HomeMy WebLinkAboutSUB200800318 Application 2008-12-16 �ti ;ommunity Development Department
at County of Ai.,,Jmarle 401 Mcl Road Charlottesville,VA 22902-4596
Voice (434)296-5832 Fax:(434)972-4126
`v Planning Application 1
PARCEL/ OWNER INFORMATION
TMP Q56A Q QQ O OOO Owners) ICHILESr 'ENRY it OR ROT-VC-7
Application#r SUR/00800318
PROPERTY INFORMATION
Legal Description ACREAGE
Magisterial Dist. Whitehall Land Use Primary Residential --Single-family(incl. modular homes)
Current AFD Not in A/F District Current Zoning Primary R2 Residential
APPLICATION INFORMATION
House # Street Name Apt/Suite City State Zip
Street Address 5803 TABOR ST CROZET 22932-
Entered By: Todd Shifflett on 12/17/2008
Application Type Subdivision Plat
Project: Crozet Streetscape Project Phase 2 6,410.00
Received Date 12/16/2008 Received Date Final w
T tal --Submittal Date 12/22/2008 Submittal Date Final T ''_i.,'Closing File Date Revision Number
Comments:
Legal Ad Per Zoning Ordinance
SUB APPLICATION(s)
Type Sub Application Date Comments:
Boundary Line Adjustment 12/17/2008
Easement Plat 12/17/2008
APPLICANT/ CONTACT INFORMATION
Primary Contact
Name JACK KELSY,TRANSPORTATION ENGINEER Phone# ( ) - 3376
Street Address OFFICE OF FACILITIES DEVELOPMENT-COB Fax # ( ) -
City/State Zip code -
E-mail jkelsey@albemarle.org Cellular # ( ) -
Owner/Applicant
Name CHILES, HENRY B OR RUTH D Phone # ( ) -
Street Address P 0 BOX 299 Fax # ( ) -
City/State BATESVILLE VA Zip Code 22924-
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
Appl ition for Review of �`'�
'�:iil 'a
Boundary Line Adjustment & Easement Plats
Boundary Line Adjustment= ❑ Fifiseinent= NA
102
(3 folded copies of plat) (ieled copies of plat)
❑ Groundwater Assessment
(Required if a less than 21 acre lot is created from a 21 acre or greater lot)
$250 +$25 per new lot of less than 21 acre =
Project Name: CROZET STREETSCAPE PROJECT PHASE 2
Tax map and parcel: 56A2-01-00-010 Magisterial District: WHITEHALL DCD
Zoning:
Physical Street Address(if assigned): 5803 TABOR STREET
Location of property(landmarks,intersections,or other):
PROPERTY ON THE SOUTHEAST CORNER OF THE
CROZET AVENUE-TABOR STREET INTERSECTION
Contact Person(Who should we call/write concerning this project?): JACK KELSEY, TRANSPORTATION ENGINEER
Address OFFICE OF FACILITIES DEVELOPMENT State Zip
Daytime Phone( ) EXT. 3376 Fax#( ) E-mail jkelsey@albemarle.org
Owner of Record
Address City State Zip
Daytime Phone( ) Fax#( ) E-mail
Applicant(Who is the Contact person representing?): COUNTY OF ALBEMARLE
Address OFFICE OF FACILITIES DEVELOPMEI,'ty State Zip
Daytime Phone( ) EXT. 3376 Fax#( ) E-mail jkelsey@albemarle.org
Owner/Applicant Must Read and Sign
The plat application process includes providing all the information required in Chapter 14 Subdivision of Land of
the Albemarle County Code.
The foregoing information is complete and correct to the best of my knowledge. I have read and understand the
provisions of Chapter 14 Subdivision of Land of the Albemarle County Code.
Signature of Owner, Contract Purchaser, Agent Date
JACK KELSEY, TRANSPORTATION ENGINEER EXT. 3376
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY SUB# aoog
Fee Amount$ 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
11//19/07 Page 1 of 1