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SDP200900040 Application 2009-05-11
t.5 Community Development DepartmentCountyof ,emarle 401 Mcre Road Charlottesville, VA 22902 -4596 ti Voice : (434) 296 -5832 Fax : (434) 972 -4126 Planning Application 1 PARCEL / OWNER INFORMATION TMP 07800-00-00-020M0 Owner(s): MJH FOUNDATION Application # SDP200900040 PROPERTY INFORMATION Legal Description ACREAGE 11 PETER JEFFERSON PLACE Magisterial Dist. Rivanna Land Use Primary Open Current AFD Not in A/F District Current Zoning Primary Planned Development Mixed Commercial APPLICATION INFORMATION House #Street Name Apt / Suite City State Zip Street Address L Entered By: Lisa Jordan on 05/11/2009 Application Type [te Development Plans Project: Martha Jefferson Hospital (Right Turn Lane) -Major 6,645.00 Received Date 05/11/2009 Received Date Final Total Fees $ 270.00 Submittal Date 05/11/2009 Submittal Date Final Total Paid $ 270.00 Closing File Date Revision Number Comments: Legal Ad r SUB APPLICATION(S) Type Sub Application Date Comments: Major Amendment 05/11/2009 APPLICANT / CONTACT INFORMATION Primary Contact Name Rummel, Klepper & Kahl, LLP Phone # (804) 782 -1903 Street Address 801 E Main Street Suite 1000 Fax # 804) 782 -2142 City / State Richmond VA Zip Code 22905 -0000 E -mail rmckinney @rkk.com Cellular # ( ) f Owner/Applicant Name MJH FOUNDATION Phone # (434) 982 -7303 Street Address 459 LOCUST AVE Fax # 434) 982 -7324 City / State CHARLOTTESVILLE VA Zip Code 22902 - E -mail ronald.cottrell @mjh.org J Cellular # ( ) Signature of Contractor or Authorized Agent Date J c-1 Application for ]`ijor & Minor Site Plan . ' nendments and All Reinstatements of Denied or Deferred Site Plans XMajor Amendment (Subject to Planning Commission Review) = $270 Minor Amendment (alterations to parking, circulation, 17 folded copies ofplan are required building size, location) = $95 8 folded copies of sketch plan are required Reinstate Plan Review After 10 day Denial = $200 Reinstate Plan After Site Review Denial or Suspension = 565 Reinstate Plan Deferred by Applicant To a specific date = $35 Indefinitely = $75 17 folded copies ofplan are required Groundwater Assessment (Required for all non - residential site plans not serviced by public water) Was a Groundwater Assessment conducted for the existing site plan? YES NO 2, g Tier 3 Groundwater Review = $400 I A If If NO NO and and the the new new plans plans show show a a use use greater less than than 000 2 allons gallons per per day day Tier 4 Groundwater Review = $1,000 If YES and the use goes from less than to more than 2,000 gallons per day Tier 4 — Tier 3 = $400 If YES and the use does not change from Tess than to more than 2,000 gallons per day No fee Relief from conditions of approval from Planning Commission or landscape waiver by agent = $180 Extension of approval prior to expiration of an approved plan = $45 Rehearing of Site Development Plan by the Planning Commission or Board of Supervisors = $190 Appeal of Site Development Plan to the Board of Supervisors = $240 Project Name: P JL \F fVe_S-L,A Tax map and parcel: C ' RC,a(tMagisterial District: (___ ____ A Zoning: t k I.K.L' Physical Street Address (if assigned): tl PE V re_ Location of property (landmarks, intersections, or other): i' 4 Pl' \F C' 1 1 l_cf s 1 rp APPNm\A J4_ 14ex - 31 o 1A UN5ET.X 1c cA=PA(,.- ,L e Z Sr C(.l,C W4s Contact Person (Who should we call/write concerning this project ?): fl f t lope_ . 11.3 Address E 4Th 1 F N..\ \)`k FJ \ . L t? I JCOCity ( _ C_1aA`(_ State Nt }s Zip Daytime Phone ( 1 `1 ) jC) Fax # (eli1) ` J._ 4.M 4-, E -mail rte' 1C\ s f C c m Owner of Record Jam F REA\ \W Address t---1 City [ N Zip S, 4j'Daytime Phone (4.Y4 9 F'3C a Fax # ( Cj N. 7 3 E -mail C tu V`.:st, , , cc tV_S ri \ t`c Applicant (Who is the Contact person representing ?): Address City State Zip Daytime Phone ( Fax # ( E -mail FOR OFFICE USE ONLY SDP # Fee Amount $Date Paid ' ) / I c' By who? t)) / lie' ! / ') Receipt # f 'Ck# / J '; By: County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 1(//19/07 Page 1 of 2 intended use or justification r ' request: FWE i. X J ANA t. C N Ir-S A i 3.1.ti. 1 'L 1 ice. F arc P rti\ —a V Yt tic.Kc' ©*., N t1 1 C c ONAC -s -V Owner /Applicant Must Read and Sign This site plan as submitted contains all of the information required by Section 32.5 (Preliminary Plan) or Section 32.6 (Final 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 32.4.3.3 as the case may be. For Final Plans Only: To the best of my knowledge, 1 have complied with Section 32.4.3.1 and obtained tentative approvals for all applicable conditions from the appropriate agencies. Sig ture of Owner, Contr ct Pur a' -r, Agent Date A/74 C l Al,&s J C.0t-4 Print Name Daytime phone number of Signatory 11//19/07 Page 2 of 2