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HomeMy WebLinkAboutSDP202300002 Application 2023-01-03Application for Initial Site Plan or Final Site Plan or Site Plan Exception :l _ Project Name: 5EMt�4o (' N61(;HI-S Tax ma and arcel s : hA 4 S 1 R V' G /4 C, — *j kur oy �p c p p O T Zoning: I Contact (who should we contact about this A project) TwS41 ra S � r f' '" S ct Street Address �) Z �' "t r2J - Iy � /54e;& �p City ��+lo-> k J ViJLP State V `, II Zip Code 221 o f Phone Number 3 f 'yy-1 ' S/(/O Email rik's d-t h /fj S Nxe ^ eYLR 1 P.lti+li'i t Owner of Record =A Q A LA, G C 1 Street Address �w+r..rv. ✓�. City state zip cnae Phone Number Email Applicant wV%ar o Recoro1 Street Address CityState Zip Code Phone Number Email Residential Type of unit(s): # of building(s): Sq. ft. of building(s): # of units per building: Total # of units: Resulting density: Acreage of site: Acreage in open space: Acreage in roads: Average gallons of water used per day: bd Non-residential I/Commercial ❑ Industrial ❑ Quasi -Public Sq. ft. of building(s):�Ly'I Acreage of site: 1 ) Acreage in open space: Acreage in roads: Average gallons of water used per day: FOR OFFICE USE ONLY SDP # Fee Amount S Date Paid By who? Receipt # Ck# By: County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126 REVISED 8/1512022 1 of Intended use or justification for reauest: Scsse.,n, L.t-se_s dagt:p./+e Pit l " O SA rv, ia.-, a .) 1Ve rO u 1d j SiX se O-e bLr (ol,'ti .3 FEES SITE DEVELOPMENT PLAN SITE PLAN EXCEPTION Technology Surcharge 4% of each transaction Initial Site Plan Final Site Plan Exception to drawing of site plan under section 32.3.5(a) Approved No Preapplication plan Prea lication Ian ❑ ❑ $861.12 Fee $828+Technology Surcharge ,_,// Ill $1,476.80 Fee $1,420+Technology Surcharge ❑ $1 846 $1,846 $33.12 $58.80 Fcc$1,775+ Fee S1,775+ Plus Plus Technology Technology # of dwellings_ X$16=$_X.04= # of dwellings_ X$16=$_X.04= Surcharge$71.00 Surcharge $7 1.00 S s +Fire Rescue +Fire Rescue Plus Nonresidential square fee[ X .016 = Plus Nonresidential square feet 4%2r q�X 0.016 = Fee of $100 Fee of $100 $ X.04= $ LAD!, I x.04= 4 0, Let TOTAL $ TOTAL $ 211 (0217- r 7-3 +Fire Rescue Fee of $100 +Fire Rescue Fee of $100 A completed application and all ,supplemental documents should be submitted via the Community Development Aonlr fin- if paper is the only option, then one copy of a completed application and all supplemental documents may be provided. ❑ Site plan has a parking structure. Included are revised architectural elevations, drawings, photographs or other visual materials submitted with the initial site plan. The elevations shall be p2rt of the approved final site plan. Notices required by Section 32.4.2.1 (f) Initial notice fee to be provided in conjunction with an application, for preparing and mailing notices and published notice = $448 GROUNDWATER ASSESSMENT (Required for all non-residential site plans not serviced bP public water) ❑ If the plans show a use using less than 2,000 gallons/day (average) Tier 3 Groundwater Review = $627.12 Fee $603 +Technology Surcharge $24.12 ❑ If the plans show a use using greater than 2,000 gallons/day (average) Tier 4 Groundwater Review = $1,354.08 Fee $1302+Technology Surcharge S52.08 ❑ Special Exception = $523.12 Fee $503 +Technology Surcharge This application may require additional review by the Fire Marshal. Fees in addition to those shown on this application may be required by the Fire Prevention Code Fee Schedule. A copy of the schedule is available from the Fire Marshal. Owner/Applicant Must Read and Sign This site plan as submitted contains all of the information required by Section 32.5 (Initial Site Plan) or Section 32.6 (Final Site Plan) of Chapter 18 of the Code of the County of Albemarle. I understand that plans which lack information required by said sections shall be deemed incomplete and shall be denied by the agent within ten (10) days of submittal as provided in Section 32.4.2.1 or Section 32.4.3.1 of Chapter 18 of the Code as the case may be. By signing this application I am consenting to written comments, letters and or notifications regarding this application being provided to me or my designated contact via fax and or email. This consent does not preclude such written communication from also being sent via first class mail. For Final Plans Only: To the best of my knowledge I have complied with Section 32.4.3.1(2) of Chapter 18 of the Code Signature of 04kner, Contract Purchaser, Agent leellb .\}r1G�-I Siv7rn-D LnR. Print Name 10-t23 - 2o2Z Date Li- 3 t* - 22-7 - S f'+b Daytime phone number of Signatory Site Plan Application REVISED 8/15/2022 Page 2 of 2