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HomeMy WebLinkAboutSDP201000029 Letter of Revision 2010-04-06 (2)SITE DEVELOPMENT DATA EXISTING USE: ADDRESS- 3263 PROFFIT RD. MART14A CHARLOTTESVILLE, VA 22911 9_'QTr%DV IIC*n[rA[ rIE-r1rC7 10,000 S, F, (FOOTPRINT) 20,000 S.F. (GROSS) OUTPIATIE TAX MAP ID #,- 032AO-02-00—OO1 AO VIA DEED BOOK: D.B. 1415, PG. 057 PROPOSED USE: __2n4_� submittal Type EXPANSION 2—STORY MEDICAL OFFICE Reviewed and Approved by the 10,600 S.F. (FOOTPRINT) Comm inity Development Departm ent 21,200 S.F. (GROSS) Fil Lo 41,200 S.F. (TOTAL GROSS) ZONING: re HIGHWAY COMMERCIAL (HC) BUILDING HEIGHT: (PER ALBEMARLE COUNTY CODE, CHAPTER 182 SECTION 21.4) NOT TO EXCEED 65' —PROVIDED ANY STRUCTURE EXCEEDING 35' SHALL BE SET BACK FROM ANY STREET RIGHT OF WAY, IN ADDITION TO MINIMUM YARD REQUIREMENTS, A DISTANCE OF NOT LESS THAN 2' FOR EACH 1 OF HEIGHT IN EXCESS OF 35' PROVIDED: 2—STORY MEDICAL OFFICE @ 29t—O't MINIMUM YARD REQUIREMENTS: (PER ALBEMARLE COUNTY CODE, CHAPTER 18, SECTION 2.1.7.1) ADJACENT TO PUBLIC STREETS: STRUCTURES (EXCEPT SIGNS) — 30' MIN OFF STREET PARKING OR LOADING SPACE 10' MIN. MAXIMUM NUMBER OF EMPLOYEES: 65 PEOPLE EXISTING PARKING: 79 EXISTING SPACES FOR EXISTING USE PARKING REgUIREMENTS: I SPACE/200 S.F. NET OFFICE FLOOR AREA OIL L, 11 F 0 U.80*41,200 S.F. = 32,960 S.F. (NET) FIELD SURVEY SOURCE: 32,960 5,F./200 5,F, 165 SPACES REQUIRED BOUNDARY AND TOPOGRAPHY AND BENCHMARKS PARKING PROVIDED.: PROVIDED BY OWNER PER ROGER W. RAY & 53 IS I ASSOCIATES, INC. DATED FEBRUARY 18, 2009. 1411 PROPOSED P RKING SPACES NEW BENCHMARK: - 94 PARKING �PACES TOTAL (INCLUDING 8 1 r% to - AC EA G. USE ARE .PARCEL SIZE. 4.13 AC. (179,903 S.F.) BUILDING FLOOR AREA- 41,200 S.F., GREENSPACE 16 ,880 S.F. 9 0/) (,e,-) INTERIOR LANDSCAPING: AREA REQUIRED. 5;/.p OF TOTAL PARKING AREA 0,05*121,823 S.F. = 6,092 S.F. REQUIRED 22,354 S.F. PROVIDED I TREE/10 PARKING SPACES REQUIRED, 198/10 = 20 TREES REQUIRED 74 TREES PROVIDED TREE CANOPY CALCULATIONS 10% TREE CANOPY REQUIRED 4.13 AC.*43,560 S.F., AC,*0.10 = 17,990 S,F, REQUIRED EXISTING TREE CANOPY = 13,113 S.F, PROPOSED TREE CANOPY = 22,635 S.F. TOTAL TREE CANOPY PROVIDED. 