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Home My WebLink AboutARB201300147 Application 2013-10-01 41 Albemarle Cou`a., Communit y Development Department 401 ire Road Charlottesville,VA 22902-4596 Planning Application Voice:(434)296-5832 Fax:(434)972-4126 PARCEL/ OWNER INFORMATION TMP 03400-00-00-07000 Owner(s): DURKIN, THOMAS J OR JAN R Application # ARB201300147 PROPERTY INFORMATION Legal Description ACREAGE TRACT 1 Magisterial Dist. Rivanna 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 4798 STONY POINT RD BARBOURSVILLE, 22923 Entered By Todd Shifflett Application Type Architectural Review Board 10/01/2013 Project Durkin Property-AT&T Wireless Facility ( Received Date 09/30/13 Received Date Final Submittal Date 10/07/13 Total Fees Closing File Date Submittal Date Final Total Paid Revision Number Comments Legal Ad SUB APPLICATION(s) Type ( Sub Applicati Comment I. Personal Wireless Facility 10/07/13 'APPLICANT/ CONTACT INFORMATION ContactType uv Name Address I CityState Zip I ,Phone ( PhoneCell Owner/Applicant DURKIN THOMAS I OR JAN R 4798 STONY POINT RID .BARBOURSVILLE ;22923-21 _. Primary Contact CHERYL L.TAYLOR-VELOCITEL,INC. 4164 INNSLAKE DR., #B GLEN ALLEN,VA 23060 8048528275 Signature of Contractor or Authorized Agent Date Architectural Iview Board Applicatitni I No, Part A: Applicant,Contact and Parcel Information Project Name: SDP201300048 - Durkin CV373 Tax map and parcel(s): 03400-00-00-07000 Physical Street Address: 4798 Stony Point Rd. Contact Person: Cheryl L. Taylor Business Name: Velocitel, Inc. Address 4164 Innslake Dr. , #B City Glen Allen State VA Zip 23060 Daytime Phone(804) 852-8275 Fax#( ) E-mail c.taylor @velocitel .com Owner of Record: Ascension Enterprises Address 4798 Stony Point Road City Barboursville State VA Zip 22923 DaytimePhone(434 975-4041 Fax#( ) E-mail 3rdbasted @gmail .com 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 $590.00 X County-wide Certificate of Appropriateness Structures 750' or more from the EC,no taller than 5 stories No Fee Structures located behind a structure that fronts the EC No Fee X Personal wireless service facilities No Fee Fencing or Equipment or Lighting No Fee Additions to ARB-approved buildings No Fee Minor amendments to site or architectural plans No Fee Building permits where the change is 50%or less of the altered elevation No Fee NOTE: For SIGNS, use the combined APPLICATION AND CHEKLIST FOR SIGNS. FOR OFFICE USE ONLY BP# ARB# Fee Amount$ 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. construction of 131 ' -6" wireless facility located off of Stony Point Road to improve wireless coverage in the surrounding area. The site will be as camouflaged as possible from surrounding residential properties . The ground equipment will not be visible from the property owner' s dwelling or surrounding properties . 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. !.! !1 q30//3 Si gnat 0- of owner, o er's representative D g e � ' resentative ate f p or contract purchaser Cheryl L. Taylor, Agent for AT&T 804-852-8275 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 OVER—