HomeMy WebLinkAboutSDP201700053 Application 2017-08-21 a t Community Development Department
'� Albemarle Co G y • 4( IntireRoad Charlottesville.VA22902-4596
,,�, + .) voice•(434)296-5832 Fax:(434)972-4125
+•7r .f Planning Application
PARCEL rin3VVITER INFORMATION
TMP 03200-00-00-04500 Owner(s): ROUTE 29 LLC
Application# SDP201700053
PROPERTY INFORMATION
Legal Description [ACREAGE
Magisterial Dist. Rio -I Land Use Primary Residential -- Single-family (incl. modular homes' 1
Current AFO •Not in A/F District .v Current Zoning Primary Neighborhood Model District
!APPLICATION INFORMATION
Street Address L J I Entered By
—' — - Jennifer Smith,
Application TvPe Site Development Plans L-_� 22. 01
Project Hollymead Town Center - Blks Cl, C3 &C4 - INITIAL
Received Date 08/21/17 F ei:ed Gate Final 1 Submittal Date 08/21/17 Total Fees` 2737
_
Closing File Date _ Submittal Date Final Total Paid 2737
Revision Number
Comments ,
Legal Ad ,.
SUB APPLICATION(s)
Type Sub Applicatio Comment
Initial Site Plan 08/21/17
[APPLICANT / CONTACT INFORMATION
ContactType Name Address City State ( Zip Phone PhorteCell
Cr+.rav;4y;D=ar1: ROUTE 29 LLC `.P 0 BOX 5548 CHARLOTTESVILL 22905
=nrsary Cor''sct SCOTT COLLNS - COLLINS ENGINEERING a200 GARRETT STREET,SUITE �CHARLOTTESVILL 22902 4342933719
Signature of Contractor or Authorized Agent Date
Application for
Initial Site Plan or Final Site Plan or Site Plan Exception w*c_
Project Name: HOLLYMEAD TOWN CENTER-BLOCKS C1, C3&C4 '3DP 0/ 7- 53
Tax map and parcel(s): 03200-00-00-04500 (PORTION OF) Zoning: NMD
Contact (who should we contact about this project) SCOTT COLLINS-COLLINS ENGINEERING
Street Address 200 GARRETT STREET, SUITE K
City CHARLOTTESVILLE State VA Zip Code 22902
Phone Number 434-293-3719 Email scott@collins-engineering.com
Owner of Record ROUTE 29, LLC
Street Address PO BOX 5548
City CHARLOTTESVILLE State VA Zip Code 22905
Phone Number 434-975-3334 Email ulcwww@embargmail.com
Applicant UNITED LAND CORPORATION
Street Address PO BOX 5548
City CHARLOTTESVILLE State VA Zip Code 22905
Phone Number 434-975-3334 Email ulcwww@embargmail.com
Type of Development
m Residential ❑ Non-residential
Type of unit(s): TOWN HOM ES ❑ Commercial
#of building(s): ,mot 77 ❑ Industrial
❑ Quasi-Public
Sq.ft.of building(s): St fl#07./,..7 Nt- /2.6e6 )
Sq.ft.of building(s):
#of units per building: /
Acreage of site:
Total#of units: 77 Lrrif
Acreage in open space:
Resulting density: /S,R D A
Acreage in roads:
Acreage of site: %83
1 Average gallons of water used per day:
Acreage in open space: I_ 3o #.
Acreage in roads: 1 07 Az
Average gallons of water used per day:
FOR OFFICE
��l'1 USE ONLY Q SDP# I '3- C
Fee Amount$ (1 1 Date Paid% i-11 By who Receipt#IO' Ck#334s By
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville,VA 22902 Voice: (434)296-5832 Fax: (434)972-4126
REVISED 11/02/2015 Page 1 of 2
•
Intended use or justification for request:
P,t-r' 77 se) 1T , i)
Comments/Attachments:
FEES
SITE DEVELOPMENT PLAN SITE PLAN EXCEPTION
Initial Site Plan Final Site Plan Exception to drawing of site
plan under section 32.3.5(a)
Approved No
Preapplication plan Preapplication plan
P6x77=►23Z.
