HomeMy WebLinkAboutSDP202100030 Application 2023-04-04Application for
Letter of Revision
it
Z 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 CommunityDevelopment Apply for no Ijpaper is the only option,
then one copy of a completed application and all supplemental documents my be provided
Final Site Plan Name and Number: Scott's Ivy Exxon Final Site Plan Amendment (SDP2021-00030)
Contact (who should we contact about this project) Collins Engineering
Street Address 200 Garrett Street, Suite K
City Charlottesville State" Zip Code22902
Phone Number 434-293-3719 Email scoft@collins-engineering.com
Owner of Record SR&DR LLC
Street Address 1031 Milton Drive
City, Keswick State VA Zip Code 22947
Phone Number Email scottsivyexxon@gmail.com
Applicant Collins Engineering
Street Address 200 Garrett Street, Suite K
City Charlottesville State VA Zip Code22902
Phone Number 434-293-3719 Email scoff@collins-engineering.com
SUBMITTAL REQUIREMENTS:
m The appropriate fee,
m The site plan number that the change applies to,
m A request letter describing the proposed changes from the owner or authorized agent,
m 4 copies of the plan that shows the proposed changes,
Changes must be shown on the sheet or sheets from the approved final site Alan, or on an 11"X1T' 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 and belief.
c�CeZL` �e 3-30-23
Signature of Owner, Agent Date
Scott Collins 4345-293-3719
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY LOR #
Fee Amount $ Date Paid By who? Receipt # Cld! 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