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HomeMy WebLinkAboutSDP201500054 Application 2015-10-26Albemarle County . Planning Application Community Development [department 4CI Mcl nti re Ro ad Ch arl ottesv i I I e. VA 229D2-4596 Voice : (434) 296 -5932 Fax : (434),972-4126 TMP 03200 -00 -00 -01000 owner(,): CHARLOTTE SVILLE-ALB EMARLE AIRPORT AUTHORITY Application # ,,�' DP 1 JrQ'005 PROPERTY INFORMATION Legal description ACREAGE CH'VILLE /ALREMARLEAIRPORT Magisterial Dist. Lhite Hall F-1 Land Use Primary Commercial Current AFD Not in Af F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address I15 AVIATION DR CHARLOTTESVILLE, 22911 I Entered By Type Site Development Plans anirelle Rath ElApplication I10;25/2015 Project Landmark Aviation Hanger - Major Received Date Closing File Date Revision Number 10 f 26 f 15 Received Date Final Submittal Date 10 {26 {15 Submittal Date Final Total Fees 1734.8 Total Paid 1500 Comments Legal .Ad PROJECT: SDP2Di5DDD54 Landmark Aviation Hangar - Major Site Plan Amendment (Electronic Plan Review) MAGISTERIAL DISTRICT: White Hall TAIL MAR /PARCEL: 032DO -00-00-0IDDD LOCATION: At the intersection of Airport Road [649] and Dickerson Road [GD6], approximately .75 miles from the intersection with Seminole Trail [Route 29]. PROPOSAL: Request for approval of a major site plan amendment to add an 18,00D SF hangar at Charlottesville Alb►entarle Airport. The proposal includes associated utility relocations /extensions, grading and erosion control. J ZONING: RA -Rural Areas -agricultural, forestal, and fishery uses; residential density (0.5 unit /acre in development lots). ENTRANCE CORRIDOR: Yes ISUB APPLICATION Type Sub APPI icatio Comment Manor Amendment :10/26/15 ........................................................................................................................................:.......................................:.......................................................................................................................................................................... ............................... APPLICANT / CONTACT INFORMATION CofttactType Name ,&dress City State Zip Ph-DW I PhoneCell ApFriant LANDMARK AVIATION - LOUIS 1500 CiT WEST BOULEVARD, HOUSTON, TX 77042 7133000766 ............ ............................... a.......................................................................... ............................... a............................................... ............................... a............... ............................... a.............................:..................................:. ............................... 4hxre:p'Applkant CHARLOTTESVILLE- ALBEMARLE AIRPORT :201 BOWEN LOOP CHARLOTTESVILL :22911 ............ ............................... _ ......................................................................................................... _ .............................................................................. _ .............................................. _ ............................. :.................................. :.................................. Primiary C. =_nta:t KENT O'DONAHUE 1551 COMMERCE ROADr SUITE VERONAr VA :24482 5402483220 Signature of Contractor or Authorized Agent Date B AND ASSOCIATES INC REFLECTING TOMORROW TO County of Albemarle - Planning and Comm. Dev. 401 McIntire Road Charlottesville, VA 22902 LETTER OF TRANSMITTAL DATE 10-26-2015 JOB No. 34150042 ATTENTION Ellie Ray RE Landmark Aviation Hanger - Major Amendment VIA ❑ U.S. Mail ❑ U.P.S. ❑ Airborne Express ❑ Fed. Express os** Hand Delivered ❑ Picked Up ® Other F� WE ARE SENDING YOU ® Attached ❑ Under separate cover via ❑ Shop drawings ® Prints ® Plans ❑ Copy of letter ❑ Change order ❑ ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION 16 10/26/15 ® For review and comment 24x36 Plan Set - 4 Sheets 1 10/26/15 11 x17 Plan Set - 4 Sheets 1 10/26/15 Application for Major Site Plan Ammendment Application 1 10/26/15 Initial Site Plan Checklist 1 10/26/15 Final Site Development Plan Checklist THESE ARE TRANSMITTED as checked below ® For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ® For review and comment ❑ REMARKS 091WAIIIINS SIGNED: PLANNERS • ARCHITECTS • ENGINEERS • SURVEYORS ROANOKE • RICHMOND • NEW RIVER VALLEY • SHENANDOAH VALLEY 1561 Commerce Road • Suite 401 • Verona, Virginia 24482 • (540) 248 -3220 • FAX (540) 248 -3221 Application for��' m Major or Minor Site Plan Amendments Existing Site Plan Name & Number: l� CharI ots y:k -lit bPl wt - /t,�,00�� Tax map and parcel(s): Par+ bT n3260 - 60 -60 - 61 DOD Zoning: r �M At( S Z ri✓ Z ATA Contact (who should we contact about this project): B// A-Ler- "t ssoc-,`c�,1�.c . Street Address ��(�� �7Mmeae goo''( ror— 14"14- 06rlotirc e. City Uect'(1'2�- State V /'t Phone Number 3a.1 p Zip Code a �lyga Email 6c121s. CG Tier 3 Groundwater Review= $510 If NO and the new plans show a use using greater than 2,000 gallons /day (average) Owner of Record Chc& ers t,,'k ] em alle- A t'r,00 r l / 0- Z r, `- U Street Address �� �OI J �{� L OO,O Tier 4 minus Tier 3 = $590 If YES and the use does not change from using less than to more than 2,000 gallons /day (average) City V)O'd-0 ->PS tg.'rlQ. State UA Phone Number Zip Code 9// Email No fee Applicant &XnGr /'1 cy is / y, tit, a n - Lola `c 9rc\,dA Pr'cA Street Address 1 0 0 C.'4j40 g-&-t- gone _u,,j J , S C -4e. 626c) City 90 (As State %X Phone Number 713) 3 00 - 07&(, Zip Code %7U142 Email / rC1146Gr/'yi IN 10✓te(Meyk 60tvi FEES Rf Major Amendment ❑ Minor Amendment (alterations to parldng, circulation, building = $1500 size, location) = $500 16 folded copies of Inn are required 8 folded copies ofplan are required Notices required by Section 32.4.2.1 (f) Preparing and mailing or delivering up to fifty (50) notices = $200.00 plus the actual cost of first class postage. Preparing and mailing or delivering, per notice more than fifty (50) = $1.00 plus the actual cost of first class postage. GROUNDWATER ASSESSMENT (Required for all non-residential site plans iiol serviced by public wales) Was a Groundwater Assessment conducted for the existing site plan? ❑ YES ❑ NO If NO and the new plans show it use using less than 2,000 gallons /day (average) ❑ Tier 3 Groundwater Review= $510 If NO and the new plans show a use using greater than 2,000 gallons /day (average) ❑ Tier 4 Groundwater Review = $1,100 If YES and the use goes from using less than to more than 2,000 gallons /day (average) ❑ Tier 4 minus Tier 3 = $590 If YES and the use does not change from using less than to more than 2,000 gallons /day (average) ❑ No fee 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 oft Co in ments /Attachments: Owner /Applicant Must Read and Sign M/Maior Atendment This major amendment as submitted contains all of the information required by Section 32.5 (Initial Site Plan) and Section 32.6 (Final Site Plan) of the Albemarle County Zoning Ordinance. 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 as the case may be. ❑ Minor Amendment This minor amendment as submitted contains all of the information required by Section 32.5 (Initial Site Plan) and Section 32.6 (Final Site Plan) of the Albemarle County Zoning Ordinance. I hereby certify that the information provided on this application and accompanying information is accurate, true, and correct to the best of my knowledge. 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. 1nA/ G Signa­U4 of Owner, Conh•act Purchaser, Agent Date �c�u rs i �16er��e (713) Soo - 0-7 Print Name Daytime phone number of Signatory FOR OFFICE USE ONLY SDP # Fee Amount S Date Paid By who? Receipt # Ck# 113': REVISED 06/10/2015 Page 2 of 2 Project Name: MUR'2I1 Mte Nan Lo ,dmar Checklist Firm • &J-7-0- -t- S r Inc . 4 %ii � /RGINIP 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. E [325.21b] Scale and size. 30 D The plan shall be prepared to the scale of one (1) inch equals twenty 2 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. ko 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. Z[3 Z.5.1 c] Dimensions. plan shall be dimensioned to at least the following standards for accuracy: Th Boundary, setback and zoning lines: 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. f� Proposed structures, roads, parking lots and other improvements: Within five (5) feet. U/ [32.5.2 ] General information. t The name of the development; names of the owner, L] developer and individual who prepared the plan; C( 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; /�jcounty and state; D or point; 0" 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) 