U $752 plus$16/dwelling 1. $1,290 plus$16/dwelling ❑ $1,613 CI $1,613
unit and/or$0.016 per unit and/or$0.016 per '
square foot of square foot of
nonresidential structure nonresidential structure
$ $ 2/,SZZ.
16 folded copies of the plan #of copies required for submittal will be noted with 8 folded copies of the plan
plus an additional 6 copies if within an Entrance Corridor your initial approval letter. Copies of the plan should
be folded and in blue or black ink.Also provide 1
reduced copy of the plan no larger than 11 by 17 in.
U The initial site plan has a parking structure. U The final site plan has a parking
❑ Included are architectural elevations,drawings, structure.
photographs or other visual materials showing any ❑ Included are revised architectural elevations,
parking structure proposed on the site and surrounding drawings,photographs or other visual
structures and land uses. materials submitted with the initial site plan.
The elevations shall be part of the approved
final site plan.
GROUNDWATER ASSESSMENT
(Required for all non-residential site plans not serviced by public water)
❑ If the plans show a use using less than 2,000 gallons/day(average) Tier 3 Groundwater Review=$548
U If the plans show a use using greater than 2,000 gallons/day(average) Tier 4 Groundwater Review=$1,183
❑ Special Exception=$457
Notices re. ' •. b Section 32.4.2.1 (I) �L 'Z 737 W
Preparing and mailing or delivering up to fifty(50)notices $215.00 •lus the actual cost of first class postage.
Preparing and mailing or delivering,per notice more than fifty(50)=$1.08 plus the actual cost of first class postage.
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 Fina 'lans Only:To the best of my knowledge,I have complied with Section 32.4.3.1(a)of Chapter 18 of the Code.
— Zi-/7
Signature '-•wner,Contract Purchaser,Agent Date
�v1T GCGG� toy-V7- 7719
Print Name Daytime phone number of Signatory
REVISED 11/02/2015 Page 2 of 2
itial Site Plan '
Checklist "'
Project Name: 1171,67.414 ��.,,✓f�,,.; &cc,( c 1 G 3
Firm: erii-c„s E/tt,4,G
This checklist must be completed, signed and submitted with the application. The information contained in this checklist
reflects the contents of the Section 32 of Chapter 18 of the Code of the County of Albemarle also known as the Site Plan
Ordinance as of January 1, 2013. The applicant is responsible for insuring that no revisions to the Ordinance have
occurred since preparation of this document
Plans which lack the information required by this checklist shall be deemed to be incomplete and shall be denied by the
agent with ten (10) calendar days after the applicable submittal deadline[Section 32.4.21.
An Initial Site Plan shall contain the following:
l "[32.5.1 a]Number of copies.
'Sixteen(16)clearly legible copies in blue or black ink of the plan shall be submitted.
L9[32.5.2 1171 Scale and size.
(Er The plan shall be prepared to the scale of one(I) inch equals twenty(20) feet or to another scale approved by the
agent in a particular case. No sheet shall exceed forty-two(42) inches by thirty-six(36) inches in size.
(9KThe plan may be prepared on one(1)or more sheets. If prepared on more than one(1)sheet, match lines shall
clearly indicate where the several sheets join.
LV.The top of the sheet shall be approximately either north or east.
0'132.5.lc]Dimensions.
EV-The plan shall be dimensioned to at least the following standards for accuracy:
Er-Boundary, setback and zoning lines: One foot in one thousand(1:1,000) feet.
E Existing contours: One-half(1/2)of the contour interval required in section 32.5.2(d).
'Proposed contours: Within five(5)feet horizontally and vertically.
Er-Existing structures, utilities and other topographic features: Within five(5)feet.
'Proposed structures, roads,parking lots and other improvements: Within five(5)feet.
0 [32.5.2 a]General information.
f'The name of the development;
a"—names of the owner,
Q'developer and individual who prepared the plan;
atax map and parcel number;
'boundary dimensions;
'zoning district;
ILK—descriptions of all proffers,special use permits and conditions thereof,special exceptions and conditions
thereof,variances and conditions thereof, application plans,codes of development and bonus factors applicable
to the site;
LW/Magisterial district;
2county and state;
C"north point;
lyscale; one datum reference for elevation(where section 30.3, flood hazard overlay district, is involved, United
States Geological Survey vertical datum shall be shown and/or correlated to plan topography);
(the source of the topography;
'departing lot lines;
Ciminimum setback lines,yard and building separation requirements;
le-the source of the survey;
O/1heet number and total number of sheets; and
2' the names of the owners,zoning district,tax map and parcel numbers and present uses of abutting parcels.
