HomeMy WebLinkAboutCLE201800155 Application 2018-10-23Request for a waiver, modification,
or substitution permitted by Chapter
❑ Relief from a condition of approval = $457
Provide the following
j -21'-'3 copies of a written request specifying the
section or sections being requested to be
�j waived, modified, varied or substituted, and
any other exhibit documents stating the
{
reasons for the request and addressing the
applicable findings of the section authorized
to be waived, modified, varied or substituted.
Variation to a previously approved Planned
Development rezoning application plan or
Code of Development = $457
Provide the following
❑ 3 copies of the existing approved plan
illustrating the area where the change is
requested or the applicable section(s) or
the Code of Development. Provide a
graphic representation of the requested
change.
❑ 1 copy of a written request specifying the
provision of the plan, code or standard for
which the variation is sought, and state the
reason for the requested variation.
Project Name and Assigned Application Number (SDP, SP or ZMA):�'(�'-S gutLDwo i z-01 gf-,,Z-� q Ae
Tax map and parcel(s): I "1 q'C) yCO4>,,4
Contact Person �`� "3U e--TCJ
6
22C-ia ZZ
Address l ( 05— 0011104 l n% City (! % (_7&77 3V I Gl
Daytime Phone# ( ) 10'�; —065-5-Fax#
Owner of Record J-`7 /ti (7 -7 AS u L`o `,,I
Address 1Jyy Freo*VAY ST.
Daytime Phone# (
Fax# (
Email 3% 04-)t�e�mAIL..(ool f
City C04077Z-75U W- State VA
Applicant (who is the Contact Person representing?)
T3 iMt- � Vt--& i U 1?c--S /—G c
Email
Zip-ZZ(i Z 'j
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Owner/Applicant Must Read and Sign
The foregoing information is complete and correct to the best of my knowledge.
By signing this application I am consenting to written comments, letters and or notifications
regarding this application being provided to me or my designated contact via fax and or email.
This consent does not preclude such written communication from also being sent via first class
mail.
Signature of Owner, Contract Purchaser, Agent
Print Name
Z 1 0C-T-,?,ot �?
Date
(I --/0
Daytime phone number of Signatory
***If multiple property owners are required to sign the application per Section 33.2 b (lb)
then make copies of this page and provide a copy to each owner to sign. Then submit each
original signed page for the Special Exception Application.
Tax Map & Parcel Number : 11Y% �; '! ' y" S, 0i W i- Cr 77U-?,U11-14 , 04 2 Z VO T
Owner Name of above Parcel: 07(,AJ0 6-4 A-"5-YC0,'y\
FOR / OFFICCE;USE ONLY SDP, SP orZMA #
By who? 1 J(W h VCV'hYVS (_ Receipt #
Fee Amount $ 57 Date Paid
If-
Ck# 3oc7a By