HomeMy WebLinkAboutACSA199800002 Application 1998-01-27 • c:
APPLICATION TO AMEND THE ,�,°F�A County of Albarle
2�rl i Department ofem Planning and Community Development
SERVICE AUTHORITY 401 McIntire Road
r 4 '►+- Charlottesville,VA 22902-4596
JURISDICTIONAL AREAS 804 296-5823
APPLICANT Name: Ellis A.- Sprouse
Signature: , ovw2-- Phone: 804-823-4874
Address: 4774 Three Notched Road
Charlottesville. Va. 22901
CO-APPLICANT Name (or agent, if any): Beverly Ercenbrieht
Signature: � o, Phone: 804-974-2284 or 804-823-5816
Address: P. o, Box 192
Crozet. Va. 22932
JURISDICTIONAL AREA DESIGNATION REQUESTED:
❑ Water and Sewer ❑ Water Only
❑ Water Only to Existing Structure(s) 9 Limited Service(Describe in Justification
below)
PROPERTY LOCATION (Address) Beaver Hill Drive/Beaver Hill Lake Drive/Beaver Hill Lane
Tax Map(s)/Parcel Number(s): 5 7-R
CURRENT SERVICE AREA DESIGNATION (If any):
❑ Water and Sewer 0 Water Only •
• Water Only to Existing Structures 0 Limited Service
JUSTIFICATION FOR REQUEST: To connect existing mobile home lots to nnhl i r sewer
Hookup is approximately 100' to service area rnnnarti.,n desired to replace fielSd
line system.
•
Reference telephone conversation between John Grady and Rev Rrranhr;phr
• For Staff Use Only
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DATE SUBMTi i>rD: / ."�L 2— l DATE$130 FEE PAID:
PROPERTY IS LOCATED (Check Appropriate):
❑ Inside or ❑Outside a Growth Area? ❑ Adjacent to SAJA?
❑ Inside or ❑Outside a Water-Supply Watershed? 0 Adjacent to a Growth Area?
Location and distance of water/sewer line proposed to provide service
REQUEST FOR AMENDMENT ADOPTED: 0 Yes 0 No Date of Action