13o113 S.F� (t25)+221635 S Fo = 39,026 S; F. PROVIDED STREET TREES AID k.2LVUL11U J AVL[ Lij TOP OF A CONCRETE POST. LOCATED AT THE INTERSECTION OF U.S. RT. 29 AND T. RT, 649 12,4' SE OF THE SW CORNER OF CRENSHAW'S GARAGE, 45a5' WEST OF THE NW CORNER OF GREENTOP MOTEL; AND 46.5 NE OF THE CENTERLINE OF T. RT, 649, AND 85.5' NW OF THE CENTERLINE OF THE S.B.L. OF U,S. RT. 29. ELEVATION — 5 52.708 NG-VD29 ROAD ROAD FRONTAGE REQUIRED PROVIDED ROUTE 29 300' 6 LARGE OR 8 LARGE 8 MEDIUM 4 ARMSTRONG MAPLE 2 RED MAPLE 2 AUTUMN PURPLE ASH IROUTE 6491 215) 1 4 LARGE 4 RED MAPLE IMPERVIOUS AREA: EXISTING CONDITIONS PROPOSED DEVELOP ME WATERSHED: NORTH FORK RIVANRA MEDICAL&ENTAL.- LAND USE CODE 720: = 55,335 Sf. (31%) 'INT - 119j482 SiF (66%) (BELOW WATER INTAKE.) ' r + — . 'TRIP GENERATION) PER ITE, 8TH EDT JU QUILDIZNG. TRAFFIC ( MEDICAL OFFICE BUILDING DAILY: 1470 VPD BEFORE YOU DIG CALL 1-800-552-7001 AM PEAK:- 95 VPH PROTECT YOUR -SELF, GIVE THREE PM PEAK: 130 VPH WORKING DAYS NOTICt RIVANINA DISTRICT ALBEMARLE COUNTY, VIRGINIA Ibid U VICINITY MAP NOTES. 1, ALL STORM PIPE LENGTHS ARE MEASURED FRCS ,i CENTER OF DRAINAGE STRUCTURES (D.I. OR M. 2� ALL SAN. SE'NER PIPE LENGfH!-., 5. '7 tvIEASUREID BEVNEEN IN 10 '31JRFACES OF MANHOLES ('UPPER STATION- LOWER STATION-4 J LENCTFI) 1 CONTRACTOR IS TO MAKE HIS OWN TAKE-OFF ON THESE PLANS AS ANY QUANTITIES SI-IOWN ARE APPROXIMATE ON12Y TO SHOW SCOPE OF INORX OWNER: SHEET NO. I OF 15 MARTHA JEF-FERSON HOSPITAL 459 LOC'.'d"UST AVENUE CH r- V,,, 2 2'9 0 2 ARLOTTESVILLE, PkIC)NE NQif (434)-982-7038 F FAX; (4-34')-982-70*16, CO1%1TACT: MICHAEL R. SPATZ EMAIL. rn i chap, 1. spa 1,70�_Pfnj h,o rg INDEX ;OVER SHE C T" ET TITLE 2 PROPOSED LEGEND 'I _'.3 ASPHAL'I Pmaorn•.a 3 SANRAr-c( SE-WILR' LIN[ 15 ATE W ER LINE 4 STORM PI PSG. 15 DRAINAGE STRUCTURE NUMBER 1-,174--1 PROPOSED MliSHCD f,RADE CON ]"OUR E LEVAMN 15 ENO TES EDGE OF PNVEMENT D - 63- DEIJOTES� TOP OF CURB 15 DENOTE S' FACE OF CURB 7 (MEASURED TO BACK OF ANY ROLL FACE CURB) 15 D[NOTES EBACK OF CURB NOTES. 1, ALL STORM PIPE LENGTHS ARE MEASURED FRCS ,i CENTER OF DRAINAGE STRUCTURES (D.I. OR M. 2� ALL SAN. SE'NER PIPE LENGfH!-., 5. '7 tvIEASUREID BEVNEEN IN 10 '31JRFACES OF MANHOLES ('UPPER STATION- LOWER STATION-4 J LENCTFI) 1 CONTRACTOR IS TO MAKE HIS OWN TAKE-OFF ON THESE PLANS AS ANY QUANTITIES SI-IOWN ARE APPROXIMATE ON12Y TO SHOW SCOPE OF INORX OWNER: SHEET NO. I OF 15 MARTHA JEF-FERSON HOSPITAL 459 LOC'.'d"UST AVENUE CH r- V,,, 2 2'9 0 2 ARLOTTESVILLE, PkIC)NE NQif (434)-982-7038 F FAX; (4-34')-982-70*16, CO1%1TACT: MICHAEL R. SPATZ EMAIL. rn i chap, 1. spa 1,70�_Pfnj h,o rg INDEX ;OVER SHE C T" ET TITLE 2 0F 'I _'.3 r (;ENERAL NOTIE'S' & 'rfPICAL DETAILS 3 OF 15 EXISTING CONDITIONS) PLAN 4 OF 15 DEMOLITION &- TREE PROTEc.