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HomeMy WebLinkAbout16 Wolfview Invest Vol 3417 Ph 97 00-500040 Gateway 5.15.00DEVELOPMENT PERMIT MINIMUM SUBMITI'AL REQUIREMENTS ,,, '1-$100.00 Development Permit Application Fee. ~I~ -:j:_ Drainage and erosion control pla~ with supporting(iirainage Repo§o (2) copies each. Notice of Intent (N. 0.1.) if disturbed area is greater than 5 acres. LEGAL DESCRIPTION . \\.~q W5 (Wo\..;\JtX.w 't~!'>l-""'E.l-l-T~ vo~. ;~11 Pt... 0i-i) APPLICANT (Primary Contact for the Project): Name IV\"'f"\lUt.\.l ~ l-'\OR,l"1 A-tl 1 \,.\..? Street Address 5~\ u ~t." C.\l. '>'1-Ti QR."niC. State T6 Zip Code 1761.fD Phone Number 't 1 a, I 1.1. o -t, q <. "?> PROPERTY OWNER'S INFORMATION: Name ~"1<. t'n:\\:~Lo?ov\_O'> StreetAddress t'5'lJDO Dool..i.t f?DA!) E-Mail Address "t"'!\.~Jt.J1ot~Q"'·'""" Fax Number 47 'f I ?..t.O -3 s~l/ City AoD~~ol-1 State r;.. Zip Code 7?oo/ Phone Number qn/ 2 n -3·n3 ff. 21 l E-Mail Address GJ.r:~oo ~t11ifMo.;l .. ,e.i. ARCHITECT OR ENGINEER'S INFORMATION: Name 1"\"1:-\Qt~t\. i 'tJ\0Rl1A1{, LL? '-------· Fax Number tin/ H~ -t'io/ Street Address 5o\. v~"t.."(.!tS~'I'/ f>iZ:c.-J~ $""""€. io'f State -1-'f>...._._ Zip Code 17fJ1tO E-Mail Address ~ c.,...~!cl..cll.,..J....°"~"'" -""" Fax Number C/7't/z.uo-<f,'5k>>f Application is hereby made for the following development specific site/waterway alterations: l Lt:."-itc.~1 of -.J t(,!HJW~ ACKNOWLEDGMENTS: The information and conclusions contained in the above plans and supporting documents comply with the current requirements of the City of College Station, Texas City Code, Chapter 13 and its associated Drainage Policy and Design s rds . As "tion of approval of this permit application. I agree to construct the improvements proposed in this application ~,.,.,...11nnto th ts and the requirements of Chapter 13 of the College Station City Code. "-D£wLOPMENT PERMIT DPERMIT.DOC 3'24199 Contractor 1 of2 CERTIFICATIONS: (for proposed alterations within designated flood hazard areas.) A. I, • , cerofy that any nonresidential strucwrc on or proposed to be on this site as part "If this application is to prevent damage to the structure or its contents as a result of flooding from the 100 year .orm . '-...__...... Engineer Date B. I. ---+-++-~f-----__.. certify that the finished floor elevation of the lowest floor, including any basement, of any f l structure, proposed as part of this application is at or above the base flood elevation established in the latest Federal urance Administration Flood Hazard Study and maps, as amended . Engineer Date C. I. \J t. ~<)'11:-c.c..A e'-o&bAi-l , certify that the alterations or development covered by this pennit shall not diminish the flood-carrying capaeity of the waterway adjoining or crossing this pennitted site and that such alterations or d pment are consistent with requirements of the City of College Station City Code, Chapter 13 concerning f.Joodways and of floodway fringes. 5--(2 -IJO Date 5'r?ov Date Conditions or comments as part of approval:------------------------ In accordance with Chapter 13 of the Code of Ordinances of the City of College Station, measures shall be taken to insure that debris from construction, erosion, and sedimentation shall not be deposited in city streets, or existing drainage facilities . All development shall be in accordance with the plans and specifications submitted to and approved by the City F.ngineer for the above named project. All of the applicable codes and ordinances of the City of College Station shall apply. EVELOPMENT PERMIT DPERMIT.DOC 3n.4/99 2of2 THIS FORM REPLACES PREVIOUS FORM 3510-6 (8-98) Form Appr~ed. OMB No. 2040-0188 See Reverse for Instructions .. - &EPA United States Environmental Protection Agency NPDES Washington, DC 20460 FORM Notice of Intent (NOi) for Storm Water Discharges Associated with' .