972 -4126 REVISED 06/10/2015 Page 1 of 4 County of Albemarle - Initial Site Plan Checklist 432.5.2 bJ Information regarding the proposed use. Written schedules or data as necessary to demonstrate that the site can accommodate 0� 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; JUVI gross residential density; square footage of recreational areas; the percentage and acreage of open space; maximum square footage for commercial and industrial uses; j maximum floor area ratio and lot coverage for industrial use; GY maximum height of all structures; A 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. f32.5.2 cJ Phase lines. If phasing is planned, phase lines and the proposed timing of development. �[3 5.2 dJ 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; *j proposed grading (maximum five [5] foot contours) supplemented where necessary by spot elevations; 0 areas of the site where existing slopes are critical slopes. [32.5.2 e] Landscape features. Cr The existing landscape features as described in section 32.7.9.4(c). [A2.5.2 j] Watercourses and other bodies of water. The name and location of all watercourses and other bodies of water adjacent to or on the site; PO indicate whether the site is located within the watershed of a public water supply reservoir. [32.5.2 gJ Onsite sewage system setback lines. The location of onsite sewage system setback lines from watercourses including intermittent streams and other bodies of water. [32.5.2 h] 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. ✓ / [3;. 5.2 iJ Streets, easements and travelways. The existing and proposed streets, including proposed bike lanes, access easements, alley easements and rights -of -way, and travelways, L� ogether with street names, L� tate 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 t� [32.5.2j] Existing sewer and drainage facilities. G� Th location and size of ��dramage existing water and sewer facilities and easements, he storm drainage system, channels, and 1 4F drainage easements. el WTh 5.2 k] Proposed sewer and drainage facilities. proposed conceptual layout for / water and sewer facilities and lJ the storm drainage system, indicating the direction of flow in all pipes and watercourses with arrows. [37.5.21] Existing and proposed utilities. p' The location of other existing and proposed utilities and utility easements, Wr including existing telephone, cable, Ci electric and gas easements. [ 2.5.2 m] 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. @([3 5.2 n] Existing and proposed improvements. 21The location and dimensions of all existing and proposed improvements including buildings (maximum footprint and height) and other structures; 0/ walkways; fences; V walls; trash containers; outdoor lighting; landscaped areas and open space; recreational areas and facilities; NW parking lots and other paved areas; loading and service areas; — /signs; and L� the proposed paving material types for all walks, parking lots and driveways. A• [32.5.2 o] Areas to be dedicated or reserved. 3 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 shall include a note on the plan stating that the land is to be dedicated or reserved for public use. s [32.5.2p] Landscape plan. N&ff: thwe e's !ou(sc�o•4� �orwv�`o�tcr 4 54jM �ow�►cscS, A landscape plan that complies with section 32.7.9, if it is required to be submitted with the initial site plan. [32.5.2 q] Traffic generation figures. t 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; PWJindicate the estimated number of vehicles per day and the direction of travel for all connections from the site to a public street. 011'f32.5.2 r] Symbols and abbreviations. 61� 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 [32.5 .2 sJ 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 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. 0/1. 