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Home My WebLink AboutSDP200800088 Application 2008-05-28y ue +rig Cc dnity Development Department, Zoning &County of ,bemarle Current Development Division 401 McIntire Road Charlottesville, VA 22902 -4596 Planning Application 1 Voice : ( 434) 296 -5832 Fax : ( 434) 972 -4126 OWNER INFORMATIO TMP ' 07800 -00- 00-07100 Owner(s):: MIH FOUNDATION Application #_ SDP200800088 Legal Description JACREAGE Magisterial Dist. I Rivanna Land Use PrimarylOffice Current AFD INot in A/ F District I Current Zoning Primary I Planned Development Mi Commercial J APPLICATION • • House # Street Name Apt / Suite City State Zip Street Address 1575 STATE FARM BLVD CHARLOTTESVILLE 22911- 1 Entered By: Lisa Jordan on 0512812008 Application Type Site Development Plans Project: Martha Jefferson Hospital - Minor 5,941.00 Received Date 05/28/2008 Received Date Final Total Fees Submittal Date 06/09/2008 Submittal Date Final Total Paid Closing File Date Revision Number Comments: 5 large rolled plans submitted with this application and SDP200800089 Legal Ad SUB • Type Sub Application Date Comments: Minor Amendment 05/28/2008 CONTACTAPPLICANT / • • Primary Contact Name Rimmel, Klepper & Kahl LLP Phone # (804) 782 -1903 Street Address 801 East Main Street Suite 1000 Fax # (804) 782 -2142 Zip Code 23219 -0000City / State Richmond VA p E -mail mmills @rkkengineers.com Cellular # Phone # (434) 982 -7303 Fax # (434) 982 -7324 Zip Code 22902 - Cellular # Phone # (434) 982 -7303 Fax # (434) 982 -7324 Zip Code 22905 -0000 Cellular # ( ) - Signature of Contractor or Authorized Agent Date Owner /Applicant Name MJH FOUNDATION Street Address 459 LOCUST AVE City / State CHARLOTTESVILLE VA E -mail ronaid.cottrell @mjh.org Phone # (434) 982 -7303 Fax # (434) 982 -7324 Zip Code 22902 - Cellular # Phone # (434) 982 -7303 Fax # (434) 982 -7324 Zip Code 22905 -0000 Cellular # ( ) - Signature of Contractor or Authorized Agent Date Applicant Name Martha Jefferson Health Services Corp Street Address 459 Locust Ave City / State Charlottesville Va E -mail ronald.cottrell @mjh.org Phone # (434) 982 -7303 Fax # (434) 982 -7324 Zip Code 22902 - Cellular # Phone # (434) 982 -7303 Fax # (434) 982 -7324 Zip Code 22905 -0000 Cellular # ( ) - Signature of Contractor or Authorized Agent Date Application foi,vlajor & Minor Site P1a Amendments and All Reinstatements of Denied or Deferred Site Plans ; Major Amendment (Subject to Planning Commission Review) _ $270 Minor Amendment (alterations to parking, circulation, I 7 folded copies ofplan are required building size, location) _ $95 8 blded copies o sketch plait are required Reinstate Plan Review After 10 day Denial = $200 Reinstate Plan After Site Review Denial or Suspension = $65 Reinstate Plan Deferred by Applicant To a specific date = $3 Indefinitely - $75 17 olded copies o lan are required Groundwater Assessment (Required /hr a// iron residrntidi site plans unt .crrriCrd hr J)1ihliC tt'uter) Was a Groundwater Assessment conducted for the existing site plan? YES NO If NO and the new plans show a use less than 2,000 gallons per day Tier 3 Groundwater Review = $400 If NO and the new plans show a use greater than 2,000 gallons per 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 less 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: Tax map and parcel:Magisterial District: N\ \V 1s. a? m Zoning: ) Physical Street Address (if assigned): 1^) "ANA -.. rN. .N -. 1 X_ _k -- 3} -_ c J4 Location of property (landmarks. intersections, or other): Contact Person (Who should we call /write concerning this project?): 1Address `t ( C t 1 .I ti -1i_ ( -l._ ` y `•11f .. ICCC ity _ I l__1 ; h, L.' "ai -- State _ ZiP Daytime Phone (j) 1tIL_W Fax #( J E -mail J Owner of Record tN _t '.l r E t_a \ ! .C' \ - - \YY K_>t:iilF Address Z1 _ iC= >_ 1 -. `3! < - City4`<1 _.State Zip Daytime Phone (H14 J) — Fax # (x {' c l . : } ti r E -mail Applicant (Who is the Contact person representing'. ke F i 'f `Y_- 1-v -- \ Address { L i 1 i.1. _ F ; 1 `( P t f - -- City t :Vi >.>`_1?t ; =`i 11 1 _ State ii \ Zip -4='( 1 Daytime Phone (V cl / + _C.J Fax # ('-) 1 `tt_ .' /._ E -mail - t t C < - . C i t 1 \ _(-' = , t -\ ( =i FOR OFFICE USE ONLY SDP # Fee Atnount S Date Patdslr7 L By nho'.' Ay 1 `C.'' -' Receipt # r i Ck# 1 L t. 4". % ' ' n - -- County of Albemarle Department of Community Development 1 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 11 ' 19 ,'07 Page I of Intended use or iustificatio )r request: PAf.it.tlSl L-C3 CSI -i-- / , LS.. b ti _ j ld i!_r t 1 FP1aC' F= F; 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 aPyJieffb 2nditions from the appropriate agencies. ignat of O her ontract Pur, aser, Agent Date Print Name Daytime phone number of Signatory 1 1/ 19/07 Page 2 of 2