·· ·, CONSTRUCTION ACTIVITY Under a NPDES a.tneral Permit Submission of this Notice of Intent constitutl!!S notice that the party identified in Section I of this form intends to be authorized by a NPDES permit issued for storm waler discharges associated with construction activity in 1he State/Indian Country Land identified in Section II of this form. Submission of this Notice of Intent also constitutes notice that the party identified in Section I of this form meets the eligibility requirements in Part 1.8 .. of the general permit (including those related to protection of endangered species determined through the procedures in Addendum A of the general permit), understands that continued authorization to discharge is conlWlgent on maintaining permit eligibility, and that implementation of the Storm Water Pollution Prevention Plan required under Part IV of the general permit wiH begin at the time the permlttee commences work on the construction project identified in Secion' II bel0w. IN ORDEA TO OBTAIN AUTHORIZATION, ALL INFORMATION REQUESTED MUST BE INCLUDED ON THIS FORM. SEE INSTRUCTIONS ON BACK OF FORM. L Owner/Operator (Applicant) Information Name: I01R1A11:.1·0 IS I I ? I ~ rv I i:p.l 1 l, I I I I I I I I I I I I I I I I I Phone: I"' 11 1" l81z.1L-l?1<-1ei 15"'! Address: I P I 0 I 1' 1° l~I 111' 1 'f1 Statusd [£! I I I I I I I I I i I I I I I I I I I I I I· Owner/Operator: City: lf>1~1'11A1l'l1 I I I I I I I I I I I I I I I I I State:~ DpCode: 1 7 1718101~1-1 I I I I U. Pfolect/Slte Information Is the facility located on Indian Country Lands? Project Name: I l I l I • I ~ I q I I~ 1l1 R1 ~ IS I l~1f lll..IJ:.l.i.l.f"..i.l..t.~ro1~1 l C i Li 'E. IP. (BJ :i:._llljJJ Yes 0 No IZJ I • ProjOOt AdclreSSil.ocation: I ~ 1"1 I 1t1~1T1~1R1S1£1t1r1~101~1 Io If I I S!~ I \,I I A I~ Ii) I I ~1 ~11.101 I .. City: jC1D1L1L1E.1£.,l~I l~lil/\1i1'1D1iJ.1 I I I I I I I I State: l.!..eJ Zip Code: I 7 11 I f3 I '4 I O I -I I I I I Latitude: I ~ I !) I ) I i I ) I b I Longitude: I 0 I~ I~ I \I~ I Lt I~ I County: I~ 1R-1~ 11:1° I!> I I I I I I I I · 1 I I 1 · I I Has the Storm Water PoRution Prevention Plan (SWPPP) been prepared? Yes lXJ NoO ' ' ' Optional: Address d location of IXJ Address in Section I abo~~ 0 Address in Section II above 0 Other address (if known) below: SWPPP for viewing SWPPP Phone: Address: I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I .. •' .. .. . . City: . I I I I I I I I I I I I I I I I I I I ·1 I I I State: lJ_J . ZipCode: I I I I I 1-1 I I I I Name of Receiving Water: 1i1u 1R1T 10 1ll1 I c, I ?-.1 ~ I~ I l'-1 I I I I I I I I I I I I . 10111t11\ 1i1° 111 1° I 1°111 1 1'\1i.1°10 1° I Based on instruction provided in Addendum A of the permit, are Month Day Hlar Month Day .)Hf there any listed endangered or threatened species, or designated Estimated Construction Start Date Estimated Completlor! Date critical habitat in the 'project area? Estimate of area to be disturbed (to nearest acre): I I I I I 1't1 Yes D No~ Estimate of Likelihood of Discharge (choose only one)°:· I have satisfied permit eligibility with regard to protection of 1 . 0 Unlikely 3. IZJ Once per week s. D Contiooat endangered species 1hrough the i(ldk;ated section of Part 1.8.3.e.(2) of the permit (check one or more boxes): .. 2. 0 Once per month 4. 0 Once· per day (a) l2?J <b> D <c> D <d> D .. DI. Certification .. I certify under penahy 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 this system, or those persons directly responsible for gathering the i~ormation, the information submitted is, to the best 9f· 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 kn<>Wirig violations. Print Name: IL I A IR I P-1 'f I I 'I I 0 I \J i to\ 1· l, I I I I I I I I I I I I I I I I I I I I Date : I I I I I I I ' Signature: . EPA Form 3510-9 replaced 351<>-6 (8-98) Instructions -EPA Form 351<HJ Fonn Approved. OMB No. 204(}()188 &EPA Notice of Intent (NOi) for Storm Water Discharges Assoclatlld with Construction Activity to be Covered Under a NPDES Permit ~ . ·,.,,,., ~. .. Who Muat File e NOllce d Intent Form Under the provisions of the Clean Water Ad. as amended, (33 U.S.C. 1251 etseq.; the