-I-ION PLAN 5 OF 15 EROS 1011 C0[-,fTR0L [-.JOTES AND DETAILS 63- OF 15 INITIAL EROSION C_.0f-,ITROL PLAf-A 7 OF 15 OVERALL EROSION CONTROL. PLAN 8 OF 1 S LAYO U]" PLAN 9 OF 15 OTILIP( PLAN 10 OF 15 0,R1 YDING & DRAINAGE PLACV11 11 OF -15 DRAINAC'E LSE SCr-flPT1C-j1-41S ek ANALYSIS 2 OF '15 `s�`)TORtvl PROFILIES & H(--,L CALCUILATIONS 13 OF 15 STORMlillATER QUALITY ANALYS1'.:;3 14 OF 15- "FILTE FORA, " INLE-r r� ,ar_--S &_ DETAILS 15 OF 15 STORMWATER QUANTITY ANALY,E�IS 'I 5A OF 15 13MP/SWN1 DETAILS LL-1 EXISTING LANDSCAPE PLAN LL-2 REIAOVAL OF EXrSTING PLAJ%1TS LL-3 PROPOSE'D LANDSCAPE PLAN LL-4 PROPOSED LANDSCAPEE PL_Afj El i 00 ELECTRICIAL LEGEND AND NOTES' E1,01 SITE PU%N—LIGJ­ITING E1.02 SITE PL, ',N—ZOINING E1,03 LlGi­rriw� CUT SHEETS EXISTING E1.04 F 1. 05 PROPERT`( LINE SMITARY SEINER 'HATER LINE POVIEP LINE U DENOTES UNDERGROUND 0V RHU-0 ELECTRICAL LIN[ - O M.10TIES G A LI S NE CUL'rLRT OR STORM SEWER PIPE FIRE HYDRANT EXISTING CONTOUR ELEVATION LIGHTING CUT S31-1EETS LIGHTING Cu-r SHEE'rs 4. CONTRACTOR 'SHALL BE RESPONSIBLE F(JR Compt-CrMl AND FINAL AMEPTANCE OF ALL CONSTRUCTION AND UTILI'I"Y LINES, 5, CONTRACTOR SHALL COMPL ( WITH VIRGINIA STORM WATER MANACEMENT PERMITS, A STORM WATER POLLUTIOt,1 PRMI'l"I'lON PO-14 SHALL BE DEVELOPED AND IMPLEMENTED BY TFIE CONTRACTOR FOR Tms CONSTRI-Jr.TION A(,'fIV1T'(_ ENGINEER: RUMMEL, KLEP PER, & KAHL, LLP 801 E. MAIN STREET, SUITE '10.00 Rr ICHMOND, VIRGINIA 23219 PHIONE NO, (80 A)782-1 9023 FAX NO, (804)782-2142 E-MAIL rrnckinney(q-_rkk.com i'rm. 4. k,AC`H,AEL t-jkc-KII-�INEY, P,,E, EX&IN15 ME �MOOY CMMAWra:, OV MAIO, HNA rV.1 VQei VA E ME U NUI I Y 'C"cv.1i 04343f E 'rm VM LCW4. I Fiv I L 19 MOif 3 or .4144V OV-4dAso V'�, 7 z L0 Lr5 did f, 4 XOAMOA -W LE k. G 4Af f,_G"1'r4 W I I (f E 10 W. 51 W 1,211 k t &EXC"Ut IMEKL"f PYN Vf > 2 to 11 d7 Wnlhlfihirik� AL41F,1141 POS A 1"MI-11111.1 =11F111-111aklix-01 1r2a%1Y14A.;ae0_1:e 4s(; 0 4,4iA t M0 .111A ;WZAA ALuo_tv M, f1h, f1Kj VA 4.5, 510 �0 3 Ail E-5 f 1M, 05 M, 0, 110RD., �jfa'fikaofWife 1Ar.VA2d MAKE T "ff P1 2 1_33 RW M A til U M1 L VA 0111M 11JEA1 5"Jul 'ka P �4 i i I'm. %& -cl W.,t..4,ux rxr ar{?,.- fw, 'AJ K;Akff R AN 0�?#O MiAj, tsrjA 51n:UA h(fiVAjo 461114AlWhk .01i IL HK s jj! EE P 91 11h MKI111H.5 LAMM& h CY's "_fvj r oj.q t; t P. NI. 4 V] a 141 P9 I'll sr CO-04LANflMi 1 Llj �04141rk 9- V LLJ 0 _ _ 0 U 2.1 Uk Lb, 2 JAI 150 it k-t%mj-, V.vlvm�� I.