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Home My WebLink AboutARB202100026 Application 2021-04-19Architectural Review Board Application�� Part A: Applicant, Contact and Parcel Information Project Name: Green Clean at 3290 Worth Xing Tax map and parcel(s): 046B4-00-00-001 DO Physical Street Address: 3290 Worth Xing Contact Person: Craig Van Bremen Business Name: Green Clean Charlottesville LLC Address 5215 Colley Ave City Norfolk Daytime Phone C__) 614-778-6180 Fax # C__) State VA Zip 23508 E-mail craig@gcawexpress.com Owner ofRecord: Green Clean Charlottesville LLC Address 5215 Colley Ave City Norfolk Daytime Phone C__) Fax # (___) State VA zip 23508 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 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# ARB# Fee Amount $ Date Paid By who? Receipt # Check # By County of Albemarle Dept of Community Development, 401 McIntire Rd, Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126 102015 PW 1 oft 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. 04/19/2021 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,