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) R4. Provide copies of off -site easements, or letters of intent to grant them from off -site property owners. (Albemarle County Engineering Policy) 0 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) Reid 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 co tains all_nf formation required by this checklist. co T - Signature of Owner, Contract Purchaser, Agent Date 0 611 _ . LA l'�yo) o2VT —.S12.20 Print Name Daytime phone number of Signatory REVISED 06/10/2015 Page 4 of 4 a Final Site Development Plan�1� Checklist Project Name: L u n &V-k Firm :_ -r ftSSoL,`r_C �n� 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 ofAlbemarle 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. This final site Dian has: an initial site plan that was approved for the development and it remains valid; SDP - 20 - satisfied all of the requirements of section 32.6 below; and satisfied all of the conditions delineated in the letter provided under section 32.4.2.5(c) required to be satisfied prior to �f submitting the final site plan. J Author ed preparer. The plap, and any amendments to a plan, is prepared and sealed, signed and dated by one of the following An architect licensed to practice in the Commonwealth of Virginia. • professional engineer licensed to practice in the Commonwealth of Virginia. • land surveyor licensed to practice in the Commonwealth of Virginia. A certified landscape architect licensed to practice in the Commonwealth of Virginia. ❑ Number of copies when first submitted. 0 Provide the number of copies as directed in the Initial Site Plan approval letter ❑ One (1) reduced copy of the plan no larger than eleven (11) by seventeen (17) inches in size. 21 Scale ^a}d size. ld The plan is prepared to the scale of one (1) inch equals twenty (20) feet or larger, or to another scale approved by the agent i a particular case. U/ No Other scale approved - one (1) inch equals 31) (� feet, by LEI No sheet exceeds forty -two (42) inches by thirty-six (36) inches in size. L, The plan IS prepared on one (1) sheet. OR The plan IS prepared on more than one (1) sheet and match lines clearly indicate where the several sheets join. L� The top o each sheet is approximately North or East ❑ Dimensions. The plan is dimensioned to at least the following standards for accuracy: 0 J Boundary, setback and zoning lines: Within one one - hundredth (0.01) of a foot. ® Existing contours: Within one -half (1/2) of the contour interval required in section 32.6.2(c). Proposed contours: Within one (1) foot horizontally and vertically. U Spot elevations: Within one -tenth (0.10) of a foot. Existing critical structures including utilities and other topographic features: Within two (2) feet, provided that for critical structures, which include, but are not limited to, gas lines, other utilities, pipes, conduits, walls and buildings to be preserved, within one -tenth (0.10) of a foot. Proposed structures, roads, parking lots and other improvements: Within one one - hundredth (0.01) of a foot. REVISED 06/10/2015 Page 1 of 4 Site Plan Ordinance Section 32.6 - Contents of final site plan Albemarle County - Final Site Plan Checklist c In addition to containing all of the information required to be on an initial site plan, as provided in section 32.5, a final site plan shall contain the following: Gd Demonstrate compliance with chapter. Specific written schedules or notes as necessary to demonstrate that the requirements of this chapter are satisfied. 0 1' Propos d grading. Proposed grading (up to twenty [20] percent slope, maximum two [2] foot contours; over twenty [20] percent slope, maximum five [5] foot contours). Water d sewer facilities. (Detailed plans for proposed water and sewer facilities, including all pipe sizes, types and grades; proposed connections to existing or proposed central water supplies and central sewage systems; location and dimensions of proposed easements and whether they are to be publicly or privately maintained; profiles and cross sections of all water and sewer lines including clearance where lines cross; A all water main locations and sizes; valves and fire hydrant locations; all sewer appurtenances by type and number; the station on the plan to conform to the station shown on the profile and indicate the top and invert elevation of each structure. © Draina e and grading plans. Detailed construction drainage and grading plans: Profiles of all ditches and channels whether proposed or existing, showing existing and proposed grades, and invert of ditches, cross pipes or utilities; typical channel cross sections for new construction; and actual cross sections for existing channels intended to remain; Profiles of all storm sewer systems showing existing and