HomeMy WebLinkAboutARB201700026 Application 2017-03-28Albemarle r-3unty
Planning Application
TmPLq6qo0-0lD-00-078=A0
Application # F -AR820.17000=26
Community Development Departa
401 McIntire Road Charlottesville, VA 229024
Voice: (434%296-5832 Fax - (434; 972-4-
COUNTY OF ALBEMARLE SCHOOL BOARD ALBEMARLE HIGH SC
Legal Descriptior i ACREAGE ALBEMARLEj3ACjCjouETrjGREER
fragisterial Dist. Jack Jouett El Lard Lse Primary Office
Current AFD Not in A/F Disterct Fj CLrFert ZorirgPrimar; Rural Areas
[APPLICATION INFORMATIRO—N
Street Address 190 LAMBS LN cHARLoTrESVILLE, 22901 Ertered
Applicaticn Type Architectural Review Board Judy Marbrt t
JV2W20177
Pru.md [AHS -Metal Panel Replacernent/wftKlows - Ph. 2
Received Date Final Submittal Date 04/03/17 Total Fees
Received DateF63/ 28i 17
Closing File Date
Subrnfttal Date Fir.al I
Total Paid
Revision Number
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Comments
Legal Ad
IMAM APIPUILA-HUN
County -wide Building Permit
1APPLICANT I CONTACT INFOR14ATION
OwnerAp pl i cant COUNTY 7F AL e BIA R LE s C�;_d b -L _2�
Primary Contact WORTIE BREED EN/FES-PMD
04103/17
CHARLOTTESWILL z 22W7-
401 FOCINTIRE ROAD HARLOTrESVILL 22932
Signature of Contractor or Authorized Agent7a Date
Architectural Review Board Application
Part A; Applicant, Contact and Parcel Information
Project Name: 74t+C,
Tax map and parcel(s): Physical Street Address: F4 `tom rL,/-a V V 1 to tz-r
Contact Person: I` 'f o t4—V t i` PF;' fz- r--Pl�)%4J
Business Name: �+ L A t., lam,,, G T' `( ,
Address +Z' ] City - State Zip
�"'y--r �6I"Z,%h r"t'�✓R-��r7�'r/ 2. � �l�l3t;'Mp@i.�,
Daytime Phone L_) Fax # C__) E-mail
Owner of Record: A V'r3 • G T -r 1�v r31. 11. S Ct-4 l
Address -4-- (� G 1•r7't r- L. f7"p City State Zip
Daytime Phone Fax # C_, E-mail
Part B: Review Type and Fee
Select review type
'm 1
Review by the Architectural Review Board
Conceptual Plan/Advisory Review (for a Special Use Permit or a No Fee
Rezoning)
Preliminary/Initial Review of a Site Development Plan No Fee
Final Review of a Site Development Plan $1075.00
Amendment to an approved Certificate of Appropriateness $ 242.00
Building Permit Review r"' 00
County -wide Certificate of Appropriateness
Structures 750' or more from the EC, no taller than 5 stories No Fee
Structures located behind a structure that fronts the EC
No Fee
.Personal wireless service facilities
No Fee
Fencing or Equipment or Lighting
No Fee
Additions to ARB -approved buildings
No Fee
Minor amendments to site or architectural plans
No Fee
Building permits where the change is 50% or less of the altered elevation
No Fee
NOTE: For SIGNS, use the combined APPLICATION AND CHEKLIST FOR SIGNS.
FOR OFFICE USE ONLY BP#
Fee Amount $ Date Paid
By who?
ARB#
Receipt # _Check # By
County of Albemarle Dept of Community Development, 401 McIntire ltd, Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-41.26
101208 Page I oft
OVER
Part C: Description of Proposal
Describe your proposal. Attach a separate sheet if necessary.
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Part D: Applicant Agreement
Applicant must read and sign
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Each application package must contain folded copies of all plans and documents being submitted.
Only (1) set of building material samples is required. All submittal items, including building material
samples, become the property of Albemarle County. Applicants are encouraged to maintain duplicate
copies of all submittal items in their own files.
• Only complete application packages will be scheduled for ARB review. The application package is not
complete without the appropriate checklist, completed, signed, and included with the required submittal
materials indicated on the checklist.
I hereby certify that I own the subject property or have the legal power to act on behalf of the owner in filing this
application. *See submittal requirements below. I also certify that the information provided on this application
and accompanying information is accurate, true, and correct to the best of my knowledge, and that the attached
plans contain all information required by the appropriate checklist.
0 1 ON �110
Signature of owner, owner's representative
or contract purchaser
Printed name, Title
'v rte• g
Date
(-I-��+D c- c, & 1 �-
Daytime phone number of Signatory
*Ownership Information:
If ownership of the property is in the name of any type of legal entity or organization including, but not
limited to, the name of a corporation, partnership or association, or in the name of a trust, or in a fictitious
name, a document acceptable to the County must be submitted certifying that the person signing above has
the authority to do so.
If the applicant is a contract purchaser, a document acceptable to the County must be submitted containing
the owner's written consent to the application.
If the applicant is the agent of the owner, a document acceptable to the County must be submitted that is
evidence of the existence and sco a of the agency. Attach the owner's written consent.
.r4 11/2010 Page 2 of 2
OVER --'.