HomeMy WebLinkAboutSDP201000060 Application Letter of Revision 1 2010-12-14Application for
Letter of Revision
❑ Letter of Revision = $95
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Final Site Plan Name and Number: L �./� /�" �7n� /%�y�,�r, �j/ Jy g 9L-
Contact Person (Who should we call /write concerning this project ?): 6.�'eo l/ &�
Address 'z-'i7 L'�tOx o"96 S Z City State � _ Zip 14 a
Daytime Phone" 6441— %S;Z9 Fax # E- mail�ahctk ,iE,6,%ryfL��'Trir�,.?
Owner of Record L G/r?.C.. ST . ✓A D.:�s Ti �Z)
Address �O. ,�>l< 02,�6,g7 city ��Z�i /G�y.atf� State Zip
Daytime Phone" b j-O y Fax # C � �/ �j�3Q E -mail
Applicant (Who is the Contact person representing ?): �
Address* , /3yA 96?, 2- City _ Ct/ G�'�/ /�_ State !.!�" Zip 4;2
Daytime Phone 6Y�_ �S Fax #
� �c/' 5213C> E -mail
SUBMITTAL REQUIREMENTS:
❑ 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 must be shown on the sheet or sheets from the approved final site plan, 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
my knowledge and belief
Si a ure ' Owner,' ent
Date'
Print Name aytime phone number of Sienatory
FOR OFFICI US ONLY LOR #
5 Fee Amount $ Date PaiddI "1 /o By who? lot , S UL J Ulpe eipt # � /Z5 Ck# iD � By: f +aC
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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