Residential Building Permit Handout.pdf

COUNTY OF ALBEMARLE

Department of Community Development

401 McIntire Road, North Wing

Charlottesville, Virginia 22902-4596

Phone (434) 296-5832 Fax (434) 972-4126

January 12, 2009; Revised – 10/30/14, 11/1/15, 02/24/17, 3/27/2017

1

RESIDENTIAL BUILDING PERMIT APPLICATION

PACKET/INFORMATION

Residential Building Permit Applicant:

The information attached has been developed to assist you with applying for a Residential

Building Permit. Enclosed you will find:

1. Building Permit Online Services Information

2. Building Permit Application;

3. Process Information;

4. Inspection Guidelines;

5. Minimum Standards for Drawings;

6. Residential Swimming Pool Permit Checklist;

7. Building Permit Fee Schedule

8. Addressing Notice

9. Private Groundwater Well Testing Information

10. Notice to Homebuilders of Single-Family Attached Homes – Effective 1-1-2017

11. Virginia Stormwater Management Documents and examples (VSMP, ESCP, SWMP,

SWPPP, PPP, Critical Resources Plan).

Please review the information and complete the attached application. The completed Residential

Building Permit Application may be mailed to the address on above letterhead; and/or delivered

to the Community Development office at 401 McIntire Road – 1st floor, North Wing.

Upon receiving completed application, an Intake Specialist will be assigned to your application

for review and processing. You will be contacted by an Intake Specialist who will discuss

provisions for payment of fees and clarification of any information that has been provided.

We do hope that our customers find this packet of information useful when applying for a

residential building permit. Comments and suggestions may be submitted in writing or by

calling our department at 434-296-5832.

Sincerely,

Community Development Staff

Issued October 17, 2016

TO: ALL Community Development Building Permit Customers

DID YOU KNOW?

The Community Development Department now offers online services and email

notifications for many of your Building Permit needs.

� Need to know your Building Permit Number before the permit is issued? (email address

required)

o If contact email addresses have been provided, once your Building Application has been

entered into County View (Albemarle County's development tracking system), Primary Contact

or General Contractor will be notified via email to advise that your permit is being processed

and to provide the Building Permit Number.

� Need to know the status of your Building Permit?

o Using the Building Permit Number – you can access County View Web’s Building Application -

Inspection and Reviews Page to track the building permit through the Review Process. You will

know immediately which review types are pending and which have been approved or denied.

You can access building permits on County View Web at: http://countyviewweb.albemarle.org.

� Need to know if your Building Permit has been issued? (email address required)

o If contact email addresses have been provided, once your Building Permit has been issued, the

Primary Contact and/or General Contractor will be notified via email that the permit is ready for

pick-up or mailing. You can also find the status of your building permit on County View Web.

� Need to know the results of your inspection?

o Inspection results are typically entered in County View the afternoon of the inspection. Using

your Building Permit Number - you can access the Building Application - Inspection and

Reviews Page in County View Web the following day to find out if your inspection was

approved or denied.

� Need a Certificate of Occupancy? (email address required)

o If contact email addresses have been provided, once your building permit has been completed

and a Certificate of Occupancy (CO) issued, the CO will be emailed to the Primary Contact. You

may also get copies of your CO online through County View Web – Building Application Permit

Documents Page.

� Questions about how to use County View Web?

o If you have questions about how to use County View Web, or are curious about other

information that may be available, please visit County View Web’s FAQ and Tutorials page at:

http://www.albemarle.org/department.asp?department=cdd&relpage=2769;

or send an email with your questions to [email protected].

PARCEL/OWNER INFORMATION STREET ADDRESS

County of Albemarle Department of Community Development

401 McIntire Road Charlottesville, VA 22902-4596

Voice: (434) 296-5832 Fax: (434) 972-4126

TMP ______________________________

Current

Owner(s) ______________________________

House # Street Name Apt / Suite

BUILDING WORK INFORMATION

Work Class:

Addition

Alteration

New

Demolition

Remodel

Other

Frame Type:

Concrete

Masonry

Steel

Other

Wood

Vinyl

Water Supply Type:

Artesian Well

None

Central Well

Private

Public

Sewage Disposal

Type:

None

Private

Public

Footing / Foundation

Type:

Basement

Crawl Space

Other

None

Slab

Jurisdictional Area Other Foot /

Found Desc.:

Work Valuation Power Company

Work

Description

Directions

Use Group

Construction Type

# of Stories

1st Floor

2nd Floor

3rd Floor

Finished Basement

Other Habitable

Total Habitable Sq. Footage

Porches

Decks

Garage

Swimming Pool

Unfinished Basement

Other Unfinished

Total Unfinished Sq. Footage

Total Building Sq. Footage

Square Footages:

Front

Left Side

Back

Right Side

Zoning Pre-Construction?

Fire Alarms Required?

Fire Sprinkler NAPA Code Year?

Setbacks:

Inspection Line: (434) 972-4179 Building Application

Land Use?

Bldg Pre-Construction?

PROPOSED USE INFORMATION

Dwelling Units

Carports

Garages

Other

Accessory Structures

Bedrooms

Mobile / Prefab. Homes

Baths

Kitchens

Elevators/Escalators/Lifts

Mobile Offices/Prefab. Units

Paint Spray Booths

Swimming Pools/Hot

Tubs/Spas (Res. Only)

APPLICATION CONTACT INFORMATION

E-mail

Primary Contact

Cellular #

Phone #

SUB-CONTRACTOR INFORMATION

Business Name: License Types: State License # Locality License #

City / State

Street Name

Name

Fax #

Zip Code

E-mail Cellular #

Phone #

City / State

Street Name

Name

Fax #

Zip Code

Owner / Applicant

E-mail Cellular #

Phone #

City / State

Street Name

Name

Fax #

Zip Code

Mechanics Lien

E-mail Cellular #

Phone #

City / State

Street Name

Name

Fax #

Zip Code

General Contractor

Separate permits may be required for Electrical, Plumbing, Heating, Ventilating, and Air Conditioning.

This permits becomes null and void if work or construction authorized is not commenced within 6 months, or if

construction or work is suspended or abandoned for a period of 6 months at any time after work is commenced.

I hereby certify that I have read and examined this application and know the same to be true and correct. All provi-

sions of laws and ordinances governing this type of work will be complied with whether specified herein or not.

The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or

local law regulating construction or the performance of construction.

By signing this building permit, the owner and/or their agent hereby grant employees of the Albemarle County

Community Development & Real Estate Departments the right to enter and inspect the subject property Monday

through Friday between the hours of 8:00 a.m. and 5:00 p.m., holidays excepted.

If you are not the owner of record, please check which applies:

I certify that I am the agent for ________________________________________________________ ,

The Owner, and am authorized to submit this application on behalf of the Owner under the agency

I am neither the Owner nor the Owner’s agent. I certify that written notice of this application, by pro-

viding a copy of this application, will be mailed to the Owner at the following address:

Within 10 days of today’s date as required by Virginia Code §15.2-2204(H). I understand that, if I do

not provide the notice to the Owner as provided herein, the building permit application and every other

subsequent approval, permit or certificate related thereto could be determined to be void.