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville,VA 22902 Voice: (434)296-5832 Fax: (434)972-4126
REVISED 06/10/2015 Page 1 of 4
County of Albemarle-Initial Site Plan Checklist
l [32.5.2 bJ Information regarding the proposed use.
a/Written schedules or data as necessary to demonstrate that the site can accommodate
Et'the proposed uses,
(9Yincluding proposed uses and maximum acreage occupied by each use;
Ermaximum number of dwelling units by type including the number of bedrooms for multifamily dwellings;
'gross residential density;
lr 'square footage of recreational areas;
lYthe percentage and acreage of open space;
aKnaximum square footage for commercial and industrial uses;
[Ymaximum floor area ratio and lot coverage for industrial use;
L9rmaximum height of all structures;
'schedule of parking including the maximum amount required and the amount provided;
Er the maximum amount of impervious cover on the site;and
aKif a landscape plan is required,the maximum amount of paved parking and other vehicular circulation
areas.
1il/[32 5.2 cJ Phase lines.
LIB' If phasing is planned,phase lines and the proposed timing of development.
Cs' .5.2 Topography and proposed grading.
[3 dJ S Existing topography(up to twenty [20] percent slope,maximum five [5] foot contours,over twenty [20] percent
slope,maximum ten [l 0] foot contours) for the entire site with sufficient offsite topography to describe prominent
and pertinent offsite features and physical characteristics,but in no case less than fifty(50) feet outside of the site
unless otherwise approved by the agent;
GI: proposed grading(maximum five [5] foot contours)supplemented where necessary by spot elevations;
( areas of the site where existing slopes are critical slopes.
"32.5.2 el Landscape features.
lEr The existing landscape features as described in section 32.7.9.4(c).
Er[32.5.2 fJ Watercourses and other bodies of water.
EcThe name and location of all watercourses and other bodies of water adjacent to or on the site;
Dr indicate whether the site is located within the watershed of a public water supply reservoir.
lt' [32.5.2 g/Onsite sewage system setback lines.
L9'The location of onsite sewage system setback lines from watercourses including intermittent streams and other
bodies of water.
GY[32.5.2 hi Floodplain and related information.
3 The boundaries of the flood hazard overlay district,the base flood elevation on the site,the elevation of the lowest
floor, including any basement,and for any structures to be flood-proofed as required by section 30.3,the elevation
to which the structures will be flood-proofed.
Cr[32.5.2 iJ Streets, easements and travelways.
2--The existing and proposed streets, including
ay-proposed bike lanes,
13--access easements,
Valley easements and rights-of-way, and travelways,
laYtogether with street names,
e'state route numbers,
'right-of-way lines and widths,
'centerline radii and pavement widths.
REVISED 06/10/2015 Page 2 of 4
. , County of Albemarle-Initial Site Plan Checklist
-32.5.2 jJ Existing sewer and drainage facilities.
O' The location and size of
it existing water and sewer facilities and easements,
0Cthe storm drainage system,
a drainage channels, and
Cd' drainage easements.
732.5.2 kJ Proposed sewer and drainage facilities.
Er The proposed conceptual layout for
Pr water and sewer facilities and
0' the storm drainage system, indicating the direction of flow in all pipes and watercourses with arrows.
0--[32.5.2 I] Existing and proposed utilities.
O'The location of other existing and proposed utilities and utility easements,
Er including existing telephone,
2r-cable,
C3'electric and
0'gas easements.
1Y[32.5.2 m] Ingress and egress.
eThe location of existing and proposed ingress to and egress from the property,
GYShow the distance to the centerline of the nearest existing street intersection from the proposed ingress and egress.
❑ [32.5.2 n] Existing and proposed improvements.
la" The location and dimensions of all existing and proposed improvements including
'buildings (maximum footprint and height)and other structures;
Er walkways;
Er fences;
0' walls;
Cittrash containers;
Er-outdoor lighting;
Er-landscaped areas and open space;
ti recreational areas and facilities;
2r parking lots and other paved areas;
oading and service areas;
L3' signs;and
Gk.-the proposed paving material types for all walks, parking lots and driveways.