- 1,.,i OsT E, vl < 21 U. W ; Wf, W.-WWWRO'. W-41iff ME 7 7 11 UNIRkA K V,"_ uEnA:h 1"We Elul in AD Wd4w.-VA 46 �_-,All 12— .1� < UP 11,414 4A f LA IAL JA vam, 1hmoAx 1A Lfj AfAefXIMUE CMrflf MOAAF10.1. APPROVALS DEPARTMENT OF COMMUNITY DEVELOPMENT PLANNER / ZONING ENGINEER iNspre-rioNs AR8 IDEPARIMENT OF FIRE RESCUE ALBEMARLE COUNTY SERMEE AUTHORITY— VIRGINIA DEPARTMENT OF TRANSPORTATION HEALTH DEPARTMENT DATE SDP 2009-00034 Z CL 4" CA 0 --, 0 �1 m u" t. (; rf Ld Ce 121 '00 z M z CL VM LCW4. I Fiv I L 19 6A Xf 6 14 h a — 4VAN154A MOW 1141JAVUMNIAUS -VAV.)Ur .4144V OV-4dAso V'�, 7 z L0 Lr5 L14 f-9 CIL V) < Al I 'A AM I D 10 _ Al W, : U. MAVAL I L f YA J I f IL "W;ALf." j - > LL_ I L r 07, 1"MI-11111.1 =11F111-111aklix-01 1r2a%1Y14A.;ae0_1:e 0 lb paf AG "MIUM1441 e.r.',rir F, mr 0 cr- A rt ,Oil j� m4 o ori 'ka P �4 i i I'm. %& -cl W.,t..4,ux rxr ar{?,.- fw, 'AJ K;Akff R AN 0�?#O MiAj, tsrjA 51n:UA h(fiVAjo 461114AlWhk .01i IL HK �'v V t's G14? I .1 EE P 91 11h U. at), 1v lmtw Gr_ -riumulumv AW tUfAr VJ V'A a 141 J I'll sr CO-04LANflMi 1 Llj �04141rk 9- V LLJ 0 _ _ 0 U Uk Lb, 2 JAI Ld it .114.U. Luvaul wilt 'Ali It NWEA < 21 1M It' UNIRkA K V,"_ uEnA:h 1"We in AD Wd4w.-VA 46 2:1 12— .1� < UP 11,414 4A f LA IAL JA vam, 1hmoAx 1A Lfj Pi iLM-AMILILLAM, I&AIMULM -1 13 1j] li auahtj� 4 CL Ali 71 r, —fW1 C U12-11 i I I - � L 0 Q1.1 01S PA TA ULFtth (If6hii V tc lr.bI, APPROVALS DEPARTMENT OF COMMUNITY DEVELOPMENT PLANNER / ZONING ENGINEER iNspre-rioNs AR8 IDEPARIMENT OF FIRE RESCUE ALBEMARLE COUNTY SERMEE AUTHORITY— VIRGINIA DEPARTMENT OF TRANSPORTATION HEALTH DEPARTMENT DATE SDP 2009-00034 Z CL 4" CA 0 --, 0 W V, z LLJ Ld Ce 121 '00 z M z CL CA U-) LJ W U cr; k- z La LJ � V) 1.- V_ z Q 4 �u C W D > LU W z 0 U 0 a W V) L_4 Pr cm 4 z L0 Lr5 L14 f-9 CIL V) < LLI Lj X LL_ Q LLJ V1 V) LLJ C-) l­_ > LL_ I L 0 0 cr- ;> U-11 Z LIJ V) LLJ 0 0 U LLJ Ld > < _j (J� 0 U M < z < LLJ < CL F- 7) 0 T_ C� k.� _2 ID z 0 LIJ 0 W may 03 -7 F— 0 0 W LU U Q 1 7) Ft V1 r.F! _j �4 z 40; � yet", %L U C) LU .A,-Z 3. LM ri rA U Vi LLM tJ z z W/S REEN Y )-UJ9P-STEf AD' W/S S51,109J4012E � p 2 xl cc at ENCLOSURE GATES (TO MATCH -MASONRY) CL z V) 'CE�S ---------- w X z LIT E R 0 z F LLI cr� D- 0 rio r Dil 2fi z F- m Ld z- > 0,4 NA IST )p DIRECTIO ING IL 4 W,/ STO P BAR > e-4 D uj Z Ln cl % > -7- "K V) 4. 