__________________________________________________________________________________

Signature of Owner, Contractor, or Authorized Agent Date

Signature of Owner, Contractor, or Authorized Agent Date

ELECTRONIC RECORDS STATEMENT: Albemarle County is creating and using electronic records

and electronic signatures as allowed by the Uniform Electronic Transactions Act (Virginia Code §

59.1-479 et. Seq.). As an applicant to the Building Permit process, you may consent to receive, or have

online access to, electronic records and receive and create records having electronic signatures related

to Building Permits, Correspondence, Inspection Tickets and Certificates of Occupancy (the Building

Permit transactions).

Initials of Owner, Contractor or Authorized Agent Date

Your agreement to conduct Building Permit transactions by electronic means does not prevent you

from refusing to conduct other transactions by electronic means.

PRINT OWNER NAME

PRINT ADDRESS CITY/STATE ZIP CODE

COUNTY OF ALBEMARLE

Department of Community Development



Phone (434) 296-5832 Fax (434) 972-4126 Inspections Hot Line (434) 972-4179

Dear Applicant:

Thank you for applying for a Building Permit with the Department of Community Development. We hope you find this handout beneficial as you go through the application and building processes.

Once your application is complete, it will be processed and reviewed as quickly as possible. A typical application requires seven to

ten (7 – 10) business days to review, but may vary depending on staff workload and the complexity of your application.

Your application will be considered complete and ready for the review process once we have the following:

1. A complete and accurate Building Permit Application form, to include all applicable State and County Contractor

License Information (i.e. Contractor License Numbers, Locality Business License information, for all General and

Sub-Contractors),

2. Payment of applicable Building Permit Fees (cash or check - expected day of the initial application request),

3. Required documentation, which may include the following:

a. Two (2) copies of your plans (See Minimum Standards for Drawings handout enclosed)

b. Two (2) copies of your RECORDED PLAT for all new and exterior additions/renovations. You will need to show the location of project on the plat and distance to property lines.

c. Virginia Stormwater Management Program (VSMP) documentation; Erosion & Sediment Control Agreement or

Plan, SEE LINK on last page), Critical Resources Map, Stormwater Pollution Prevention Plan (SWPPP, SEE LINK

on last page)

d. Groundwater / Well documentation via the Thomas Jefferson Health Department

e. Commercial Permits – two (2) copies of the approved, signed site plan.

Please note that if you do not provide all required documentation for this application within six (6) months of your initial application

date, your application will become VOID. Should you wish to continue with your project at a later date; you will be required to

initiate a new application, complete with documentation and fees.

Once your application has been reviewed and approved; you will be issued a Building Permit. Your Building Permit and associated

stamped plans must be onsite throughout the building process and available for public inspection.

For those projects that have a Virginia Stormwater Management Program (VSMP) requirement, the building permit and

Stormwater Pollution Prevention Plan (SWPPP with inspection documents) must be posted in a prominent place on the

construction site. This can be in a central location on-site if more than one lot is under construction, or on the lot. All VSMP

documents must be accessible by the county engineering inspector at all times. It is a permit violation not to have the SWPPP

information posted.

You are now ready to begin work on your building project.

To keep your Building Permit active throughout the building process, YOU MUST COMMENCE WORK WITHIN SIX MONTHS

OF THE ISSUANCE DATE, AND YOU MUST REQUEST AT LEAST ONE (1) INSPECTION WITHIN A SIX-MONTH TIME

PERIOD until the project is complete. If you are not ready for a specific inspection type, you may keep your permit active by

providing other evidence that work is being performed.

You will be issued a CERTIFICATE OF OCCUPANCY, prior to occupancy, once this department has received all (if applicable)

Health Department Operations Permits; and your project has received APPROVAL ON ALL REQUIRED INSPECTIONS. An

APPROVED FINAL INSPECTION may serve as your CERTIFICATE OF OCCUPANCY for internal alterations to existing

buildings or structures.

If you have questions at any time throughout the application or building process, please feel free to contact us at the address or

numbers above. You may track the status of your application/building permit and inspections via the web at

http://countyviewweb.albemarle.org.

January 12, 2009; Revised – 10/30/14, 5/4/15, 3/27/2017

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INSPECTIONS GUIDELINES Inspections are a vital part of the building process to ensure that your building project meets State and County Codes. These

Codes/Inspections are intended to protect the safety and welfare of our citizens.

To keep your Building Permit active throughout the building process, you must request at least one (1) inspection within a six-month

time period until the project is complete. If you are not ready for a specific inspection type, you may keep your permit active by

providing "other evidence" that work is being performed. "Other evidence" must be in writing to this office, in the form of a simple

progress report/memo stating what progress has been made during the past six (6) months. To ensure your report/memo is processed

correctly; please include the Building Permit Number and Owner Name & Address.

The complexity of your building project will dictate your required inspections. Simple projects (i.e. Small Sheds) may require only Zoning

Inspections to ensure buildings are not placed in easements, or that they meet property setback guidelines. More complex projects may

require numerous types of inspections. If you have questions about required inspections, please contact this office during normal business

hours (8:00 a.m.-5:00 p.m., Monday—Friday).

Code Inspections may be requested via the Inspection Hotline at (434) 972-4179, or by contacting this office. You may place an

Inspection Request at any time, but the request must be received before 4:00 p.m. during business hours (Monday — Friday) to be

placed on the next business day's Inspection Schedule. Requests received after 4:00 p.m. will be scheduled for the second business day.

Due to workload; requests for specific inspection times cannot be honored. If you require an approximate time for your scheduled

inspection, you will need to contact your inspector between 8:00-8:30 a.m. the day of your inspection.

If you have specific Code questions during your project, you may request to speak to an Inspector during their in-office times of 8:00-8:30

a.m. and 3:00-4:00 p.m., Monday—Friday. You may also request to speak to the Plans Reviewer during the business hours of 8:00 a.m.-3:00

p.m., Monday-Friday.

A Preliminary Zoning (PZ) Inspection may be required for some projects prior to the issuance of the building permit to verify property line

setbacks and easements. Please mark the property lines, and stake-out the four corners of the structure. Please ask your Intake Support

Specialist at the time of application if a PZ is required.

Typical Required Code Inspections:

1. Footing Excavation Inspection prior to the placement of concrete; and Preliminary Zoning Inspection, if not already performed.

2. Foundation waterproofing and drain tile inspection prior to backfill.

3. Rough-in Inspections for Electrical, Mechanical and Plumbing installations prior to a Framing Inspection. Or, IF all Rough-in

installations are ready, they can be scheduled with the Framing Inspection.

