HomeMy WebLinkAboutSDP201000083 Application Letter of Revision 1 2011-07-25"Application for
Letter of Revision
[J Letter of Revision = $100
Final Site Plan Name and Number:
yti `t
G
N
Contact Person (Who should we call /write concerning this project ?): N — r ' IYOWix K
Address s S5 r�sr City IN /n/N/1'1' j State 0!q Zip s"Za
Daytime P ne � Fax # Jl r.71 -500$ E-mail Q/ ��jQyYtit�'i/ Y�'lc YI�Cpvy�
Owner of Record LCOLLO A kri AL
Address AG G F! , I Y {,4 N 5tea'7- _ City S 19M State _ Zip Z9153
Daytime Phone (5AQj �%[/T 4 (J%l� Fax # L_) E -mail _J�NW%*,J 1 11Ah0AA] - e /tv8
Applicant (Who is the Contact person representing ?): aNb'fR.11CJr1ph.irLLC
Address J� �iS' CitYJ J� �'J 1 State Zip J
Daytime Phone ( ) Z'57q �! Fax # ) 5� S(�og E -mail •fjil��p(,� - V 9f
SUBMITTAL REQUIREMENTS:
VThe appropriate fee,
E/ The site plan number that the change applies to,
N/ A request letter describing the proposed changes from the owner or authorized agent,
V 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 "X 17" 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
st of my In and belief.
_3�FL
Signature of caner, Agent Date
�,EFFlZEt lM •` ���c„ 513 SYZ -Syq
Print Name Daytime phone number of Sienatory
FOR OFFICE USE ONLY LOR #
Fee Amount $ 100 m Date Paid By who? NA141`1 ► (+IM Receipt 4' 7370 _) Ck #"I q 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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