Act), except as provided by Part l.B.3 the permit, Federal law prohibits discharges of pollutants In storm water from construction activities wllhout a Na1lonal Pollulant Dlacharge ElrnN1ian System Permit. Opera1or(a) of constlUction sites where 5 or more acres are dlslurt>ed, smaller sites that are part of a larger common plan of deYelopment or sale where 1here Is a cumulative disturbance of at least 5 acres, or any site designated by the Ointelor, must submit an NOi to obtain coveiage under an NPOES Storm Water Construction General Permit. H you have questions about whether you need a permit under the NPOES Storm Water program, or H you need information as to whether a particular program is administered by EPA or a State agency, write to or telephone the Notice of Intent Processing Cen1er at (703) 931-3230. Where to Fne NOi Form NOia muat be sent to the following address: Storm water Notice of Intent (4203) USE PA 401 M. Street, SW Washington , O.C . 20460 Do not send Storm Water Pollution Prevention Plans (SWPPPs) to the above address. For overnight/express delivery of NOls, please include the room number 2104 Northeast Ma!I and phone number' (202) -260-9541 in · the address. When to Fite This form must be filed at least 48 hours before construction begins. Colllpletlng the Form OBTAIN AND READ A COPY OF THE APPROPRIATE EPA STORM WATER CONSTRUCTION GENERAL PERMIT FOR YOUR AREA. To complete this form, type or prfnt, using uppercase letters, in the appropriate areas only. Please place each character between the marks (abbreviate if necessary to stay within the number of characters aUowed for each Item). Use one space for breaks between words, but not for punctuation marks unless they are needed to clarify your response. H you ha...e any questions on this form, caR the Notice of Intent Processing Center at (703) 931-3230. Section L Fadllly Ownerl'Operator (Applcant) lnl'ormatlon Provide the legal name, malling address, and telephone number of the person, firm, public organization, or any other entity that meet either of the following two criteria: (1) they have operational control over construction plans and specifioatlons. including the ability to make modifications to those plans and apeclficatlons; or (2) they have the day-to-day operational control of tioee activities al Ile prqect nieoessary to ensure cxmi:mance with SWPPP requiremenls or other permit conditions. Each person that meets either of these criteria must file this form. Do not use a colloquial name . Correspon- dence for the permit will be aent to this address. Enler the appropriate lefter to lndi<:ale the legal sta1u8 of Ile owner/operator of the project: F = Federal; S = State; M = Public (other than federal or state); P == Private. Secllon H. ProjectlSlte Information Enter the ofllcial or legal name and complete street address, including city, county, state, zip code, and phone number of the project or site. if it lacks a street address, indicate wi1h a general sta1ement the location of the site (e.g., Intersection of Slate Highways 61 and 34). Complete site infonnatlon must be provided for pennil coverage to be granted. The applicant must also provide the latitude and longitude of the fadlty In degrees, minutes, and seconds to the nearest 15 seconds. The latitude and longitude of your facility can be located on USGS quadrangle maps. Quadrangle maps can be obtained by callng 1-800 USA MAPS. Longitude and latitude may also be obtained at the Census Bureau Internet site: htlp:llwww.ceneus.gov/ogH>lnlgazetteer. Latitude and lotlgilude for a facility in decimal form must be converted to degrees, minutes and seconds for proper entry on the NOi form. To convert decimal latitude or longitude to degreea, minutes, and seconds, follow the steps In the followi'lg example. Convert decimal latitude 45.1234567 tO: degi'ee8, minutes; and seconds . 1} The numbers to the left of the decimal point are degrees. 2) To obtain minutes , multiply the first four numbers to the right of the decimal point by 0.006. 