4. Framing Inspection (after Rough-ins have been approved or with Rough-ins).

5. Insulation Inspection prior to the installation of gypsum board. (Note: The R values for Albemarle County are as follows; R15 for

exterior walls, R19 for floors and R38 for roofs and ceilings.)

6. Final Inspections for Electrical, Mechanical, Plumbing, Zoning, Building and Engineering.

7. Depending on your project; other inspections may be required (e.g. Inside Gas Line, Outside Gas Line, Underground Tank, Above

Ground Tank, Water Line, Underground Tank, etc.) prior to your Final Building Inspection.

VSMP Inspections;

Virginia Stormwater Management Program (VSMP) inspections will occur at the start of your project and randomly at any other time.

These inspections will be to ensure that all erosion and sediment control measures and any stormwater management measures are in

place and functioning correctly. Additionally, measures from the stormwater pollution prevention plan will be checked, as well as

inspections which should be occurring on-site by the designated operator and the designated responsible land disturber. All inspection

documentation must be available and posted prominently on-site for the benefit of the VSMP inspector and the public. Please be aware

that the operator must be performing inspections of the site at the intervals specified in the state general construction permit.

Occupying a new building:

Prior to occupancy of any new building, permission must be obtained from the Building Official in the form of a Certificate of

Occupancy, or a Temporary Certificate of Occupancy.

To obtain a Certificate of Occupancy all Final Inspections must be completed and approved. If you are on a private water/septic system,

you must also provide this office with an Approved Operations Permit from the Thomas Jefferson Health Department (434) 972-6259.

Certificates of Occupancy are normally issued after 3:00 p.m. the day following your Final Inspections and receipt of all required

Operations Permits.

Temporary Certificates of Occupancy are granted under certain circumstances, and can only be granted at the discretion of the

Building Official.

January 12, 2009; Revised — 10/30/14, 5/4/15, 3/27/17

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January 12, 2009; Revised – 10/30/14, 5/4/15, 3/27/17

RESIDENTIAL SWIMMING POOL PERMIT CHECKLIST

When applying for a permit for a Swimming Pool, please have the following items:

TWO COPIES OF YOUR RECORDED PLAT INDICATING:

PROPOSED LOCATION OF THE SWIMMING POOL

DISTANCES TO ALL PROPERTY LINES WITHIN 100 FEET

You may obtain a copy of your recorded plat at the Albemarle County Clerk’s Office – 2nd Floor, 501 E.

Jefferson Court Square, Charlottesville, Virginia - business hours are 8:00a.m. - 4:30p.m., Monday

through Friday – Phone 434-972-4083.

You must also show the location of the following (if applicable) on the copies of your recorded plat. If

you do not know the location of the following items, you may obtain this information from the Thomas

Jefferson Area Health Department at 1138 Rose Hill Drive, Charlottesville, Virginia – business hours are

8:00a.m. - 4:30p.m, Monday through Friday – Phone 434-972-6219.

LOCATION OF WELL CAP LOCATION OF EXISTING SEPTIC FIELD

LOCATION OF RESERVE FIELD AREA

THOMAS JEFFERSON AREA HEALTH DEPARTMENT APPROVAL OF POOL LOCATION Once you have applied for your pool permit with the Department of Community Development, it will be

your responsibility to take the permit information and accompanying copy of recorded plat to the Thomas

Jefferson Area Health Department for review. Once the Thomas Jefferson Area Health Department has

approved the location of the pool, return to Community Development Department for issuance of the

permit (barring any other problems). The purpose of this requirement is to ensure that compliance with

Section 4.1 of Albemarle County’s Zoning Ordinance is maintained, and that the addition of a pool

does not remove the only available reserve septic disposal field area.

NOTE: A Preliminary Zoning Inspection is required prior to your permit being issued. Once the

area has been marked (staked), it is the responsibility of the CUSTOMER AND/OR

CONTRACTOR to schedule this inspection by contacting the Community Development

Department at 434-296-5832.

January 12, 2009; Revised – 10/30/14, 5/4/15, 3/27/17

RESIDENTIAL SWIMMING POOL PERMIT CHECKLIST (CONT’D)

For your information, following is a list of Safety Enclosure requirements based on the 2012 International

Swimming Pool and Spa Code (ISPSC).

ISPSC requires that all residential swimming pools, over 24” deep, whether in-ground or above ground, be

enclosed with a fence or an approved power safety cover complying with ASTM F1346.

Fence Details:

• At least 48” tall

• No more than a 2” gap under the fence

• Openings shall be small enough that a 4” sphere will not pass through

• No ornamental indentations that can be used as a ladder

• Maximum mesh size for chain link fences is 1-1/4”

• Maximum mesh size for diagonal lattice fences is 1-3/4”

• If the fence is made of horizontal and vertical members, and the distance between the tops of the

horizontal members is less than 45”, the horizontal members shall be installed on the swimming

pool side of the vertical members and the vertical members shall be no more than 1-3/4” apart

Gate Details:

• Same requirements as for fences (see above)

• Must swing outward, away from the pool

• Self-closing and self-latching

• If the latch is less than 54” above the bottom of the gate, the latch shall be mounted on the

swimming pool side of the gate and shall be at least 3” from the top of the gate, and there shall not

be any openings larger than 1/2” within 18” of the latch

There are special alarm requirements if there is a door from the house that leads directly into the

pool enclosure.

Alarm Details:

• Must be wired to activate when the door is opened

• Produce a distinct sound, which can be heard throughout the house, for at least 30 seconds

• Automatically reset

• Deactivating buttons or switches shall be mounted at least 54” above the threshold of the door, and

shall not allow deactivation for more than 15 seconds.

Further questions may be addressed to the Albemarle County Department of Community

Development.

Page - 1 - of 5 Updated 11/1/15

COUNTY OF ALBEMARLE

Department of Community Development 401 McIntire Road, North Wing


Phone (434) 296-5832 Fax (434) 972-4126

Community Development Department

Permit Fee Schedule Effective 11/1/15

A. Building Permits a. New Residential (including additions)

Use Groups R-3 and R-5 (one and two family dwellings).

Calculate on gross finished square footage

Fee – per square foot ..................................................................................................... $0.53

Minimum fee ............................................................................................................... $80.00

Note: For garages, decks, and porches use fee schedule for accessory

structures. No additional fee for landings less than 10 sq. ft.

b. Accessory Structures (residential)

Residential attached garages, detached garages, sheds, decks, and

porches 10 sq. ft. or larger. Calculate on gross finished square footage.


Minimum fee ............................................................................................................... $27.00

c. Residential Swimming Pools / Hot Tubs / Spas

Fee - each ..................................................................................................................... $54.00

d. Mobile Homes / Prefabricated Homes

Fee - each ..................................................................................................................... $48.00

e. New Commercial (including additions)

Use groups A-1, A-2, A-3, A-4, A-5, B, E, F-1, F-2, H-1, H-2, H-3,

H-4, H-5, I-1, I-2, I-3, I-4, M, R-1, R-2, R-4, S-1, S-2, TWR or U, or an

addition to an existing commercial structure in any such use group

Calculate on gross square footage.

