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HomeMy WebLinkAboutSE202100024 Application 2021-06-03• • P 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 : Bonumose, Inc. 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) None assigned Tax map and parcel(s): Parcel ID:07800-00-00-020FO Applicant / Contact Person Kevin Schafer, Design Develop LLC Address 418 E Main Street City Charlottesville State VA Zip 22902 Daytime Phone# ( 434 ) 665-4144 Fax# ( ) Email kschafer@designdevelopllc.c Owner of Record JDM II SF NATIONAL LLC C/O STATE FARM MUTUAL AUTOMOBILE Address One State Farm Plaza Daytime Phone# ( Fax# ( City Bloomington State IL Zip 61710 Email County of Albemarle Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 • • 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. Signature of Owner / Agent / Contract Purchaser Print Name FOR OFFICE USE ONLY APPLICATION# Date Daytime phone number of Signatory Fee Amount $ Date Paid By who? Receipt # Ck# By 0111: N■-/• APPLICATION FOR A SPECIAL EXCEPTION CERTIFICATION THAT NOTICE OF THE x 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, Bonumose, Inc. [Name of the application type & if known the was provided to JDM II SF National LLC C/O State Farm Mutual Automobile [Name(s) of the record owners of the parcel] the owner of record of Tax Map and Parcel Number Parcel ID: 07800-00-00-020FO by delivering a copy of the application in the manner identified below: on Hand delivery of a copy of the application to Date [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] x Mailing a copy of the application to JDM II SF National LLC C/O State Farm Mutual Automobile [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] on 06/04/2021 to the following address One State Farm Plaza Date Bloomington, IL 61710 [Address; written notice mailed to the owner at the last known address of the owner as shown on the current real estate tax assessment books or current real estate tax assessment records satisfies this requirement]. of Applicant Kevin Schafer, Design Develop LLC Print Applicant Name 05/28/2021 Date