0 V) V) Q6 QL 30 TAPER CIO < > x car -ON L T Nfik-kTIO ,A m TA ? P. A 00 > FOR' LA- --�PAVEMrNT "A" Tj 0' Imp, PARKING C�- �At 1"LTBACK -P A E PA A G b-lL > u Lij CL 7r 0 7D (D 0 Li in < \�A Ile) CL 0 10 L f r t t-pp, A po .1 Aal FFZ z IL "A 10 -Lj < 4 n R5 9' C, A 0 \�N 7 C C) 'pj y R:� 1 0 V) L w/coNCRETE HP­5 y Nz IGNA r X, BUMPER BLOC J)" tv 4 0 Lli ,j c) IA- �A Ld G 2 Z�" z z < C) Alr 1" 2 G U R u T uj u u Y . It CG-6(TYP.' J" N % A A 4,00 A _e_54� rl- . . _"- ' - . . I . . -.,A, , I". , k-�n IL CUTS A 0. --A -EX. SIGN 4, .�pl TO 8E MODIFIED -jB 10 F1 LITER B (J iva) -fit W 0 % N-15 1 o 91101, w _w ---- - -- C' 286. A A CURB CUT G @8 10 — FI LITE R -CG I Al �A (Z) EDGE (TY'P,) LIGH III N G NOTES Iti �THE SPILLOVEF OF LIGHTING FROM PARKING AREA LUMINAIRES ONTO PUBLIC 10, Lu x ROADS OR -ROPERTY IN RESIDENTIAL OR RURAL AREA ZONING DISTRICTS j3 Pf —HALF (1/2) FOOT CANDLE.. 0 SHALL NOT EXCEED ONE 2. EACH OUTDQLO,,R LUMINLAIRE EQUIPPED WITH A LAMP WHICH EMITS 3000 OR -V MORE INITIAL ILUMENS SHALL BE A FULL CUT—OFF LUMINAIRE OR A !A DECORATEVE LUMINAIRE WITH FULL CUT—OFF OPTICS. ij NOTE, SITE' SIGNAGE REQtIRES SEPARATE PERMITS PER ZONING ORDINANCE 4.15. FIELD SURVEY SOURCE:t BOUNDARY" AND TOPOORAPHY AND UENCRMAPM 5)� PROYIOED Ble OWNER PER ROIGER W. RAY ALL ROOF TOP EQ�IIPMENT SHALL NOT BE VISIBLE FROM THE ROUTE 29 N ASSOCIATES, INC. DATED FEBRUARY 113, 2.009. ENTRANCE CORRIDOR. OEACHMARK,� J �'k .2s,V -i, US COAST AND GEODETIC SURVEY Z155 71 NOTE: SOURCE FqR BUILDING/PARKING SETBACK mp Or A CONORM POST; 1.00AICLO Al 1�le lNlMeC­TJ()A OF U4S, RT, 21) AND 5T. RTt 649 REGULATIONS IS FROM ALBEMARLE COUNTY ZONING 1214' SE OF THE SW CORNER Of' 'GRENSHAW"S cx ORDINANCE. GARAGE; L 45J5' WEST OF TjiE NW CORNER OF GREENTOP A- AND 4G.W Ne 'OF RLINC OF S1, rOl, HEIGHT REGULATICIIS. HEIGHT OF THE BUILDING NOT 549, TO EXCEED 65 NY STRUCTURE EXCEEDING,2 35' AND 85.5' NW OF THE CENTERLINE OF THE '53,B.L. br vk 20 0 20 40 OF U.S. RT. 29. 51 P C' 'ELEVA rio K� 55.2,708' SHALL BE SET BA FROM ANY STREET RIGHT OF Emil "CALr­ IN FEET WAYL, IN ADDITION MILNIMUM YARD REQUIREMENTS A DISTANCE OF NOT LESS THAN 2' FOR EACH 1 OF HEIGHT IN EXCESS OF 35 SDP 2009-00,034 pF AL (41-1-Mi 7:a �'�RGIT�1P COUNTY OF ALBEMARLE Department of Community Development 401 McIntire Road, Room 227 Charlottesville,Virginia 22902-4596 Phone(434)296-5832 Fax (434)972-4126 Rachael McKinney RK&K 2100 E. Cary Street, Suite 309 Richmond, VA 23223 September 13, 2012 RE: SDP 2010-029- Martha Jefferson Outpatient Care Center- Final