Fee - per square foot for 0 – 5000 sq. ft. ........................................................................ $0.22

PLUS – per square foot for excess over 5,000 sq. ft. ........................................... $0.15

Minimum fee ............................................................................................................... $80.00

f. Change of Building Occupancy Classification

Fee - for evaluation .................................................................................................... $161.00

g. Commercial Swimming Pools Fee - each .................................................................................................................. $328.00

h. Elevators / Escalators / Lifts

Fee - each ................................................................................................................... $258.00

i. Paint Spraying Booths

Fee - each ..................................................................................................................... $27.00

j. Mobile Office / Pre-manufactured Units

Fee - each ..................................................................................................................... $48.00


k. Tents

Fee - each ..................................................................................................................... $54.00

l. Alterations / Repairs

All use groups. No increase in gross square footage.

Fee – per square foot .................................................................................................... $0.18

Minimum fee ............................................................................................................... $80.00

B. Electrical Permits a. New Residential (including additions)

Use Groups R-3 and R-5 (one and two family dwellings)

Fee - Included as part of the building permit fee under Section 5-201(A).

b. Accessory Structures (residential)

Fee - each ..................................................................................................................... $32.00

c. Mobile Homes / Prefabricated Homes

Fee - each ..................................................................................................................... $32.00

d. New Commercial (including additions)

All use groups (A-1, A-2, A-3, A-4, A-5, B, E, F-1, F-2, H-1, H-2, H-3,

H-4, H-5, I-1, I-2, I-3, I-4, M, R-1, R-2, R-4, S-1, S-2, TWR or U)



Minimum fee ............................................................................................................... $80.00

e. Swimming Pools / Hot Tubs/ Spas

Bonding

Fee - each ..................................................................................................................... $32.00

Equipment Wiring

Fee - each ..................................................................................................................... $32.00

f. Alterations and repairs of structures in all use groups –

No increase in gross square footage.


Minimum fee ............................................................................................................... $80.00

g. Signs

Fee - each ..................................................................................................................... $48.00

h. Temporary Service

Fee - each (unless the service is part of a building permit paid under 5-201(A)) ...... $102.00

i. Early Service

Fee – each (unless the service is part of a building permit paid under 5-201(A)) ....... $65.00

j. Fuel Dispensing Pumps

Fee - each ..................................................................................................................... $32.00

k. Alarm Systems

Calculate on gross finished square footage


Minimum fee ............................................................................................................... $80.00

C. Plumbing Permits a. New Residential (including additions)


Fee – each Included as part of the building permit fee under Section 5-201(A).

b. Mobile Homes / Prefabricated Homes

Fee - each……………………………………………………………………….. ....... $32.00


c. New Commercial (and additions to existing)



Fee – per fixture ............................................................................................................. $9.00

Minimum fee ............................................................................................................... $80.00

d. Alterations / Repairs of all use groups


Fee – per fixture ............................................................................................................. $9.00

Minimum fee…………………………………………………………….. .................. $80.00

e. Water Lines

Fee - each (unless the lines are included as part of a permit paid under 5-201(A)) .... $27.00

f. Sewer Laterals

Fee - each (unless the lateral is included as part of a permit paid under 5-201(A)) .... $27.00

g. Fire Suppression Systems

Fee – each head………………………………………………………………………. . $0.86

Minimum fee……………………………………………………………… ................ $80.00

D. Mechanical Permits a. New Residential (including additions)


Fee - Included as part of the building permit fee under Section 5-201(A).

b. Mobile Homes / Prefabricated Homes

Fee – each…………………………………………………………………………..... $32.00

c. New Commercial (and additions to existing)





Minimum fee……………………………………………………………… ................ $80.00

d. Alterations / Repairs - All use groups.



Minimum fee……………………………………………………………… ................ $80.00

e. Underground Tanks (including associated piping)

Fee – each (unless the tanks are included as part of a permit paid under 5-201(A)) . $183.00

f. Aboveground Tanks (including associated piping)

Fee – each (unless the tanks are included as part of a permit paid under 5-201(A)) . $108.00

g. Gas / Oil Lines

Fee – each (unless the lines are included as part of a permit paid under 5-201(A)) .... $38.00

h. Furnaces / Woodstoves /Gas Log Systems

Fee – each (unless the system is included as part of a permit paid under 5-201(A)) .. $70.00

i. Range Hoods

Fee – each .................................................................................................................... $27.00

j. Hood Suppression Systems

Fee - each ..................................................................................................................... $32.00


E. Amusement Rides a. Kiddie Rides

Fee - each ..................................................................................................................... $16.00

b. Major Rides

Fee - each ..................................................................................................................... $27.00

c. Spectacular Rides

Fee - each ..................................................................................................................... $43.00

F. Demolition Permits Fee - each ......................................................................................................................... $102.00

G. Miscellaneous a. Other Permits

Building, electrical, plumbing, mechanical, or amusement devise permit not

identified above

Fee per inspection ........................................................................................................ $32.00

b. Re-inspections

For each inspection of work performed after the second inspection of such work

Fee per inspection ........................................................................................................ $32.00

c. Plan Amendments

New plans submitted requiring a fire/safety/structural review

Fee - each……………………………………………………………………….. ....... $32.00

d. State Surcharge (Applications subject to a state surcharge)

Fee ..................................................................................................................................... .2%

H. Refunds For permit applications withdrawn or voided after processing.

Refund shall not exceed 80% of original fee.

Refund must be requested in writing.

State Surcharge is non-refundable.

I. Zoning Inspections* a. Foundation of main and accessory structures

The fee for each inspection following the laying of the foundation

of main or accessory structures – each ………………………………………….. ..... $16.00

b. Surface water drainage pipes and culverts

The fee for each inspection pertaining to the size and location of

surface water drainage pipes and culverts - each……………………………….. ....... $11.00

c. Subsurface stone for parking lot or entrance

The fee for each inspection to determine the proper depth of the sub-

surface stone for a parking lot on, or entrance onto, the property being

developed, prior to the final surfacing of the parking lot or entrance - each ............... $11.00

d. Final site inspection

The fee for each final site inspection before a certificate of occupancy

or a temporary certificate of occupancy - each…………………………………. ....... $16.00

J. J. VSMP and VESCP fees * (Code section 17-207 and 208) a. Stormwater Pollution Prevention Plan ........................................................................ $209.00

b. Agreement in Lieu of a Erosion and Sediment Control Plan ...................................... $150.00

c. Any land disturbance over 1 acres…………refer to Water Protection Ordinance application


K. Review of groundwater assessment information required by sections 31.2.2

or 32.5.7:* Tier 1 assessment under Albemarle County Code § 17-401

Fee…….. .............................................................................................................................. $54.00

*IN ADDITION TO BUILDING FEES.

