a i` 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 ov Virginia Stormwater Management Program (VSMP) Application for Albemarle County - Project Name: Old Trail Village Block 22 SWM & ESC Plan (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: WPO201700071 (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. 55E-01-A1 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 Dave Brockman Address 1005 Heathercroft Cir. Suite 400 City Crozet State VA Zip 22932 Daytime Phone(702) 985-9088 E-mail dave@oldtrailvillage.com 7/1/14. Revised: 7/10/14. 1/7/14 Page 1 of2 RIB. All Fees [Code section 17-208] For new or modified plans;Total acres proposed to be disturbed 5.76 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 11 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;$150 El C. Registration Statement on the official DEQ form. l2 D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ® E. Stormwater Management Plan satisfying the requirements of code section 17-403. • F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ▪ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. ID H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. El I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Jeremy Fox Address 914 Monticello Rd. City Charlottesville State VA Zip 22902 Daytime Phone(434) 977-0205 E-mail jfox@roudabush.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY WPO# Fee Amount$ Date Paid By who? Receipt# Ck# By: 7/1/14. Revised: 7/10/14. 1/7/14 Page 2 of . Community Development Departmerd AlbemIllarle Cour 4 1, 401 Aire Road Charlottesville.VA 22902-4596 Skip? :(434)296-5832 Fax:(434)972-4126 --- 14 Planning Application PARCEL/OWNER INFORMATION TMP OSSEO-01-00-000AI. Own e r(s) MARCH MOUNTAIN PROPERTIES LLC Application# I WP0201700071 PROPERTY INFORMATION Legal Description I OW TRAIL PARENT TRACT OLD TRAIL.GOLF CLOS&PARENT D Magisterial Dist.tWhite Hall LI Land Use Primary Commercial 0 Current AFD [Not in A/F Dristritt 7;1 Current Zoning Primary Aural Areas APPLICATION INFORMATION Street Address Entered By Jennifer Smith71 Application Type 'Water Protection Ordinances ---;1 kb/VI017 Project Old Trail Village Block n SWM &ESC Plan Received Date 10/06/17 Received Date Final Submittal Date Total Fees 1700 Closing File Date Submittal Date Final Total Paid 1700 Revision Number Comments Legal Ad SUB APPLICATION(s) Type , Sub Applicatio Comment Stormwater Management/BMP Plan 10/06/17 Erosion and Sediment Control Ftian 10/06/17 APPLICANT /CONTACT INFORMATION ContactType Name Address CityState Zip Phone PhoneCell *ivneriAppetairt !MARCH MOUNTAIN PROPERTIES LLC 1005 HEATHERCROFT CR I CROZET VA 22932 fl.rta'y Czrtscs JEREMY FOX 914 MONTICELLO RD CHARLOTTESVILL :22902 4349770205 topitcamt DAVE BROCKMAN 1005 HEATHERCROFT QR. CROZET,VA 22932 7029859088 Signature of Contractor or Authorized Agent Date avwL1 Virginia Stormwater Management Program (VSMP) Application for Albemarle County ��RGIh'lP Project Name: Old Trail Village Block 22 SWM & ESC Plan (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: TBD (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. 55E-01-A1 Suzanne J. Brooks 2_1(..- Tax Map&Parcel Print Name of Property Owner ignat 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 Owners)to receive correspondence: Print Name Dave Brockman Address 1005 Heathercroft Cir. Suite 400 City Crozet State VA Zip 22932 Daytime Phone(702) 985-9088 E-mail dave@oldtrailvillage.com 7/1/14,Revised: 7/10/14, 1/7/14 Page 1 of 2 `4100ll B. All Fees [Code section 17-208] For new or modified plans; Total acres proposed to be disturbed 5.87 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 J 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;$150 ❑ C. Registration Statement on the official DEQ form. (] D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402. ❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403. F. Pollution Prevention Plan satisfying the requirements of code section 17-404. ® G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405. CI H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of stream buffers. ❑ I. Requested Variations or Exceptions as provided in code sections 17-407 and 408. ❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the requirements of code section 17-422. Provide 2 copies of all plans and any supporting documents. Professional seals must have original signatures. Additional information if not provided on plans and documents: Name of a Contact Person for correspondence(usually the plan preparer,consultant or agent) Print Name Jeremy Fox Address 914 Monticello Rd. City Charlottesville State VA Zip 22902 Daytime Phone(434) 977-0205 E-mail jfox@roudabush.com *When applications and plans are reviewed,but not approved,and a response to comments is not received within 6 months from the date of county comments,the application will be deemed withdrawn. Applications without valid owner's signatures will not be considered valid. FOR OFFICE USE ONLY / WPO# I -- Fee Amount$I ,W Date Paid �(/�J`(p``1 By whol\fft • ita Receipt# 11144 Ck# %,11$ By: dyi 7/1/14,Revised: 7/10/14, 1/7/14 Page 2 of 2 PHONE(434)977-0205 -1111 FAX(434)296-5220 INFO@ROUDABUSH.COM ROUDABUSH, GALE &ASSOCIATES, INC. A PROFESSIONAL CORPORATION LAND SURVEYING Serving Virginia Since 1956 ENGINEERING 914 MONTICELLO ROAD LAND PLANNING CHARLOTTESVILLE,VIRGINIA 22902 WILLIAM J.LEDBETTER,L.S. BRIAN D.JAMISON,L.S. JIM L.TAGGART.P.E. DAVID A.JORDAN.L.S. DAVID M.ROBINSON,P.E. KRISTOPI1ER C.WINTERS,L.S. AMMY M.GEORGE,L.A. TO: Albemarle County Engineering DATE: October 6,2017 JOB#: 8053 ATTN: Ms. Emily Cox,P.E.,Civil Engineer II County of Albemarle Department of Community Development 401 McIntire Road, Charlottesville,VA 22902 X Attached _under separate cover via the following items: #of Copies Date Job# Description 2 10-06-17 8053 Old Trail Village-Block 22 SWM& ESC Plan& SWPPP 2 10-06-17 8053 Old Trail Village-Block 22 SWM Calculations 1 10-06-17 8053 VSMP Application & Submittal Check($1,700) These are transmitted as checked below: For Approval/Signature For your use _Please Return _As Requested Resubmitted w/Revisions X Review/Comment For Bids Due Other REMARKS: SIGNED: COPY TO: (2.4,44447 Jeremy L.Fox If enclosures are not as noted, kindly notify us at once.