CV[32.5.2 of Areas to be dedicated or reserved.
Er-All areas intended to be dedicated or reserved for public use under sections 32.7.1.1, 32.7.1.2 and 32.7.1.3, and
Er shall include a note on the plan stating that the land is to be dedicated or reserved for public use.
'[32.5.2 p] Landscape plan.
d A landscape plan that complies with section 32.7.9,if it is required to be submitted with the initial site plan.
Cr[32.5.2 qJ Traffic generation figures.
Er If deemed appropriate by the agent due to the intensity of the development, estimated traffic generation figures for
the site based on current Virginia Department of Transportation rates;
Er indicate the estimated number of vehicles per day and the direction of travel for all connections from the site to a
public street.
�[3 .5.2 rJ Symbols and abbreviations.
a A legend showing all symbols and abbreviations used on the plan.
REVISED 06/10/2015 Page 3 of 4
• . County of Albemarle-Initial Site Plan Checklist
I([32.5.2 sJ Additional informatioi
Er The agent may require additional information to be shown on the initial site plan as deemed necessary to provide
sufficient information for the agent and the site review committee to adequately review the plan.
Grading Permit Requirements—If you will be looking to obtain a grading permit and the initial plan is approved and you
have satisfied the conditions of approval identified by the agent in the letter required by section 32.4.2.5(c) then a separate
Water Protection Ordinance Application for an Erosion and Sediment Control Plan must be submitted for review and
approval
In addition to the items required by the ordinance,Albemarle County Engineer, Groundwater Program Authority,
the Virginia Department of Transportation,the Albemarle County Service Authority, and the Thomas Jefferson
Health District require these items on plans submitted for initial approval. Plans will not be rejected if these items are
not present,but they are required for approval. These items are provided in an effort to communicate all initial
comments.
Er]. Reference the benchmarks used for surveys. (Albemarle County Engineering Policy)
12r2. Indicate the available sight distance for entrances and left turn lanes. (Albemarle County Engineering Policy)
0---3. Label the maximum height of all retaining walls. (Albemarle County Engineering Policy)
0'4. Provide copies of off-site easements, or letters of intent to grant them from off-site property owners. (Albemarle
County Engineering Policy)
Pr5. Show and label stream buffer limits. (WRPA Ordinance)
Cr6. Indicate the deed book and page reference for all existing utility easements located on the property. (Albemarle
County Service Authority)
Cr7. Tier 3 -Draft Groundwater Management Plan(17-403)
12(8. Tier 4—Aquifer testing work plan(17-403)
Read and Sign
In representing the above referenced firm submitting this plan for initial approval, I hereby sate that,to the best of my knowledge,the
attached pla ontains all information required by this checklist.
e-L t-17
Signature of Owner,Contract Purchaser,Agent Date
5caF 6u(4 1(37- 37i f
Print Name Daytime phone number of Signatory
REVISED 06/10/2015 Page 4 of 4
initial Site Plan
Checklist
Project Name: _' L , v-t c A -_' C i - ( L
Firm: Co tc Fvt4 .
This checklist must be completed,signed and submitted with the application. The information contained in this checklist
reflects the contents of the Section 32 of Chapter 18 of the Code of the County of Albemarle also known as the Site Plan
Ordinance as of January 1,2013. The applicant is responsible for insuring that no revisions to the Ordinance have
occurred since preparation of this document.
Plans which lack the information required by this checklist shall be deemed to be incomplete and shall be denied by the
agent with ten(10)calendar days after the applicable submittal deadline[Section 32.4.21.
An Initial Site Plan shall contain the following:
[32.5.1 a]Number of copies.
❑ Sixteen(16)clearly legible copies in blue or black ink of the plan shall be submitted.
Lie [32.5.2 Ib] Scale and size.
❑ The plan shall be prepared to the scale of one(1)inch equals twenty(20)feet or to another scale approved by the
agent in a particular case.No sheet shall exceed forty-two(42)inches by thirty-six(36)inches in size.
❑ The plan may be prepared on one(1)or more sheets. If prepared on more than one(1)sheet,match lines shall
clearly indicate where the several sheets join.