Revised: September 18, 2017

COUNTY OF ALBEMARLE



Phone (434) 296-5832 Fax (434) 972-4126

ADDRESSING NOTICE

Dear Customer,

The address for this new dwelling will be provided to the owner listed on the Building Permit between the

footing and final inspection as a new address notification letter. The new address notification letter will

include how this new address should be displayed and be sent to the Postmaster.

When a third addressable structure is built off a driveway / private road that already has two addresses,

the driveway will need to have a private road name (regardless of whether it is required to have road

improvements). A majority of the property owners whose property is served by the driveway will be

sufficient to choose the official road name and all existing addresses will be changed to use the new road

name. Please contact our office to start this process early.

If a third party entity requests the new address prior to receiving the notification letter, you can do the

following:

• A closing/mortgage company may request this address for the contract. In this instance, providing

the tax map and parcel number will be sufficient.

• The electric/telephone company may request this address. In this instance, speaking with a

supervisor, to provide verbal directions to the new dwelling, will suffice.

If your notification letter has not arrived by the time the final inspection is to take place, then you may

contact:

Elise Kiewra

GIS Specialist

(434) 296-5832 ext. 3030

[email protected]

Issued 2/16/2017

BTEX Testing – Building Permit Applications near Petroleum Release Sites

Article V. Private Groundwater Well Testing was added to Chapter 5. Building Regulations of

the Albemarle County Code, effective May 4, 2005.

Article V requires that building applications in areas with no public water service undergo a

review of their location, relative to petroleum contamination sites defined by the Virginia

Department of Environmental Quality (DEQ). If the well, which will be drilled to serve the

proposed building, is within 2000’ of a DEQ-identified contamination site, the well water needs

to be tested for four petroleum-related compounds (Benzene, Toluene, Ethylbenzene and Xylene

(BTEX)). Article V identifies the threshold levels of acceptability for each of the four

compounds. The permit applicant is responsible for getting the test done and paying for the test.

The test results need to be submitted in writing to the County. If the test results are negative (i.e.

no contaminants present over the threshold limits), a building permit shall be issued, if all other

permit review requirements are met. If the test results are positive, a building permit cannot be

issued until the applicant has identified an alternative source of potable water.

Article V states that the samples and tests shall be done by the DEQ or a certified laboratory.

Under most situations, the applicant will have to contract directly with a laboratory to do the

sampling and testing. The website referenced below contains a current listing of water testing

laboratories certified in Virginia. Look specifically for labs certified to test for the BTEX

compounds.

Virginia Department of General Services:

http://www.dgs.virginia.gov/

1. Follow the Division of Consolidated Laboratory Services link on the left of the webpage.

2. Follow the Drinking Water and Tuning Fork Certification link on the right of the

webpage.

3. Open the Certified SDWP and VELAP Laboratory Listing document at the top of the

webpage.

Attention Homebuilders of Single-Family Attached Homesfor Albemarle County

As of January 1st 2017, Albemarle County Engineering is no longer accepting “Agreements in Lieu of a

Plan” for building permit applications for attached homes. Applicants submitting building permits for

attached single-family homes must also submit a VSMP application, which includes a Registration

Statement, an Erosion and Sediment Control Plan (ESCP), a copy of the approved SWM Plan for the

development (if within a common plan of development), a Stormwater Pollution Prevention Plan

(SWPPP), and a Pollution Prevention Plan (PPP).

The VSMP application must be submitted for approval by the Engineering Department and Bonds must

be posted prior to approval of the application. Once bonds have been posted and the application has

been approved, it will then be submitted to the Department of Environmental Quality (DEQ) for issuance

of the VSMP Permit. Proof of payment for the DEQ permit must be provided before a pre-construction

meeting can be scheduled or a County Land Disturbance Permit can be issued.

Erosion and Sediment Control plans shall include at a minimum a Construction Entrance (CE) with wash

rack, Silt Fence (SF) around the perimeter of proposed land disturbance and/or BMPs, and

temporary/permanent seeding/mulching. Additional controls, such as basins/traps and diversion

ditches, may also be required.

Required applications and forms:

VSMP Application:http://www.albemarle.org/upload/images/forms_center/departments/Community_Development/forms/Engineering_and_WPO_Forms/WPO_VSMP_Virginia_Stormwater_Management_Program_Application.pdf

Stormwater Pollution Prevention Plan (SWPPP) template:http://www.albemarle.org/upload/images/forms_center/departments/Community_Development/forms/Engineering_and_WPO_Forms/Stormwater_Pollution_Prevention_Plan_SWPPP_template.pdf

Registration Statement form (from the Virginia Department of Environmental Quality (DEQ) website):http://www.deq.virginia.gov/Portals/0/DEQ/Water/Publications/CGPRegistrationStatement2014.pdf

Bonding Requirements (attached SF homes only, NOT detached SF homes):

Bonding is required for all attached (duplex or townhouse) projects. The bond amount is calculatedbased on the estimated cost of ESC measures as follows: base amount of $2,500 for a ConstructionEntrance (CE) plus $500 per attached unit.

Example for a 5-unit Townhouse project: $2,500 + ($500 per unit * 5 units) = $5,000 bond

Request to Establish a Bond form:http://www.albemarle.org/upload/images/forms_center/departments/Community_Development/forms/bonds/Bond_Request_to_Establish_a_Bond.pdf

Bonds will be returned upon termination of the VSMP permit.

lnt.rnrl U3c Oolv

D.r. Re.ivcd: _ Fe. P.id:

Re..iv.d by:

lnrrke: Foflfd to Mr gement Arllysr

REQUEST TO ESTABLISH A BOND

APPROVED PLAN #

PROJECT NAME:(As listed on the approved plan)

All parcels in the project, including any off-site work ifeasements are not provided, and current owners. Use a

separate sheet if more owners are required. Owner and tax map information must be conect, and plans must be

approved prior to bond estimates being prepared.

TAX MAPs / PARCELs:

TAX MAPs / PARCELs:

TAX MAPs / PARCELS:

TAX MAPs i PARCELS:

TAX MAPs / PARCELS:

OWNER'S NAME:

SIGNATURE: date:

OWNER'S NAME:

SIGNATURE:

OWNER'S NAME:

SIGNATURE: oate:

OWNER'S NAME:

SIGNATURE:

OWNER'S NAME:

SIGNATURE: date:

NOTE: If ownership of the property is in the name of any type of legal entity or organizationincluding, but not limited to the name of corporation, partnership, limited liability company,trust, association, etc., documents acceptable to the County must be submitted certifying thatthe person signing above has the authority to do so.

The requested estimates are;

D VESCP Erosion & Sediment Control per Water Protection Ordinance section l7-207; S0 fee

tr VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per WaterProtection Ordinance section l7-208; 5250 fee required

! Subdivision (roads, drainage, etc.) per Subdivision Ordinance section l4-435;& Water & Sewer per Subdivision Ordinance section l4-435; $269 fee required

A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please providecontact information.

