HomeMy WebLinkAboutSDP201100082 Application 2012-04-12Application for
Letter of Revision
Letter of Revision = $100
Final Site Plan Name and Number: Birdwood Golf Course Practice Tee
0
Contact Person (Who should we call/write concerning this project?): Eugene Ryang; Water Street Studio
Address
111 3rd Street SE
City
Charlottesville State
VA
Zip
22902
Daytime Phone ( ) 295-8177 Fax # () E-mail eryang@waterstreetstudio.net
Owner of Record University of Virginia Host Properties, Inc. - Contact: Chris Schooley
Address
PO Box 5307
Daytime Phone
982-3777
Applicant (Who is the Contact person representing?):
Address same as above
City
Charlottesville state VA
Lip
22905
Fax # (__) E-mail cds7c@eservices.virginia.edu
University of Virginia Host Properties, Inc. - Contact: Chris Schooley
City
Daytime Phone (__J Fax # (_) E-mail
State Zip
SUBMITTAL REQUIREMENTS:
The appropriate fee,
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 I 1"X17" copy ofthat portion ofthe
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 knowledgg and belie . l
Signatureeooff Ov(nerlrl Agent Date
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY LOR #
cX /,
UO d`'t -Z` IZ t i rPr V/1 _ ' Fee Amount $ _ Date Pai By who Receipt # __ __ _ Ck# By: I I; (
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
1/1/2011 Page I of I
J1-11,vers ity o F V; rgH Ii;a
REQUESTFOR
PAYMENT
RF'OUISITION NO.
Exhibit D
PROJECT' AND VENDOR INFORMATION
Prc it_,ct UVA Practice Tee Expansion Birdwood -_C 1903 _
Vendor Name County of Albemarle —Community Development
Type cr%:'Yer ice 1810T: Jurisdictional Permits and Fees
Letter of Revision"
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