HomeMy WebLinkAboutSDP202100022 Application 2022-10-26Application for
Letter of Revision
11
0 Letter of Revision - $118.86 + $4.75 Technology Fee = $123.61
This application may require additional review by the Fire Marshal. Fees in addition to those shown on this
application may be required as required by the Fire Prevention Code Fee Schedule. A copy of the schedule is
available from the Fire Marshal.
A completed application and all supplemental documents should be submitted via the Community Development Apply for Pane. Ijpaper is the only option,
then one copy of a completed application and all supplemental documents my be provided
Final Site Plan Name and Number: SDP2021-22 Albemarle Business Campus: Block 5
Contact (who should we contact about this project) Shimp Engineering, P.C.
Street Address 912 E High Street
City Charlottesville State VA Zip Code 22902
Phone Number 434-227-5140 Email rachel@chimp-engineering.com
Owner of Record 5TH STREET FOREST LLC
Street Address 250 W Main Street, Suite 201
City Charlottesville State VA Zip Code 22902
Phone Number Email
Applicant Same as Owner
Street Address
City State Zip Code
Phone Number Email
SUBMITTAL REQUIREMENTS:
0 The appropriate fee,
0 The site plan number that the change applies to,
0 A request letter describing the proposed changes from the owner or authorized agent,
Rl 4 copies of the plan that shows the proposed changes,
Changes must be shown on the sheet or sheets from the approved final site plan, or on an I I'WIT' copy of that portion of the approved
final site plan.
Owner/Applicant Must Read and Sign
I hereby certify that the information provided on this application and accompanying information is accurate, true and correct to the best
of my knowledge and belief.
1-6 W 10/26/2022
Signature of Owner, Agent Date
Rachel Moon 434-227-5140
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY LOR #
Fee Amount $ Date Paid By who? Receipt # Cldl By:
Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
REVISED 8/15/2022 Page 1 of 1