EMAIL:

OR REGULAR MAIL ADDRESS:

date:

Revised 6/202014, I l/l/2015

October 30, 2014, Revised – 5/4/2015, 6/10/2015

15

COUNTY OF ALBEMARLE


Charlottesville, Virginia 22902-4596 Phone (434) 296-5832 Fax (434) 972-4126

Virginia Stormwater Management Program (VSMP)

Documentation Each permit for construction of a residential dwelling MUST provide VSMP documentation.

What form this documentation must take depends upon the location of the residence and the

amount of land disturbance, as discussed below. Generally, VSMP permit documentation

consists of an application and a Stormwater Pollution Prevention Plan (SWPPP), which has four

main parts; (1) An erosion and sediment control plan (ESCP), (2) A stormwater management

plan (SWMP), (3) A pollution prevention plan (PPP), and ongoing inspection reports by the

operator.

A. For a residence being built within a subdivision, site plan, or common plan of development; The following must be provided with the building permit;

1. A SWPPP is required, following the county template. ($209 fee, according to Water Protection Ordinance section 17-208.) The SWPPP will contain the pollution

prevention plan and;

2. An agreement in lieu of a plan for an erosion and sediment control plan. ($150 fee per section 17-207)

3. An agreement in lieu of a plan for a stormwater management plan.

B. For a residence being built on an individual lot with a land disturbance of one (1) acre or less, and not part of a subdivision, site plan or common plan of development. An individual

SWPPP is not required. The following items are required with the building permit;

1. A critical resources plan. Instructions are attached.

2. An agreement in lieu of a plan for an erosion and sediment control plan. ($150 fee, per 17-207)

Land disturbance refers to any denuded areas, including driveways, drainfields, landscaping, etc.

C. For a residence being built on an individual lot with land disturbance of more than one (1) acre, and not part of a subdivision, site plan or common plan of development. An

individual VSMP general construction permit must be processed through the Department of

Environmental Quality (DEQ). A Water Protection Ordinance (WPO) application must be

submitted to the Community Development Office, separate from the building permit, with the

associated state fees and supporting documentation, which will include the SWPPP, ECP,

SWMP, PPP and other documents. This plan will be reviewed, approved and bonded prior to the

start of construction, typically a 3-6 month process. A professional engineer’s seal will be

required for the stormwater management plan.

The SWPPP template, agreements, and WPO application are available on the county website at;

http://www.albemarle.org/deptforms.asp?department=cdengwpo

Notice to Building Permit Applicants in the Rural Areas

Effective February 7, 2008, building permit applicants in the rural areas zoning district

will be required to submit a plan demonstrating compliance with zoning and water

protection ordinances. What type of plan is submitted will depend on the size of the

project. Below are descriptions of the two types;

1) For disturbances of 1 acre or more, an Erosion and Sediment Control Plan, narrative,

application (Water Protection Ordinance Application), and fee, must accompany a

building permit application and plan. Erosion Control Agreements in Lieu of a Plan will

no longer be accepted. The Erosion and Sediment Control Plan will be required to show

the existing and proposed topography, driveway, stream buffers and critical slopes

located on the site to demonstrate compliance with the county code. A performance bond

will be required upon approval, the details of which will be determined based on the plan.

While it is not required, many applicants may find it necessary to retain the

services of an engineer or surveyor to prepare and process the Erosion and Sediment

Control Plan. Requirements for this plan can be found in the Virginia Erosion and

Sediment Control Handbook (VESCH) found on the Department of Conservation website

(http://www.dcr.virginia.gov/soil_&_water). The county takes from 2 to 6 weeks to

review a plan. It typically takes 2-3 rounds of review and revision before a plan is

approved. A detailed list of County requirements for an Erosion and Sediment Control

plan can be found in the Albemarle County Design Manual – Engineering Review Final

Plans Checklist

(http://www.albemarle.org/deptforms.asp?section_id=&department=cddstds ).

2) For disturbances of less than 1 acre, an Erosion Control Agreement in Lieu of a Plan

will be accepted, if accompanied by a Critical Resource Plan. The Critical Resource Plan

must be prepared as follows:

A. Use county base mapping from the county web-site at

http://gisweb.albemarle.org/. Bring up the parcel and house location by searching

for the owner’s name or tax map number. At the bottom of the map provided,

type in a scale of 1” = 100’. Choose the Critical Resource Plan theme, and click

on “create printable map”. Print this page

B. Using a ruler to scale, draw the house and driveway on the plan, measuring 1 inch

on the plan sheet as 100 feet on the ground. Label the driveway and the house.

C. Draw a dashed line around all areas to be disturbed. Label this line; “maximum

disturbance limits”.

D. Label the stream buffer areas; “Stream buffer areas to remain undisturbed.”

E. Label the critical slope areas; “Critical slope areas to remain undisturbed.”

F. Place the following note on the plan, and have it signed by the owner, with the

owner’s name printed underneath: “I agree to build according to this critical

resource plan: signature / printed name”

An example of a Critical Resource Plan is shown below.

County staff will check Critical Resource Plans for three items:

1. Driveway grades; at any point on the driveway, to any other point, the grade must

be 16% or below. This means the difference in vertical grades, divided by the

length between two measurement points must be 0.16 or below. An example is

shown on the plan. Driveways must be at least 10’ wide, and extend to within 50’

of the proposed structure(s).

2. There must be no disturbance to the stream buffers. If disturbance is unavoidable,

a mitigation plan, application and fee will be required before the building permit

can be issued. Similar to an erosion control plan, this will take 2-6 weeks to

review, and typically takes 2-3 revisions before approval.

3. There must be no disturbance to critical slopes. If disturbance is shown, unless it

is unavoidable to obtain access to the parcel, a waiver must be requested, and will

likely be heard by the Planning Commission. This is a 6-8 week process and must

be concluded before a building permit is issued.

County Code for these requirements can be found in sections 18-4.6.6, 18-4.2, and 17-

317, at http://www.albemarle.org/department.asp?department=ctyatty&relpage=2784.

COUNTY OF ALBEMARLEDepartment of Community Development



Tel. (434) 296-5832 ● Fax (434) 972-4126

___________________Erosion Control

Agreement Number

EROSION AND SEDIMENT CONTROL AGREEMENT FOR

SINGLE FAMILY RESIDENCE CONSTRUCTION

Building Permit # _____________________________ Tax Map/Parcel _______________________________

Subdivision ________________ Phase _____ Section _____ Block _____ Lot _____ Zoning __________

A $150 fee is required with this agreement

In lieu of submitting a formal erosion and sediment control plan for development of this single family residenceand/or appurtenant structure, I agree to comply with the requirements of the Albemarle County WaterProtection Ordinance, County Code Chapter 17, the Virginia Erosion and Sediment Control Law, VirginiaCode, Title 62.1, Chapter 3.1, Article 2.3, and Erosion Control Regulations 9VAC25-840, and the VirginiaErosion and Sediment Control Handbook, latest edition. I agree to provide erosion control measures inaccordance with the Handbook standards and specifications in order to protect against the transport of soil andsediment off of the property. I further agree to comply with additional requirements determined necessary bythe Program Authority. Such requirements shall be based on established conservation standards and shallrepresent the minimum practices that Albemarle County deems necessary to provide adequate control of erosionand sedimentation on or resulting from this development. At a minimum, the following to the followingmeasures will be implemented:

1. Silt fence, sediment traps and other protective measures shall be provided in areas where sediment fromdisturbed areas may leave the site, and must be properly installed before land disturbance. Thesemeasures must remain installed and maintained until adequate stabilization is achieved as determined by theProgram Authority.