Site Plan Letter of Revision#2 Ms. McKinney: This letter is to approve the letter of revision as shown and described in the revised plan and letter of explanation dated September 13, 2012. This approval is viewed as your second Letter of Revision for the above-mentioned final site plan, entitled SDP2010-029 Martha Jefferson Outpatient Care Center Final Site Plan. Please note that a total of three (3) Letters of Revision are allowed before all changes to the site plan are required to be submitted in the form of a new site plan amendment. If you have any questions please feel free to contact me. Sincerely, Megan Yanig os Senior Planner RK iC 2100 East Cary Street,Suite 309 I Richmond,VA 23223 I P 804.782.1903 I i 800.510.4755 I f 804.782.2142 I www.rkk.com William K.Hellmann September 13,2012 Emeritus David W.Wallace County of Albemarle Stephen G.Zentz Department of Community Development J.Michael Potter Ms.Megan Yaniglos Thomas E.Mohler Senior Planner Michael W.Myers 401 McIntire Road Mark M.Dumler Charlottesville,VA 22902 James A.Zito Reference: Martha Jefferson Health Services Outpatient Care Center @ Proffit Road Joseph A.Romanowski,Jr. Application for Letter of Revision Michael L.Krupsaw Lars E.Hill J.Tommy Peacock,Jr. Dear Ms.Yaniglos, Martin C Rodgers Kenneth A.Goon There are four (4) as-built parking revisions to the previously approved site plan for the Richard J.Mains,Jr Martha Jefferson Health Services Outpatient Care Center @ Proffit Road. John A.d'Epagnier Barbara J.Hoage 1. The approved site plan reflects 11 spaces @ 9'x16' were proposed east of the Christopher F.Wright dumpster pad. As-built conditions provide a 7'x16' space striped for no parking Owen L.Peery Nancy R.Bergeron immediately east of the dumpster pad and then 10 spaces @ 9'x16'. Stuart A.Montgomery 2. The approved site plan reflects 4 spaces @ 9'x18' were proposed east of the David G.Vanscoy building,just south of the patient drop-off canopy. As-built conditions provide a Henry J.Bankard,Jr. 8.67'x18'space striped for no parking and 3 spaces @ 9'x18'. James F.Ridenour,Jr. 3. The approved site plan reflects 3 spaces @ 12'x30' were proposed for ambulance Robert J.Andryszak parking. As-built conditions provide 1 space @ 13.5'x30'and 1 space @ 14'x30'. Raymond M.Harbeson,Jr. 4. The approved site plan reflects 15 spaces @ 9'x16' were proposed west of Leake B.Keith Skinner Square at the southeastern corner of the