HomeMy WebLinkAboutSDP201000053 Application 2023-02-01Application for
Letter of Revision
W 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.
be submined via the
licadon and all sum
Final Site Plan Name and Number: St. Anne's Belfield SDP201000053
Contact (who should we contact about this project) Steve
street Address Musco Lighting 100 1st Ave
City Oskaloosa State IA Zip Code52577
Phone Number (804) 836-6785 Email steve.wiley@musco.com
Owner of Record St. Anne's-Belfield School
Street Address 799 Faulconer Dr
Charlottesville atste VA zin Cade 22903
Phone Number (434) 296-5106 ext 3346 -Emall.pcormons@stab.org
Applicant St. Anne's-Belfield School
Street Address 799 Faulconer Dr
Charlottesville
VA
Code 22903
Phone Number (434) 296-5106 ext 3346 Emall Pconnons@stab.org
SUBMITTAL REOUIREMENTS:
® 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 most be shown on the sheet or sheets from the approved final site pl8n. or on an 11"X17" 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 ref.
cry) 01/17/2023
Signature of Owner, Agent Date
Peter Cormons (703) 943-0473
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY
LOR #
Fee Amount $ Date Paid
By who?
Receipt #
Cldt 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