2. All erosion measures are subject to inspection periodically and after each runoff-producing rainfall event.Any necessary repairs to maintain the effectiveness of the erosion control devices and cleanup ofsedimentation must be made immediately. If erosion control measures are found to be inadequate, or inneed of repair, by a county inspector, you will be notified. A fee of $150 will be charged for eachreinspection that is necessary.

3. A temporary stone construction entrance shall be provided wherever traffic will be leaving a constructionsite and where there exists the possibility of transporting mud directly onto a road or other paved area.

4. All denuded areas on the site shall be stabilized within seven (7) days of final grading with permanentvegetation or a protective ground cover suitable for the time of year. Temporary soil stabilization shall beapplied within seven (7) days to denuded areas that may not be at final grade but will remain dormant(undisturbed) for longer than thirty (30) days.

5. A permanent stabilization/vegetative cover shall be established on all denuded areas within nine (9)months of the start of clearing or grading. Unless documented in writing to the Program Authority at thestart of land disturbance, the nine (9) months shall be measured from the permit issuance date. If anextension is necessary and construction extends for more than a year, a permit renewal fee of $150 willbe required.

6. During construction of the project, soil stock piles and borrow areas shall be stabilized, covered, orprotected with sediment trapping measures.

09/07, Revised 03/09, 10/14, 05/15

7. All storm sewer inlets that are operable during construction shall be protected so that sediment-laden watercannot enter the storm water conveyance system without first being filtered or otherwise treated to removesediment.

8. All temporary erosion and sediment control measures shall not be removed until disturbed areas arestabilized. After stabilization is complete, all measures shall be removed within 30 days, unless otherwiseauthorized by the Program Authority. Trapped sediment and the disturbed soil areas resulting from thedisposition of temporary measures shall be permanently stabilized to prevent further erosion andsedimentation.

I further understand that failure to comply with such requirements within three (3) working days, followingnotice by a county official, could result in a citation for violation and may require the submission and approvalof a formal erosion control plan with an appropriate performance bond as provided in Section 17-414 of theAlbemarle County Water Protection Ordinance. I hereby agree to be responsible for carrying out each ofthe duties and responsibilities enumerated above, as well as all other requirements of AlbemarleCounty’s erosion and sediment control program. I also hereby agree to maintain responsibility for thispermit regardless of the sale of the property prior to completion of the work covered by this permit.

Original: Engineering Inspector

Copies: Building Permit File

Landowner/Authorized Agent




Landowner

Print Name _________________________________________

Address ____________________________________________

City _____________________ State ________ Zip _________

Phone Number_______________________________________

Signature ____________________________ Date__________

I hereby grant the County of Albemarle the right to enter upon subject

property for inspections to ensure compliance.

Responsible Land Disturber

Print Name _________________________________________

Address ____________________________________________

City _____________________ State ________ Zip _________

Phone Number ______________________________________

Signature ____________________________ Date__________

RLD Cert. Number__________________________________

Comments/Additional Requirements from Plan Approving Authority: ____________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

_________________________________________________________________________________Office Use Only

APPROVED BY Date___________________________

COUNTY OF ALBEMARLEDepartment of Community Development



Tel. (434) 296-5832 ● Fax (434) 972-4126

___________________Erosion Control

Agreement Number

STORMWATER MANAGEMENT AGREEMENT FOR

SINGLE FAMILY RESIDENCE CONSTRUCTION

Building Permit # _____________________________ Tax Map/Parcel _______________________________

Subdivision ________________ Phase _____ Section _____ Block _____ Lot _____ Zoning __________

In lieu of submitting a formal stormwater management plan for development of this single family residenceand/or appurtenant structure, I agree to comply with the requirements of the Albemarle County WaterProtection Ordinance, County Code Chapter 17, the Virginia Stormwater Management Law, Virginia Code,9VAC25-850, and 9VAC25-870. I agree to provide stormwater management measures as determined necessaryby the Program Authority. Such requirements shall be based on established state standards and shall representthe minimum practices that Albemarle County deems necessary to provide adequate control of stormwaterrunoff resulting from this development. At a minimum, the following measures will be implemented:

1. The site shall be fully stabilized with permanent vegetation or equivalent stabilization with seven (7) days offinal grading.

2. For sites within a larger plan of development, all runoff from the house and driveway and developed areasshall runoff as directed on the overall plan, or sheet flow to adjacent vegetated areas. Runoff shall notadversely impact neighboring properties.

3. For sites without a larger plan of development, runoff shall sheet flow to vegetated areas. Such areas shallbe natural areas subject to mowing no more than 4 times per year, and at least 100 feet in flow length to thenearest property line, stream, or receiving water.

4. Roof gutters shall be directed to splash blocks or level spreaders to establish sheet flow to vegetated areas asper item 2-3. No concentrated runoff shall be discharged from the property.

5. For site without a larger plan of development, all impervious areas and storm sewer inlets shall be situatedso that water cannot enter the storm water conveyance system without first being filtered or otherwisetreated to remove potential pollutants as indicated above. Roof gutters shall not be conveyed directly tostorm sewer, ditch lines or property lines.

I further understand that failure to comply with such requirements within three (3) working days, followingnotice by a county official, could result in a citation for violation and may require the submission and approvalof a formal stormwater management plan with an appropriate performance bond as provided in Section 17- 403of the Albemarle County Water Protection Ordinance. I hereby agree to be responsible for carrying outeach of the duties and responsibilities enumerated above, as well as all other requirements of AlbemarleCounty’s stormwater management program. I also hereby agree to maintain responsibility for thispermit regardless of the sale of the property prior to completion of the work covered by this permit.

09/07, Revised 03/09, 10/14, 05/15







Landowner

Print Name _________________________________________

Address ____________________________________________

City _____________________ State ________ Zip _________

Phone Number_______________________________________

Signature ____________________________ Date__________

I hereby grant the County of Albemarle the right to enter upon

subject property for inspections to ensure compliance.