❑ The top of the sheet shall be approximately either north or east.
0' [32.5.1c]Dimensions.
❑ The plan shall be dimensioned to at least the following standards for accuracy:
O Boundary, setback and zoning Imes: One foot in one thousand(1:1,000)feet.
❑ Existing contours: One-half(1/2)of the contour interval required in section 32.5.2(d).
❑ Proposed contours: Within five(5)feet horizontally and vertically.
❑ Existing structures,utilities and other topographic features: Within five(5)feet.
❑ Proposed structures,roads,parking lots and other improvements: Within five(5)feet.
[32.5.2 a]General information.
❑ The name of the development;
❑ names of the owner,
O developer and individual who prepared the plan;
❑ tax map and parcel number;
❑ boundary dimensions;
❑ zoning district;
❑ descriptions of all proffers,special use permits and conditions thereof, special exceptions and conditions
thereof,variances and conditions thereof,application plans,codes of development and bonus factors applicable
to the site;
❑ magisterial district;
❑ county and state;
❑ north point;
❑ scale;one datum reference for elevation(where section 30.3,flood hazard overlay district,is involved,United
States Geological Survey vertical datum shall be shown and/or correlated to plan topography);
❑ the source of the topography;
❑ departing lot lines;
❑ minimum setback lines,yard and building separation requirements;
❑ the source of the survey;
❑ sheet number and total number of sheets; and
❑ the names of the owners,zoning district,tax map and parcel numbers and present uses of abutting parcels.
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville,VA 22902 Voice:(434)296-5832 Fax:(434)9724126
REVISED 06/10/2015 Page 1 of 4
Cox f Albemarle-Initial Site Plan Checklist
❑ [32.5.2 b]Information regarding the proposed use.
❑ Written schedules or data as necessary to demonstrate that the site can accommodate
00 the proposed uses,
❑ including proposed uses and maximum acreage occupied by each use;
❑ maximum number of dwelling units by type including the number of bedrooms for multifamily dwellings;
❑ gross residential density;
❑ square footage of recreational areas;
❑ the percentage and acreage of open space;
O❑ maximum square footage for commercial and industrial uses;
❑ maximum floor area ratio and lot coverage for industrial use;
❑ maximum height of all structures;
❑ schedule of parking including the maximum amount required and the amount provided;
❑ the maximum amount of impervious cover on the site; and
❑ if a landscape plan is required,the maximum amount of paved parking and other vehicular circulation
areas.
OD [32.5.2 c]Phase lines.
❑ If phasing is planned,phase lines and the proposed timing of development.
El [32.5.2 d]Topography and proposed grading.
❑ Existing topography(up to twenty[20]percent slope,maximum five [5] foot contours,over twenty[20]percent
slope,maximum ten[10] foot contours)for the entire site with sufficient offsite topography to describe prominent
and pertinent offsite features and physical characteristics,but in no case less than fifty(50)feet outside of the site
unless otherwise approved by the agent;
❑ proposed grading(maximum five [5] foot contours)supplemented where necessary by spot elevations;
❑ areas of the site where existing slopes are critical slopes.
E( [32.5.2 e]Landscape features.
❑ The existing landscape features as described in section 32.7.9.4(c).
C [32.5.2 fJ Watercourses and other bodies of water.
❑ The name and location of all watercourses and other bodies of water adjacent to or on the site;
Cl indicate whether the site is located within the watershed of a public water supply reservoir.
CY [32.5.2 g1 Onsite sewage system setback lines.
❑ The location of onsite sewage system setback lines from watercourses including intermittent streams and other
bodies of water.
Eta[32.5.2 hJ Floodplain and related information.
❑ The boundaries of the flood hazard overlay district,the base flood elevation on the site,the elevation of the lowest
floor,including any basement,and for any structures to be flood-proofed as required by section 30.3,the elevation
to which the structures will be flood-proofed.
01[32.5.21] Streets,easements and travelways.
❑ The existing and proposed streets,including
❑ proposed bike lanes,
❑ access easements,
❑ alley easements and rights-of-way,and travelways,
❑ together with street names,
❑ state route numbers,
❑ right-of-way lines and widths,
❑ centerline radii and pavement widths.
REVISED 06/10/2015 Page 2 of 4
C of Albemarle-Initial Site Plan Checklist
[32.5.2 jJ Existing sewer and drainage facilities.
