HomeMy WebLinkAboutSUB201300176 Application 2013-12-03 d� ,y Albemarle Community Development Department
401 1litire Road Charlottesville,VA 22902-4596
Planning Application :(434)296-5832 Fax:(434)972-4126
PARCEL/ OWNER INFORMATION
TMP 07800-00-00-020F1 Owner(s): STATE FARM MUTUAL AUTOMOBILE INSURANCE
Application # SUB201300176 COMPANY
PROPERTY INFORMATION
Legal Description ACREAGE PARCEL X
Magisterial Dist. Rivanna Land Use Primary Open
Current AFD Not in A/F District Current Zoning Primary Commercial Office
APPLICATION INFORMATION
Street Address Entered By
Application Type Subdivision Plat Todd Shifflett
12/03/2013
Project (State Farm &South Pantops Drive Sidewalk- B
Received Date 11/21/13 Received Date Final Submittal Date 12/16/13 Total Fees
Closing File Date Submittal Date Final Total Paid
Revision Number
Comments
Legal Ad
SUB APPLICATION(s)
Type I Sub Applicati ( Comment
Easemen t Flat..lat :
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'APPLICANT/ CONTACT INFORMATION
ContactType J Name I Address I CityState I Zip Phone PhoneCell I
tlwner�Appl,{Cant': STATE;FARM:MUTUAL AUTOMOBILE FNS ONE STATE FARM BLVD ;BLOOMINGTON I X61
Primary Contact FRANK POHL OFD
Signature of Contractor or Authorized Agent Date
Application for Review of - 421-,.
Boundary Line ' djustment & EasemePlats � ' t
El Boundary Line Adjustment= $95 151 Easement= NA
(3 folded copies of plat) (3 folded copies of plat)
❑ Groundwater Assessment
(Required if a less than 21 acre lot is created from a 21 acre or greater lot)
$250 + $25 per new lot of less than 21 acre =
Project Name: STATE FARM BOULEVARD AND SOUTH PANTOPS DRIVE SIDEWALK PROJECT
Tax map and parcel: 07800-00-00-020F1, 66, 68, 69, 70Magisterial District: RIVANNA
Zoning:C-OFFICE
Physical Street Address(if assigned): NONE ASSIGNED
Location of property(landmarks,intersections,or other): PROPERTIES FRONT ON STATE FARM BLVD OFF OF
SR 250. PARCEL 20F1 FRONTS SOUTH PANTOPS DR.
Contact Person(Who should we call/write concerning this project?): FRANK POHL, SR. PROJECT ENGINEER
Address OFFICE OF FACILITIES —Ity State Zip
Daytime Phone( ) EXT. 7914 Fax#( ) E-mail fpohl @albemarle.org
Owner of Record STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
Address ONE STATE FARM PLAZA City BLOOMINGTON State IL Zip 61701
Daytime Phone( ) Fax#( ) E-mail
Applicant(Who is the Contact person representing?): COUNTY OF ALBEMARLE
Address OFFICE OF FACILITIES DEVELOPMEI@'ty State Zip
Daytime Phone( ) EXT. 7914 Fax#( ) E-mail fpohl @albemarle.org
Owner/Applicant Must Read and Sign
The plat application process includes providing all the information required in Chapter 14 Subdivision of Land of
the Albemarle County Code.
The foregoing information is complete and correct to the best of my knowledge. I have read and understand the
provisi s of Chapter 14 Su ivision of Land of the Albemarle County Code.
' r,
Sig ture of Owner, Contract Purchaser, Agent Date / ( /7- ///-3
FRANK POHL, SR. PROJECT ENGINEER EXT. 7914
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY SUB#
Fee Amount$ 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) 972-4126
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