Responsible Land Disturber

Print Name _________________________________________

Address ____________________________________________

City _____________________ State ________ Zip _________

Phone Number ______________________________________

Signature ____________________________ Date__________

RLD Cert. Number__________________________________

Comments/Additional Requirements from Plan Approving Authority: ____________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

_________________________________________________________________________________Office Use Only

APPROVED BY Date___________________________

Issued – 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Single Family Residential Albemarle County

COUNTY OF ALBEMARLE Department of Community Development



Tel. (434) 296-5832 ● Fax (434) 972-4126

Stormwater Pollution Prevention Plan (SWPPP)

For Single Family Residential Construction within a larger plan of development

For Construction Activities At:

Project Name: ___________________________________________________________________

Address: ___________________________________

___________________________________

___________________________________

Prepared by:

Name: ___________________________________________________________________

SWPPP Preparation Date: __________________________________

(This document is to be made publicly available according to 9VAC25-880-70, Part II, section D)


Erosion and Sediment Control Plan. An erosion and sediment control plan is in place for the overall development, under the operation of the

developer. An erosion and sediment control agreement is in place for this lot, and is attached.

(Provide a signed copy of the agreement here.)

Stormwater Management Plan A stormwater management plan is in place for the overall development, under the operation of the developer.

□ Details and plans for required stormwater management measures on this lot are attached.

□ There are no required stormwater management measures on this lot.

(Provide plans and details for any stormwater management facilities or best management practices to be used on

this lot.)

Pollution Prevention Plan. (reference County Code 17-404 and State Regulation 9VAC25-880-70 part II section A.4)

A. Sources of Pollutants. Common activities and minimum control and prevention practices

Pollutant, or Pollutant

Generating Activity Location on site

Prevention Practices,

Control Measures

Clearing, grading, excavating, and un-

stabilized areas Land disturbance area

Follow Erosion and Sediment Control

Plan. Dispose of clearing debris at

acceptable disposal sites. Seed and mulch,

or sod within 7 days of land clearing

Paving operations Roads and driveways

Cover storm drain inlets and use drip pans

and absorbent/oil dry for all paving

machines to limit leaks and spills

Concrete washout and

cement waste

Current location and detail shown on

plan

Direct concrete wash water into a leak-

proof container or leak-proof settling basin

that is designed so that no overflows can

occur

Structure construction, stucco,

painting, and cleaning Structures

Enclose or cover material storage areas.

Mix paint indoors in a containment area or

in a flat unpaved area. Prevent the

discharge of soaps, solvents, detergents

and wash water, paint, form release oils

and curing compounds.

Dewatering operations Dewatering sites shown on plan

Water shall be filtered, settled or similarly

treated prior to discharge as shown on

plan.

Material delivery and storage Designated area shown on plan

Designated areas for material delivery and

storage. Placed near construction

entrances, away from waterways and

drainage paths

Material use during building process Building areas Follow manufacturer’s instructions .

MSDS’s attached.

Solid waste disposal Current designated container areas on

plan

Waste collection area will not receive a

substantial amount of runoff from upland

areas and does not drain directly to a

waterway. Containers have lids covered

before periods of rain, or are in a covered

area. Scheduled collection to prevent

overfilling. MATERIALS NOT TO BE

BURIED ON-SITE

Sanitary waste Current locations shown on plan

Convenient and well-maintained portable

sanitary facilities will be provided, and

located away from waterways or inlets.

Such facilities shall be regularly

maintained.


Pollutant, or Pollutant

Generating Activity Location on site

Prevention Practices,

Control Measures

Landscaping operations Landscape areas shown on plan

Apply fertilizers in accordance with

manufacturer’s recommendations and not

during rainfall events

Wash Waters Wash areas shown on plan

To be treated in a sediment basin or better

control as specified on plan. Minimize

the discharge of pollutants from

equipment and vehicle washing

Vehicle and equipment washing Designated areas and details shown on

plan

Provide containment and filtering for all

wash waters per the plan

Fueling

Fueling station

Provide double walled tanks, a lined

containment area, drip pans, and spill

prevention and cleanup materials.

Minimization of exposure to precipitation and stormwater. Minimize the exposure of building materials, building products,

construction wastes, trash, landscape materials, fertilizers, pesticides, herbicides, detergents, sanitary waste, and other materials

present on the site to precipitation and to stormwater.

(Identify all non-stormwater discharges to occur on your site. Keep this plan up-to-date with ongoing site

changes and inspections. See CGP, 9VAC25-880-70 section E for examples of non-stormwater discharges.)

B. Non-stormwater discharges

Discharge Pollutants or Pollutant

Constituents

Location on Site

C. Persons responsible for pollution prevention practices

(Provide the names and contact information for all persons responsible for prevention practices as listed above.)


D. Response and reporting practices

Minimize discharges from spills and leaks. Minimize the discharge of pollutants from spills and leaks and implement chemical spill

and leak prevention and response procedures as follows.

Most spills can be cleaned up following manufacturer specifications. Absorbent/oil dry, sealable containers, plastic bags, and

shovels/brooms are suggested minimum spill response items that should be available at this location.

1st Priority: Protect all people

2nd Priority: Protect equipment and property

3rd Priority: Protect the environment

1. Check for hazards (flammable material, noxious fumes, cause of spill) – if flammable liquid, turn off engines and nearby

electrical equipment. If serious hazards are present leave the area and call 911. LARGE SPILLS ARE LIKELY TO

PRESENT A HAZARD.

2. Make Sure the spill area is safe to enter and that it does not pose an immediate threat to health or safety of any person.

3. Stop the spill source.

4. Call co-workers and supervisor for assistance and to make them aware of the spill and potential dangers.

5. If possible, stop spill from entering drains (use absorbent or other material as necessary).

6. Stop spill from spreading (use absorbent or other material)

7. If spilled material has entered a storm sewer; contact locality’s storm water department.

8. Clean up spilled material according to manufacturer specifications, for liquid spills use absorbent materials and do not flush

area with water.

9. Properly dispose of cleaning materials and used absorbent material according to manufacturer specifications.

Emergency Contacts: Normal Working Hours DEQ Valley Regional Office 540-574-7800

Nights, Holidays & Weekends VA Dept. of Emergency Management 804-674-2400

Pollution Prevention Awareness All site personnel and workers will be made aware of the prevention practices and measures contained in this

document.

Qualified personnel The following personnel are responsible for inspections;

(Provide the name, telephone number, and qualifications of the qualified personnel conducting inspections.)

General permit copy A copy of the construction general permit, 9VAC25-880, will be attached to this document on the construction

site. The general permit can be found at http://www.deq.virginia.gov/Programs/Water/StormwaterManagement/VSMPPermits/ConstructionGeneralPermit.aspx

Inspection logs

Inspections will be conducted on-site, and recorded here, as required by the 9VAC25-880-70, Part II, section B

and F of the Construction General Permit.


Signed Certification

(Provide certification according to 9VAC25-870-370. For purposes of plan review and approvals, this

certification should be the owner of the property, the same signature as appears on the bonds and

applications.)

CERTIFICATION

"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations."

Owner/Operator Name: _____________________________________________ Company: _____________________________________________ Title: _____________________________________________ Signature: _____________________________________________ Date: _____________________________________________