HomeMy WebLinkAboutARB201300065 Application 2013-05-28 ,11 Albemarle Co ,t� Community Development Department
/! 401lll Road Charlottesville, VA 22902 -4596
Planning Application Voice : (434) 296 -5832 Fax : (434) 972 -4126
PARCEL / OWNER INFORMATION
TMPI 07800 -00 -00 -00980 1 Owner(s):
Application # ARB201300065 GUADALAJARA CORPORATION IV
(PROPERTY INFORMATION
Legal Description ACREAGE B GUADALAJARA RESTAURANT
Magisterial Dist. Rivanna Land Use Primary Open
Current AFD Not in A/F District Current Zoning Primary Highway Commercial
APPLICATION INFORMATION
Street Address 108 TOWN AND COUNTRY LN CHARLOTTESVILLE, 22911 Entered By
Todd Shifflett
Application Type Architectural Review Board 105/28/2013
Project (Guadalajara Mexican Restaurant - Awning
Received Date 05/23/13 Received Date Final ( I Submittal Date 06/03/13 Total Fees
Closing File Date Submittal Date Final Total Paid
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Type 1 Sub Applicati I Comment
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(APPLICANT / CONTACT INFORMATION
ContactType 1 Name I Address 1 CityState 1 Zip Phone PhoneCell
Owner /A iicant :;:..._
GD ... ........ GUS[ J1SI ;47ARA ;= . >:;' 108 T' OWN .' A0 P" COt1N' FAY F QIAROITO$Y10, .3 229I1: :: ; ,:.;:.:,.
Primary Contact Vw DIEYO LOPEZ yyyy 108 TOWN AND COUNTRY LACHARLOTTESVILL 22911 4342933538y ...:...:. ........:..._._
Signature of Contractor or Authorized Agent Date
6110
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Architectural Review Board Application 8 4*
Part A: Applicant, Contact and Parcel'Informatiom
Project Name: P t-Z, vr7ch 0 It h 1 6 w r7 1 v- , , c.. b Fk Re' O 17
Tax map and parcel(s): Physical Street Address: 10% - " Y` 1( GCty) * 1,13
Contact Person: 0-- 1 L i, L 0 e e -1
(r+
Business Name: U V 1%) () ill L A Y t Q I 112 (-, 5
Address 1 0(6 �' 0 W 171 c a v 11) H ') L rYity G 14 • I) State V P- Zip 75L 1
Daytime Phone ri 3 Z1 .3 ` 3 S 3$Fax # ( ) E -mail
Owner of Record: C.t v t3 01) L. R it (2. A c 0 P P .
Address) O€ 1 I S ' U 4 . ' ° '"i r N ) L I V A City C 11 % . - 1 State 11 A Zip - 2,29 ) 1
Daytime Phone I )l 2S 3 - 3 S – SSfax # ( ) 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
kmendment to an approved Certificate of Appropriateness $ 225.00
'3uilding Permit Review $ 590.00
County -Ivide 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
Personal wireless service facilities No Fee
Fencing or Equipment or Lighting No Fee
Additions to ARB- approved buildings No Fee
■vlinor amendments to site or architectural plans No Fee
'3uilding permits where the change is 50% or less of the altered elevation No Fee
N TE: 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
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Part C: Descript; on of Proposal
Describe your proposal. Attach a separate sheet if necessary,
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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.
Signature of owner, owner's representative Date
or contract purchaser
CaO , g e --GT - 1.- -oQe2. CPae4,dL,e) quo t'$V
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.
11/2010 Page 2 of 2
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