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HomeMy WebLinkAboutARB202200016 Application 2022-02-07Architectural Review Board Application J S`OI 1t� 1 Part A: Applicant, Contact and Parcel Information Greenbrier 7-Eleven PrWect Name; 061 WO-02-OB-00300 Tax map and arcel s : Physical Street Address: 1245 Seminole Trail Contact Person: Rachel Moon Business Name: Shimp Engineering, P.C. Address 912 E High Street city Charlottesville state VA Zip 22902 Daytime Phone Fax # E-mail Owner of Record: Greenbrier Real Property LLC Address 200 Carlton Road city Charlottesville state VA Zip 22902 Daytime Phone Fax # E-mail (Part B: Review Type and Fees - *Application FEE + Technology Surcharge $4% Select Review Type Review by the Architectural Review Board Conceptual Plan/Advisory Review Preliminary/Initial Review of a Site Development Plan Final Review of a Site Development Plan Major Amendment Building Permit Review County -wide Certificate of Appropriateness Structures 750' or more from the EC, no taller than 5 stories TOTAL FEE + surcharge $559.52 ($538.00 + $21.52) * $559.52 ($538.00 + $21.52) * $1230.32 ($1183 + $47.32) per review' $276.64 ($266.00 + $10.64) * $725.92 ($698 + $27.92) per review $559.52 Structures located behind a structure that fronts the EC $559.52 Personal wireless service facilities $559.52 Fencing or Equipment or Lighting $279.76 Additions to ARB-approved buildings $559.52 Minor amendments to site or architectural plans $559.52 Building permits where change is 50% or less of altered elevation $559.52 FOR OFFICE USE ONLY: BP# ($538.00 + $21.52) * ($538.00 + $21.52) * ($538.00 + $21.52) * ($269.00 + $10.76) * ($538.00 + $21.52) * ($538.00 + $21.52) * ($538.00 + $21.52) * Fee Amount $ Date Paid By who? Receipt # Check # By County of Albemarle Dept of Community Development, 401 McIntire Rd, Charlottesville, VA 22902 Voice: (434) 2%-5832 Fax: (434) 972-4126 7/1=1 Page 1of2 OVER Part C: Description of Proposal Describe your proposal. Attach a separate sheet if more space is needed. narrative Part D: Applicant Agreement Applicant must read and sign: • Only complete application packages will be scheduled for ARB review. The application package is not complete without the appropriate checklist - completed, signed, and included with the required submittal materials indicated on the checklist APB checklists are available at www.albemarle.om at the Community Development Forms Library. • Digital submittals are encouraged, but paper submittals are accepted. • Paper submittals: Each application package must contain I folded copy of all plans and documents being submitted, and I set of building material samples (if indicated on the corresponding submittal checklist.) All submittal items, including building material samples, become the property of Albemarle County. Applicants are encouraged to maintain duplicate copies of all submittal items in their own files. A pdf copy of all submittal items is requested. • Digital submittals: One set of building material samples may be required. See the corresponding submittal checklist for requirements. All submittal items, including building material samples, become the property of Albemarle County. Applicants are encouraged to maintain duplicate copies of all submittal items in their own files. One or more paper copies of the submittal may be requested during the review period. I hereby certify that I own the subject property or have the legal power to act on behalf of the owner in filing this application. I also certify that the information provided on this application and accompanying information is accurate, true, and correct to the best of my knowledge, and that the attached plans contain all information required by the appropriate checklist. Signature: owner/owner's representative/contract purchaser Date M Printed name, Title Rachel Moon 02/07/2022 Daytime phone number of Signatory 434-227-5140 7/1/2021 Page 2 of OVER