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HomeMy WebLinkAboutSDP000000333 Application 2021-06-25Application for
Letter of Revision
U Letter of Revision = $108
This application may require additional review by the Fire Marshal. Fees in addition to those shown on this
application may be required as required by the Fire Prevention Code Fee Schedule. A copy of the schedule is
available from the Fire Marshal.
Final Site Plan Name and Number: SDP000000333 Southside Intermediate School
Contact (who should we contact about this project) Montle Breeden
Street Address 401 McIntire Road, Suite 400
City Charlottesville State VA zip Code 22902
Phone Number 434-872-4501 EXT 3423 Email mbreeden2@albemarle.org
Owner of
Street Address 401 McIntire
Charlottesville
of Albemarle School Board WA
Suite 400
VA
Phone Number Email
Daniel Hver - Line and Grade
22902
Street Address 113 4th St NE STE 100
City Charlottesville State VA zip Code 22902
Phone Number 434 262 0169 Email dhyer@line-grade.com
SUBMITTAL REQUIREMENTS:
® The appropriate fee,
0 The site plan number that the change applies to,
® A request letter describing the proposed changes from the owner or authorized agent,
® 4 copies of the plan that shows the proposed changes,
Changes must be shown on the sheet or sheets from the approved final site plan, or on an 11"X1T' copy of that portion of the approved
final site plan.
Owner/Applicant Must Read and Sign
I hereby certify that the information provided on this application and accompanying information is accurate, true and correct to the best
of my knowledge and belief.
cjr�c 06/25/21
Signature of Owner, Agent Date
Daniel Hyer 434 262 0169
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY LOR #
Fee Amount $ Date Paid By who? Receipt # Ck# By:
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
REVISED 4/23/2018 Page 1 of 1