parking lot. As-built conditions provide Karen B.Kahl Seyed A.Saadat 14 spaces @ 9'x16'and a 8.58'x16'space striped for no parking. John C.Moore Eric M.Klein Albemarle County code requires that 165 parking spaces are required. The previously Todd E.Rousenberger approved site plan showed that a total of 198 parking spaces were to be provided. The as- Thomas M.Heil built parking revisions provide 194 parking spaces,which exceeds the code requirement. Robert D.Ostermiller Barry L.Brandt I have attached a highlighted plan that reflects the current parking conditions. Malachi M.Mills,Ill Jaynes A.Burnett Brian L.Hepting Thank you for your review and consideration of these revisions. Please feel free to Michael V.Gaffney contact me if you have any questions,or need additional information. Lee C Yowell David A.Willoughby Sincerely, Carolann D.Wicks Rummel,Klepper&Kahl,LLP Rachael T. McKinney, P.E. Senior Engineer Engineers I Construction Managers I Planners I Scientists Application for Letter of Revision �r `a XLetter of Revision=$100 Final Site Plan Name and Number: • Contact Person(Who should we call/write concerning this project?): 1. LL, __ 116. Address 7—.1(_ (D F . C.J � , City p::aC State 'U4., Zip Daytime Phone(f )141 19Q`j Fax#( ;-}8 Z1-4L E-mail s Owner of Record M,fiP- N.A, c1 Address zlnbt c, City C 1-lla,L, ac moo(\ F State \(J\ Zip Daytime Phone(S64) l cs .\ Fax#L_) E-mail kJ,' am, - 1 _ @ m,, en ow Applicant(Who is the Contact person representing?): Address City State Zip Daytime Phone( ) Fax#( ) E-mail SUBMITTAL REQUIREMENTS: XThe appropriate fee, The site plan number that the change applies to, XA request letter describing the proposed changes from the owner or authorized agent, X4 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 11"Xl 7"copy of that portion of the approved final site plan. Owner/Applicant Must Read and Sign I hereby -rtify that the information provided on this application and accompanying information is accurate,true and correct to the best 1 •• led e a 43 c7Z Sig I,:tore .f Owner,Agent Date J- Mici,,ef LcrrS 5`34— L5q 7365" Print Name Daytime phone number of Signatory FOR OFFICE�USE ONLY LOR# Fee Amount$ I O�D� Date Paid 13'12-By who?' 1 U f R 4 eceipt# C.:b4 .6 Ck# eatil-'t ` By: rn HC&Fri 1-Ca County of Albemarle Department of Community Development 401 McIntire Road Charlottesville,VA 22902 Voice: (434)296-5832 Fax: (434) 972-4126 1/1/2011 Page 1 of 1