HomeMy WebLinkAboutSE202000015 Application 2020-10-13Albemarle County
Planning Application
ARCEL OWNER INFORMATION
TMPJ 09600-00-00-014AO Or.ner(s
Application# SE202000015
Community Development
401 McIntire Road Charlottesville, VA2:
Voice:(434)296-5832 Fax:(434)
KELVIN OR SUSAN CAUGHEY P.
Legal Description I ACREAGE PARCEL A
Magisterial Dist. Sainuel Miller !"i Land Use Primary Residential -- Single -fancily (incl. modular hontee
Current AFD INot in A/F District I Current Zoning Primary Rural Areas �-
Street Address I6950 HEARDS MOUNTAIN RD COVESVILLE, 22931
Application Type Special Exception
Project SUSAN PIERCE HOMESTAY
Received Date 10/09/20 Received Date Final Submittal Date
Closing File Date Submittal Date Final
Revision Number
Comments
Legal Ad
I Entered By
—J Buck Smith'.v�
v� i10, 13/20.0
Total Fees 457
Total Paid 457
SUB APPLICATION(s)
Type Sub Applicatio Comment
APPLICANT / CONTACT INFORMATION
ContactType I Name I Address CAyState, Zip Phone PhoneCell
Onner/Apperant i PIERCE, KELVIN OR SUSAN CAUGHEV P. 8830 OLD COURTHOUSE RD VIENNA VA `: 72182 j
.. ..... .-...._. ............ .. ..... ....... .. _------
�nnary ContaB SUSAN PIERCE 6950 HEARDS MTN RD �CDVESVILLE, VA 22931 7036223995
Signature of Contractor or Authorized Agent Date
C
•
APPLICATION FOR A SPECIAL EXCEPTION \
Request for a waiver, modification, variation ❑ Variation to a previously approved Planned
or substitution permitted by Chapter 18 = $457 Development rezoning application plan or
Code of Development = $457
OR
❑ Relief from a condition of approval = $457
Provide the following
❑ 3 copies of a written request specifying the
section or sections being requested to be
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.
Project Name :
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.
Current Assigned Application Number (SDP, SP or ZMA)
'oo
Tax map and parcel(s): 09 Co O O - 0 0 - O \ 4R O
Applicant / Contact Person
-
Address t9 �15 C� N d� 1�S M�1 City �-SJ �.- State \lid Zip -2-7Lcl1k
Daytime Phone# (I D 3 ) (p Z-L - Fax#
3CIC1S t rye-\HF-k Z7,riG.CAM.
Owner of Record Y-e>-v „J �-
Address OpQo3D C,,, Az1 eu J City') 1c � State Zip
Daytime Phone# (1 O? ) (¢L Fax# (
Email
County of Albemarle
Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
•
L
APPLICATION FOR A SPECIAL EXCEPTION
APPLICATION SIGNATURE PAGE
If the person signing the application is someone other than the owner of record, then a signed copy of the
"CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE
LANDOWNER" form must be provided in addition to the signing the application below. (page 3)
Owner/Applicant Must Read and Sign
By signing this application, I hereby certify that I own the subject property, or have the legal power to act
on behalf of the owner of the subject parcel(s) listed in County Records. I also certify that the information
provided on this application and accompanying information is accurate, true, 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.
C, >]. —
Signature of Owner Agent / Contract Purchaser
Print Name
RECEIVED
COMMUNITY
DEVELOPMENT
Date
Daytime phone number of Signatory
FOR OFFICE USE ONLY APPLICATION# ,)?),026,2 C` ���/ S Y Fee Amount $
� � �O 4/-ll Uevzerl�:{1`1 ?
By who. �t S 9 c� R eceipt # C
—7 L Date Paid
By (T