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Home My WebLink AboutARB201300017 Application 2013-02-05 Albemarle Community Development Department 401 `l�ntire Road Charlottesville, VA 22902 -4596 13 Planning Application Voice : (434) 296 -5832 Fax : (434) 972 -4126 PARCEL / OWNER INFORMATION TMPI 09000 -00 -00 -01680 Owner(s): Application # ARB201300017 3ENSEN, P DOUGLAS OR PATRICIA B PROPERTY INFORMATION Legal Description ACREAGE Magisterial Dist. Samuel Miller Land Use Primary Residential -- Single family (incl. modular homes) Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address A 401 OLD SCOTTSVILLE RD CHARLOTTESVILLE, 22902 Entered By Todd Shifflett Application Type Architectural Review Board 102/05/2013 Project `Verizon Wireless - "Biscuit Run" / Jensen Property Received Date 02/04/13 Received Date Final I Submittal Date 02/04/13 Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments Legal Ad SUB APPLICATION(s) Type 1 Sub Applicati 1 Comment Personal. Wireless Facility 0'2/04/13 j (APPLICANT / CONTACT INFORMATION ContactType 1 Name L Address CityState ( Zip 1 Phone 1 PhoneCell Owner /Applicant ;JENSEN, P DOUGLAS OR PATRICIA 8 12351 STONY POINT ROAD `CHARLOTTESVILL 122911 Primary Contact STEPHEN WALLER, AICP 536 PANTOPS CENTER - PMB CHARLOTTESVILL 22911 4348250617 Signature of Contractor or Authorized Agent Date Architectural Fiew Board Applicatic d . 'x:3.5`•' Part A: Applicant, Contact and Parcel Information Project Name:Verizon Wireless - "Biscuit Run" / Jensen Property - Tier III PWSF Tax map and parcel(s): 09000 00 00 - 016B0 Physical Street Address:36 Old Scottsville Road Contact Person: Stephen Waller, AICP Business Name: Verizon Wireless Address 536 Pantops Center - PMB #405 _ City _Charlottesville _ State VA Zip 22911 Daytime Phone (434) 825 -0617 Fax # (757) 282 -5811 E -mail stephen.waller @gdnsites.com Owner of Record: Cellco Partnership d /b /a Verizon Wireless (Leasehold Interest for tower compound) Address 1833 Rady Court City Richmond State VA zip 23222 Daytime Phone (434) 825 -0617 Fax # ( ) E -mail Part B: Review Type and Fee Select review type Review by the Architectural Review Board Conceptual Plan /Advisory Review (for a Special Use Permit or a Rezoning) No Fee Preliminary Review of a Site Development Plan No Fee Final Review of a Site Development Plan $1000.00 Amendment to an approved Certificate of Appropriateness $ 225.00 Building Permit Review $ 590.00 County -wide Certificate of Appropriateness Structures 750' or more from the EC, no taller than 5 stories No Fee Structures located behind a structure that fronts the EC No Fee X Personal wireless service facilities No Fee Fencing or Equipment or Lighting No Fee Additions to ARB- approved buildings No Fee Minor amendments to site or architectural plans No Fee Building permits where the change is 50% or less of the altered elevation No Fee NOTE: For SIGNS, use the combined APPLICATION AND CHEKLIST FOR SIGNS. FOR OFFICE USE ONLY BP# ARB# Fee Amount $ Date Paid By who? Receipt # Check # By County of Albemarle Dept of Community Development, 401 McIntire Rd, Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 11/2010 Page 1 of 2 OVER —� Part C: Description of Proposal Describe your proposal. Attach a separate sheet if necessary. Please see attached project decription in narrative form. Part D: Applicant Agreement Applicant must read and sign • Each application package must contain (8) folded copies of all plans and documents being submitted. Only (1) set of building material samples is required. 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. • 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. 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. *See submittal requirements below. 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. January 31, 2012 Si ature of owner, owner's representative Date or contract purchaser Stephen Waller, AICP 434 - 825 - 0617 Printed name, Title Daytime phone number of Signatory *Ownership Information: • If ownership of the property is in the name of any type of legal entity or organization including, but not limited to, the name of a corporation, partnership or association, or in the name of a trust, or in a fictitious name, a document acceptable to the County must be submitted certifying that the person signing above has the authority to do so. • If the applicant is a contract purchaser, a document acceptable to the County must be submitted containing the owner's written consent to the application. • If the applicant is the agent of the owner, a document acceptable to the County must be submitted that is evidence of the existence and scope of the agency. Attach the owner's written consent. 1 1 /2010 Page 2 of 2 OVER