proposed grades; C� Plan view of all drainage systems with all structures, pipes and channels numbered or lettered on the plan and profile views. Show sufficient dimensions and bench marks to allow field stake out of all proposed work from the boundary lines; Reef Lca�.trs A drainage summary table for culverts, storm sewer and channels as described in the following example: Structure Description Length Invert Invert Slope Remarks Number In Out 1 42" RCP 50' 24.50 424.00 100.00% Provide Class III 2, EW 2 DI- 3B L =8 26.00 432.00 - IS -1 To 3 PG -2A 400' 420.00 400.00 5.00% D =12" 4 Grade 200' 420.00 415.00 2.50% D =18" Swale legend showing all symbols and abbreviations used on the plan; C�7 General notes, typical sections, and details of all items not covered by Virginia Department of Transportation standard drawings; and Flood plain limits for the one hundred (100) year storm for all watercourses with an upstream drainage area of fifty (50) acres or more provided that the county engineer may waive this requirement for drainage areas of less than one hundred (100) acres upon determining that the information is unnecessary for review of the proposed development. REVISED 06/10/2015 Page 2 of 4 Albemarle County - Final Site Plan Checklist Street sections. Typical street sections together with specific street sections where street cut or fill is five (5) feet or greater; centerline curve data; radius of curb returns or edge of pavement; location, type and size of proposed ingress to and egress from the site together with culvert size; symmetrical transition of pavement at intersection with existing street; the edge of street surface or face of curb for full length of proposed street; when proposed streets intersect with or adjoin existing streets or travelways, both edges of existing pavement or travelway together with curb and gutter indicated for a minimum of one hundred (100) feet or the length of connection, whichever is the greater distance. Public facilities and utilities. All public facilities, utility and drainage easements outside the right -of -way of public streets, provided that new easements may be generally shown and accurately dedicated by separate plat. All water and sewer facilities to be dedicated to public use and the easements for those facilities and shall be identified by a statement that the facilities are to be dedicated to the Albemarle County Service Authority. LA/ Signa re panel. Signature panel for signature by each member of the site review committee. Parking and loading areas. A For all arking and loading areas, indicate the size, angle of stalls, width of aisles and specific number of spaces required and provided, and method of computation. Indicate type of surfacing for all paved or gravel areas. Ef Landscape plan. t` A landscape plan that complies with section 32.7.9 G a QlM nwi Outdoor lighting. Outdoor lighting information including a photometric plan with JWT location, description, and photograph or diagram of each type of outdoor luminaire. Recre tional facilities. Specifications for recreational facilities. In addition to the items required by the ordinance, Albemarle County Engineer, the Virginia Department of Transportation, the Albemarle County Service Authority, and the Thomas Jefferson Health District require these items on plans submitted for final site plan 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 final site plan comments. fJ 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) REVISED 06/10/2015 Page 3 of 4 Albemarle County - Final Site Plan Checklist 5. Show and label stream buffer limits. (Water Protection Ordinance, WPO) 'RP 6. Indicate the deed book and page reference for all existing utility easements located on the property. (Albemarle County Service Authority) J 7. Tier 3 - Draft or Final Groundwater Management Plan (WPO Section 17 -403) 8. Tier 4 — Aquifer testing work plan (WPO Section 17 -403) Read and Sign In representing the above referenced firm submitting this plan for final approval, I hereby sate that, to the best of my knowledge, the attached plan contains zjj4 information required by this checklist. -/- 10-3 -o2b�� Signature of Owner, Contract Purchaser, Agent Date Il �ajnolCt - T_ Sy0-;2yf -3a20 Print Name Daytime phone number of Signatory REVISED 06/10/2015 Page 4 of 4