HomeMy WebLinkAboutARB202200058 Application 2022-06-14Architectural Review Board Application
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Part A: Applicant, Contact and Parcel Information
Verizon - Scruby Property Tier Ill
PrWect Name:
0550000-00-01400
Tax map and arcel s : Physical Street Address:
Greenwood Station Road
Contact Person: Nathan Holland - GDN Sites
Business Name: Verizon Wireless
Address 513 Stewart Street, Suite E city Charlottesville
State VA Zip 22902
Daytime Phone 757 305-8420 Fax # E-mail
Owner of Record: Brian Gray Scruby
Address P.O. Box 83 city Greenwood
State VA Zip 22943
Daytime Phone 540 255-6030 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
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Part C: Description of Proposal
Describe your proposal. Attach a separate sheet if more space is needed.
Installation of a Tier III Personal Wireless Service Facility with a 140' monopole tower (See Attached Site Plan)
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
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Printed name, Title
Nathan Holland
Date
6/13/22
Daytime phone number of Signatory
305-8420
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