HomeMy WebLinkAboutSE202000019 Application 2020-10-26•
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P APPLICATION FOR A SPECIAL EXCEPTION
0 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
0 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.
Christian Aid Mission -
Current Assigned Application Number (SDP, SP or
Tax map and parcel(s):
Road Entrance
59-23G1
Applicant / Contact Person Kelsey Schein
Address 912 E High Street City
Daytime Phone# ( 434 ) 227-514o Fax# (
Owner of Record
Address
1201 5th St.
Daytime Phone# ( GontacoApplicant Fax# (
City
Charlottesville
State VA Zip 22902
Email kelsey@shimp-engineering.com
Christian Aid Mission
Charlottesville
State VA Zip 22902
Email robin.tanner@christianaid.org
County of Albemarle
Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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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. Dy4igning this application, I am consenting to written comments, letters and or notifications
regarding is ap lication being provided to me or my designated contact via fax and or email. This consent does
not prec�ude s written communication from also being sent via first class mail.
Contract Purchaser
Justin
FOR OFFICE USE ONLY APPLICATION#
10/26/2020
Date
434-227-5140
Daytime phone number of Signatory
Fee Amount $
By who? Receipt # Ck#
Date Paid
By
611111i1: ufm•
APPLICATION FOR A SPECIAL EXCEPTION
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany this Zoning application if the application is not signed by the owner of the property.
I certify that notice of the application for, Christian Aid Mission
[Name of the application type & if known the assigned application #]
was provided to Christian Aid Mission
[Name(s) of the record owners of the parcel]
the owner of record of Tax Map and Parcel Number 59-23G1
by delivering a copy of the application in the manner identified below:
Hand delivery of a copy of the application to Robin Tanner, Vice President of Operations
[Name of the record owner if the record owner is a person; if
the owner of record is an entity, identify the recipient of the
record and the recipient's title or office for that entity]
10/26/2020
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person; if
the owner of record is an entity, identify the recipient of the
record and the recipient's title or office for that entity]
Date
to the following address
[Address; written notice mailed to the owner at the
last known address of the owner as shown on the
current reahs>ate tax assessment books or current real
estate taxdsses ment records satisfies this
Signature of
Justin Shimp �
Print Applicant Name
Date
10/26/2020