❑ The location and size of
❑ existing water and sewer facilities and easements,
❑ the storm drainage system,
❑ drainage channels,and
❑ drainage easements.
1[32.5.2 Ic]Proposed sewer and drainage facilities.
❑ The proposed conceptual layout for
❑ water and sewer facilities and
❑ the storm drainage system,indicating the direction of flow in all pipes and watercourses with arrows.
E([32.5.2 lJ Existing and proposed utilities.
❑ The location of other existing and proposed utilities and utility easements,
❑ including existing telephone,
❑ cable,
❑ electric and
❑ gas easements.
"[32.5.2 in]Ingress and egress.
❑ The location of existing and proposed ingress to and egress from the property,
�/❑ Show the distance to the centerline of the nearest existing street intersection from the proposed ingress and egress.
6d [32.5.2 n]Existing and proposed improvements.
❑ The location and dimensions of all existing and proposed improvements including
O buildings(maximum footprint and height)and other structures;
❑ walkways;
❑ fences;
❑ walls;
❑ trash containers;
❑ outdoor lighting;
❑ landscaped areas and open space;
❑ recreational areas and facilities;
❑ parking lots and other paved areas;
❑ loading and service areas;
❑ signs;and
O the proposed paving material types for all walks,parking lots and driveways.
E1 [32.5.2 of Areas to be dedicated or reserved.
O All areas intended to be dedicated or reserved for public use under sections 32.7.1.1,32.7.1.2 and 32.7.1.3,and
1 O shall include a note on the plan stating that the land is to be dedicated or reserved for public use.
i f [32.5.2 p]Landscape plan.
❑ A landscape plan that complies with section 32.7.9,if it is required to be submitted with the initial site plan.
E/[32.5.2 qJ Traffic generation figures.
❑ If deemed appropriate by the agent due to the intensity of the development,estimated traffic generation figures for
the site based on current Virginia Department of Transportation rates;
❑ indicate the estimated number of vehicles per day and the direction of travel for all connections from the site to a
public street.
PJ/[32.5.2 rJ Symbols and abbreviations.
❑ A legend showing all symbols and abbreviations used on the plan.
REVISED 06/10/2015 Page 3 of 4
Cot f Albemarle-Initial Site Plan Checklist
❑ [32.5.2 s]Additional information.
❑ The agent may require additional information to be shown on the initial site plan as deemed necessary to provide
sufficient information for the agent and the site review committee to adequately review the plan.
Grading Permit Requirements—If you will be looking to obtain a grading permit and the initial plan is approved and you
have satisfied the conditions of approval identified by the agent in the letter required by section 32.4.2.5(c)then a separate
Water Protection Ordinance Application for an Erosion and Sediment Control Plan must be submitted for review and
approval
In addition to the items required the ordinance,Albemarle County Engineer,Groundwater Program Authority,
the Virginia Department of Transportation,the Albemarle County Service Authority,and the Thomas Jefferson
Health District require these items on plans submitted for initial approval. Plans will not be rejected if these items are
not present,but they are required for approval. These items are provided in an effort to communicate all initial
comments.
❑ 1. Reference the benchmarks used for surveys. (Albemarle County Engineering Policy)
❑ 2. Indicate the available sight distance for entrances and left turn lanes. (Albemarle County Engineering Policy)
❑ 3. Label the maximum height of all retaining walls. (Albemarle County Engineering Policy)
❑ 4.Provide copies of off-site easements,or letters of intent to grant them from off-site property owners. (Albemarle
County Engineering Policy)
❑ 5. Show and label stream buffer limits. (WRPA Ordinance)
❑ 6. Indicate the deed book and page reference for all existing utility easements located on the property. (Albemarle
County Service Authority)
❑ 7.Tier 3 -Draft Groundwater Management Plan (17-403)
❑ 8. Tier 4—Aquifer testing work plan (17-403)
Read and Sign
In representing the above referenced firm submitting this plan for initial approval,I hereby sate that,to the best of my knowledge,the
attached plat contains all information required by this checklist.
Signature of Owner,Contract Purchaser,Agent Date
Print Name Daytime phone number of Signatory
REVISED 06/10/2015 Page 4 of 4