HomeMy WebLinkAboutSDP200900090 Application Letter of Revision 1 2010-08-16 Application for �.�__
Letter of Revision ��`
Letter of Revision= $95
Final Site Plan Name and Number: SDP 2009-90 Martha Jefferson.' Hospital,Parking Garage
Contact.Person(Who should we call/write concerning this project?): Al Krueger c/o Kahler Slater
Address 111 W Wisconsin Ave City Milwaukee . State WI zip 53203
Daytime Phone(414)272 2000 Fax#(414)272 2.001 E-mail .akrueger@kahlerslater.com
Owner of Record 'Martha Jefferson Hospital
Address 459. Locust Ave City Charlottesville State VA Zip 22902
Daytime Phone(434)654 '5255 Fax it(434)295 9224 E-mail'barbara.elias@mjh:org
Applicant(Who is the Contact person representing?): Martha Jefferson Hospital.
Address 459 Locust Ave City Charlottesville . State VA Zip 22902
Daytime Phone(434).654 5255 , Fax#(434) 295 9224 E-mail barbara.elias@mjh.org
SUBMITTAL REQUIREMENTS:
IX The appropriate fee,
IX The site plan number,that the change.applies to,
A request letter describing the'proposed changes from the owner or authorized agent,
IX 4 copies of the plan that shows the proposed changes,
IX Changes must be shown on the sheet or sheets from the approved final site plan,or on an 11"X17"copy of that portion of the
approved final site plan.
Owner/Applicant Must Read and Sign
I hereby certify that the information provided on this application.and accompanying information is accurate,true and correct to the
best of my knowledge, belief.
Signature of Owner,Agent Date
'Pay. oa lQ S Lf 3`( —,6 c(-{— 6-2-Cs"
Print Name Daytime'phone number of Signatory
FOR OFFICE USE ONLY LOR#Fee Amount'$g5.60 Date Paid� (gv By who? ti.1,1 �� .JAgeceipt# L Tl`6 ✓ Ck# 2 J 1(j /Q
By,qtr.
`County'of Albemarle Department of Community Development
401 McIntire Road Charlottesville,VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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