HomeMy WebLinkAboutSDP198400010 Application 2022-11-15Application for
Letter of Revision
11
❑ 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: SDP-1984-10
COntaCt (who should we contact about this project) Bob Ochieng, QSR and R (agent)
Street Address 584 Bellerive Road
CityAnnapolis StateMD Zip Code21409
Phone Number 301-364-9880 Ext. 1007 Email bochieng@qsrandr.com
Owner of Recordierome Johnson
Street Address 13585 Minnieville Road
City Woodbridge StateVA Zip Code22192
Phone Number Email jjohn58195@aol.com
Applicant Mitch Riese, QSR and R (agent)
street Address 584 Bellerive Road
CityAnnapolis StateMD Zip Code21409
Phone Number 610-213-6439 Email mriese@qsrandr.com
SUBMITTAL REQUIREMENTS:
R The appropriate fee,
® The site plan number that the change applies to,
® A request letter describing the proposed changes from the owner or authorized agent,
® 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.
Mitchell Rie "11/11/2022
Signature of Owner, Agent Date
Mitch Riese 610-213-6439
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