HomeMy WebLinkAboutARB202100026 Application 2021-02-17 ff-•..,_°w\ /� / J y GommunityDevelopmentDeaartr,;
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-voice (434)296-5832 Fax (434)972,4120
; !mining Application
PARCEL/ OWNER INFORMATION
TMP 046E(4-U0-OQ=0Q1DQ. Owner(s}; GREEN'CLEAN.CHARLOTGESVILLE,LLG.
Application# :%4 �' Q � Q £7
• PROPERTY INFORMATION •
Legal Description 1 FOREST LAKES,81 UNION"BANK AND`TRUST
.Magisterial Dist,IRivanna- Land-Use Primary Office
Current AFD Not.in.A/F District '✓ Current Zoning Primary iiHigh may Commercial
APPLICATION•INFORMATION
Street-Address 3290 WORTH XING CHARLOTTESVILLE;22911 Entered By
Iaenriifer SmiEh; ;.
Application Type I Arch Recto ral•Review Board 37, ,
Project, :GREEN CLEAN'AT.'3290,WORTH XING - FINAL
Received'Date .02/17121 Received Date Final Submittal Date 02/22/21 Total Fees 1075
Closing,File Date Submittal Date Final Total Paid 1075
Revision Number
Comments
Legal Ad
SUB APPLICATION(s).
Type :Sub:;pplic tio, Comment
aa h.Site.Develo.piiient_Plan" .0-2/22/21-
APPLICANT [CONTACT INFORMATION
ContactTyipe I. . .. . Nam. I' . ..Address :City State Zip: ,Phone PhoneCell
Uir�rerP.-plr_rt GREEN CLEAN CH:{RLOTTES?ILLE LLC `''5 35`COLLEY:jS+ESUITE',1'09 't'fIOREQL.K,'V- '23.508-
r.rin_ry Cpruct CRyIG.VA?J BREMEPJ_GREEN CLEAN '5215 COLLEY AVE •NORFOLK,•Vl:1 '23508 :6147786180
Signature of Contractor or,•Authoi-ized Agent Date.
Architectural Review Board Application cita "4
Part A: Applicant, Contact and Parcel Information
Project Name: GreenClean at 3290 Worth Xing
Tax map and parcel(s):046B4-00-00-001 D0 Physical Street Address:3290 Worth Xing
Contact Person:Craig Van Bremen
Business Name:Green Clean Charlottesville LLC
Address 5215 Colley Ave City Norfolk State VA Zip 23508
Daytime Phone( )614-778-6180 Fax#( ) E-mail Craig@gcawexpress.com
Owner of Record: Green Clean Charlottesville LLC
Address 5215 Colley Ave City Norfolk State VA Zip 23508
Daytime Phone( ) Fax#( ) E-mail
Part B: Review Type and Fee
Select review type
Review by the Architectural Review Board
Conceptual Plan/Advisory Review(for a Special Use Permit or a No Fee
Rezoning)
Preliminary/Initial Review of a Site Development Plan No Fee
X Final Review of a Site Development Plan $1075.00
Amendment to an approved Certificate of Appropriateness $242.00
Building Permit Review $634.00
County-wide Certificate of Appropriateness
Structures 750' or more from the EC,no taller than 5 stories No Fee
Structures located behind a structure that fronts the EC No Fee
Personal wireless service facilities No Fee
Fencing or Equipment or Lighting No Fee
Additions to ARB-approved buildings No Fee
Minor amendments to site or architectural plans No Fee
Building permits where the change is 50%or less of the altered elevation No Fee
NOTE: For SIGNS, use the combined APPLICATION AND CHEKLIST FOR SIGNS.
FOR OFFICE USE ONLY BP# 1 r�AARB# Q I`,�'/�.(�(p
Fee Amount$ Date Paid Z1 By who. rtw t�/��pt#TV V/��'T�h� # C cC C. By OS
QOTWIDCounty of Albemarle Dept of Community Development,401 McIntire Rd,Charlottesville,VA 22902 Voice:(434)296-5832 Fax:(434)972-4126
10/2015 Page 1 of 2
OVER—\
Part C: Description of Proposal
Describe your proposal. Attach a separate sheet if necessary.
Re -development of an existing bank parcel along Seminole Trail to construct a mostly
automated car wash facility and associated parking lot and infrastructure improvements
Part D: Applicant Agreement
Applicant must read and sign
• Each application package must contain (8) folded copies of all plans and documents being submitted.
Only (1) set of building material samples is required. All submittal items, including building material
samples, become the property of Albemarle County. Applicants are encouraged to maintain duplicate
copies of all submittal items in their own files.
• Only complete application packages will be scheduled for ARB review. The application package is not
complete without the appropriate checklist, completed, signed, and included with the required submittal
materials indicated on the checklist
I hereby certify that I own the subject property or have the legal power to act on behalf of the owner in filing this
application. *See submittal requirements below. I also certify that the information provided on this application
and accompanying information is accurate, true, and correct to the best of my knowledge, and that the attached
plans cont4ig all information required by the appropriate checklist.
02/16/2021
ature weer, owner's representative Date
or contract purchaser
Craig van Bremen, Owner's rep.
Printed name, Title
614-778-6180
Daytime phone number of Signatory
*Ownership Information:
• If ownership of the property is in the name of any type of legal entity or organization including, but not
limited to, the name of a corporation, partnership or association, or in the name of a trust, or in a fictitious
name, a document acceptable to the County must be submitted certifying that the person signing above has
the authority to do so.
• If the applicant is a contract purchaser, a document acceptable to the County must be submitted containing
the owner's written consent to the application.
• If the applicant is the agent of the owner, a document acceptable to the County must be submitted that is
evidence of the existence and scope of the agency. Attach the owner's written consent.
11/2010 Page 2 of 2
OVER,