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SDP200600022 Application 2022-12-13 (2)
Application for Letter of Revision s � (fl.lva © 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 fononuuzsm Derelopmcnr.Ap�rle 7a+' Ua°c If paper is the only option, then one copy of completed application and all surmlemental document v ha —vidod I Final Site Plan Name and Number: SDP200600022 Contact (who should we contact about tins project) CRISTIE WESTBERRY Street Address 943 PRESTON AVE, STE 5 city CHARLOTTESVILLE StateVA Phone Number 571.243.2206 Owner of ReeordDOWNTOWN CROZET DISTRICT LLC Street Address 400 LOCUST AVE, STE 3 CHARLOTTESVILLE s,,..,.VA Phone Number 434.284.2815 CRISTIE WESTBERRY Street Address 943 PRESTON AVE, STE 5 Zip Code22903 cwestberry@franksaulconstruction.com Code22902 gfrank@franksaulconstruction.com Cit,CHARLOTTESVILLE StateVA ZipCode22903 Phone Number 571.243.2206 Finail cwestberry@franksaulconstruction.com SUBMITTAL REQUIREMENTS: R1 The appropriate fee, Se The site plan number that the change applies to, VA request letter describing the proposed changes from the owner or authorized agent, 4 copies of the plan that shows the proposed changes, Changes nmst be shown on the sheet or sheets from the approved final site plan, or on an tl"XIT' copy of that portion of the approved final site plan. Owner/Applicant :Must Read and Sign I hereby certify th• t the information provided on this application and accompanying information is accurate, true and correct to the best of my knowle a belief. / !-7 npllde Ownei', Date CRISTIE WESTBERRY 571.243.2206 Print Name Davtime phone number of Signatory FOR OFFICE USE ONi.Y LOR # Fee Amount $__ Dale Paid —By who? _ _ Receipt ft _Ck# By: Department of Community Development 401 D4clntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 REVISED 811512022 Page 1 of 1