1234 x .006 = 7.404. 3) The numbers to the left of the decimal Point In the result obtained 'in step 2 are the minutes: 7'. 4) To obtain seconds, muHiply the remaining three numbers to the right of the decimal from the result in step 2 by 0.06: 404 x 0.06 = 24.24. Since the numbers to 1he right of the decimal point am not used, the result Is 24'. 5) The conversion for 45.1234 = 45° 7' 24'. Indicate whe1her the project Is on Indian Country Lands. Indicate if the Storm Water Pollution Prevention Plan (SWPPP) has been developed. Refer1o Part IV of the general permit for information on SWPPPs. To be eligible for coverage, a SWPPP must have been prepared. Optional: Provide the address and phone number where the'SWPPP can be viewed if different from addresses previously given . Check appropriate box. Enter the name of the closest water body which receives the project's construction storm water diScharge. Enter the estimated construction start and completion dates using four digits forthe year (I.e. 05/2711998). Enter the estimated area to be disturbed inCtuding ' but not limited to: grubbing, excavation, grading, and utilities and infrastructure instaHation. indcate to the nearest' acre; if less than 1 acre, enter •1.• Note: 1 acre = 43,560 sq. fl. Indicate your best estimate of the likelihood of storm water discharges from the project. EPA recognizes that actual discharges may differ from this estimate due to unforeseen or chance circumstances . Indicate if there are any listed endangered or threatened species, or designated critical habitat in the project area. Indicate which Part of the permit that the applicant Is eligible with regard to protection of endangered or threatened species, or designated critical habitat . . Section Ill. Certlftcetlon Federal Statutes provide for seveie penalties for submitting false information on this application form . Federal regulations require this application to be signed as fonows: For a corporation : by a responsible corporate officer, which means: (I) president, secretary, treasurer, or vice president of the corporation in Charge of a principal business function, or any other person who performs similar policy or decision making functions, or (ii) the manager of one or more manufacturing, production, or operating facltities employing more than 250 persons or having g ross annual sales or expenditures exceeding $25 million (in semnd-quarter 1980 dollars), if authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures; For a pamership or sole proprietorship: by a general partner of the proprietor, or For a municipality, state, federal, or other public facility: by either a principal executive or ranking elected official. An unsigned or undated NOi form will not be granted permit coverage. Pllperwork Reduction Act Notice Public reporting burden for this application is estimated to average 3. 7 hours. This estimate includes time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a peraon is not required to respond to, a colectlon of information unless it displays a currently valid OMB control number. Send comments regarding the burden estimate, any other aspect of the collection of information, or suggestions for improving this form, Including any suggestions which may increase or reduce this burden to : Director, OPPE Regulatory Information Division (2137), U.S. Envimnmental Proleetion Agency, 401 M Street, SW, Washington, D.C. 20460. Include the OMB control number on any correspondence. Do not send the completed form to this address . THIS FORM REPLACES PREVIOUS FORM 351~ (8-'98) ~rm Appr~ed. OMB No. 2040-0188 ,.. • • .. l '. See Reverse for Instructions . . .... -;. ·. ,\ .. ., .