HomeMy WebLinkAboutSUB200800331 Application 2008-12-16 County o /bemarle Community Development Department
i
� :Inure Road Charlottesville,VA 22902-4596
Planning Application 1 voice. (434)296-5832 Fax (434)972-4126
PARCEL/OWNER INFORMATION
TMP 056A1-01-00-05400 Owner(s). BLUE GOOSE L C
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Application# SUB200800331
PROPERTY INFORMATION
Legal Description ACREAGE
Magisterial Dist. Whitehall Land Use Primary Office
Current AFD Not in A/F District Current Zoning Primary Downtown Crozet District
APPLICATION INFORMATION
House # Street Name Apt/Suite City State Zip
Street Address 1186 CROZET AVE CROZET 22932-
Entered By: Todd Shifflett on 12/23/2008
Application Type Subdivision Plat
Project: Crozet Streetscape Project Phase 2 16,410.00
Received Date 12/16/2008 Received Date Final Total Fees
Submittal Date 12/22/2008 Submittal Date Final
Total Paid
Closing File Date Revision Number
Comments:
Legal Ad
SUB APPLICATION(s)
Type Sub Application Date Comments:
Boundary Line Adjustment 12/22/2008
'Easement Plat 12/22/2008
APPLICANT/ CONTACT INFORMATION
Primary Contact
Name JACK KELSEY,TRANSPORTATION ENGINEER Phone # ( ) - 3376
Street Address OFFICE OF FACILITIES DEVELOPMENT-COB Fax # ( ) -
City/State Zip Code -
E-mail jkelsey@albemarle.ory Cellular# ( ) -
Owner/Applicant
Name BLUE GOOSE L C Phone # ( ) —
Street Address 3675 COLSTON DRIVE Fax# ( ) -
City/ State CHARLOTTESVILLE VA Zip Code 22903-
E-mail Cellular# ( ) -
Applicant
Name ALBEMARLE COUNTY Phone # ( ) -
Street Address OFFICE OF FACILITIES DEVELOPMENT-COB Fax# ( ) -
City/State zip Code -
E-mail
Cellular# ( ) -
Signature of Contractor or Authorized Agent Date
A 1 iolication for Review of
Boundary Line Adjustment & Easement Plats '
✓❑ Boundary Line Adjustment=) 1:1 Easement = NA
(3 folded copies of plat) (3 folded copies of plat)
❑ Groundwater Assessment
(Required if a less than 21 acre lot is created from a 21 acre or greater lot)
$250+$25 per new lot of less than 21 acre=
Project Name: CROZET STREETSCAPE PROJECT PHASE 2
Tax map and parcel: 56A1-01-00-054, 54A& 55 Magisterial . WHITEHALL DCD
Zoning:
Physical Street Address(if assigned) 1186 CROZET AVENUE
Location of property(landmarks,intersections,or other)' BLUE GOOSE
Contact Person(Who should we call/waste concerning this project?) JACK KELSEY, TRANSPORTATION ENGINEER
'
Address OFFICE OF FACILITIES DEVELOPMEl � State Zip
Daytime Phone( ) EXT. 3376 Fax#( ) E-mail jkelsey@albemarle.org
Owner of Record
Address City State Zip
Daytime Phone( ) Fax#( ) E-mail
Applicant(Who is the Contact person representing?). COUNTY OF ALBEMARLE
Address OFFICE OF FACILITIES DEVELOPMENJ'ty State Zip
Daytime Phone( ) EXT. 3376 Fax#( ) E-mail jkelsey@albemarle.org
Owner/Applicant Must Read and Sign
The plat application process includes providing all the information required in Chapter 14 Subdivision of Land of
the Albemarle County Code.
The foregoing information is complete and correct to the best of my knowledge. I have read and understand the
provisions of Chapter 14 Subdivision of Land of the Albemarle County Code
Signature of Owner, Contract Purchaser, Agent Date
JACK KELSEY, TRANSPORTATION ENGINEER EXT. 3376
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY SUB# 9-6400 3
Fee Amount$ 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
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