&EPA united S1a1es env1ronmenta1 Protection Agency NPDES Wsshlngton, DC 20460 FORll No11ce of lnt.nt (NOi) for Storm water Dlacttargea AnochllllKI with .. . . CONSTRUCTION ACTIVITY Under a NPDE$ Gfmeral Pennlt. Submlsakln of this Notice of Intent ~ notice that the party identified In Section I of thiS fOrm . ii1tends to be authorized by ~ N!3DES permit issued ·for storm waler ciacharges associated with construdlon activity ln the Stlitellnclan COun1ry ,l,.and iclentilled ~ ~ II of 1his fonn . SUlimis8icin of 1hl8 Notice of Intent also constitutes notice 1hat 1he party lde"1ified In Section I of ttis fonn meets the e&glbilty requirements in Part l:S •. of the general permit (Including 1hoee related to protection of endangered speclea determined through the procedures in Addendum A of tf\e.general permit), understands that continued au1horlzation to discharge Is contingent C!f1 maintaining permit ellglbllily, and that lmplementaton of the Stonn Waler Pollution Prevention Plan required under Part IV of 1he general permit wlR begin at 1he tme·the permlltee commences wortt"on 1he con8tructtOn projecfldefltiled In SeciOn II be&Ow. IN ~RDER 10 OBTAIN AUTHORIZATION, ALL INFORMATION REQUESTED MUST BE INCLUDED ON THIS FORM . SEE INSTRU¢TIONS ON BJ\.Ck OF FORM. L OwnerJOpenlCOr (Applltant) lnfonldon Name: I'\> I €.1l 1t\1·A 1R I l &1A1R1D1~1~1t1A1~1 I I I I I I I I I I I I I Phone: I q 17 I i.1 Z.1 '!> i~ 13 I~ i'~ 13 I Addr9aa: I/ 1?1'f10 I 0 1 I \>t 0 1°1 L1£.n'1 1R101f\1~1 I I I I I I I I I I I I I I I·· Status of ~ Owner/Operator: City: IA 11) I 0 I ~ I S I 0 I t-11 I I I I I I I I I I I I I I I Slate : II.!l:/ ZipCode: l71f1°1°1' 1-1 I I I I L Ploject/Slte lnfQrmatlon Is the facility located on lndlan Country.Lands? Project Name : llll1·1\{111 I A I C I 'R1 ~ I S I 1" 1'£.1Ci.lill rPrrt i:-t-101"11 . ,,cp.: 1f-.1!lq R 1~1 ~ IL.,l Yes 0 No IZJ Projeicl Addresa4.<ication: I Q I~ I 1t1~1l1t1R1S1E1t1r1~IOl~I 101f I I '!'I" 1" I I ft I "1 I'> I 1t=1~11.101 I City: IC101L1L1~1'-1 ~1 I~ 11' 11'(f I '1o1 "11 I I I I I I I I State: IT r' I Zip coc1e : I 7171S1'f1 ° r-1 I I I I Latitude: I; I t> I ~ 1 \ I ~ 1 b I Longitude: IO I~ i~ I \ 1\ IL\ 1 ~I County: l~1~1fqc 1 0161 I I I I I I f · I I I 1 · I I Has the Storm water Pollution Prevention Plan (SWPPP) been prepared'? Yes 00 No0 .. Optional: Address of location of IXI Address in Section I above 0 Address in &!ction II above D Other address (H known) below: SWPPP for viewing SWPPP Phone: Address: I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I .. .· . City: I I I I I I I I I I I I I I I I I I I ·1 I I I State: LLJ .. ZipCode: I I I I I 1-1 I I I I Name of Receiving Waler: 111u 1Rrr10 1-.11 1 l 1 tt.1 f. It. I ~I I I I I I I I I I I I I 101'Sll 1~ 1i1° 111 1° I 1°111 '1'\li.1.0 101°1 Baaed on instruction provided in Addendum A of the pennlt, are Month Day llMr AIQnth Day .*81 there any listed endaflgered or threatened species, or designated Estimated Construction Start Date Eslln:i&ted Completion Date critical habita1 in the "prOject area? · Estimate of area to be disturb8d (to nearest acre): I I r I I 1'\1 Yes 0 No~ Eslimate of Llcelihood of Dl8charge (moose only one)·: I have satisfied permit eligibility with regard to protection of . endangered species through ~ i(ldk;ated section of Part l.B.3.e.(2) 1. 0 Unlikely 3. IZJ Once per week s. D ~,.,a1 of the permit (check o~ or more boxes): .. 2. 0 Once per month 4 . 0 Once per day '· (a)~ <b> D (c) 0 (d>D .. Cettlftca1lon I certify 161der penalty of law that this document and all attachments were prepared under my direction or supervlslOn in accordance with a system designed to assure that qualified personnel propetty gather and evaluate the information submitted. ~ on my inquiry of the person or persons who manage ·this system, or those persons directly responsible 10r gathering the i~atlon, the informallofl sublY!itted Is, to the best of. my knowledge and belief, true, accurate, an_d complete. I am aware that there are significant penalties for submitting false information, lnclUdlng the Posslbility of fine and lmprleonment for knoWlng violations. . . Print Name : If 1 '&A 1l'\1 \(.1 l~l~l~~~iL101?10l~l~l~l~I I I I I I I I I I I I I Date: 1 ··1 I I I I I Signature: EPA Form 351()-9 replaced 351~ (8-98)