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Property Name:
Street Address:
City:
Zip Code: Business Park: Industrial Park:
Sale Price (Entire Site):$
Minimum Price per Acre:$
Maximum Price per Acre:$
Minimum Lease Rate:$
Maximum Lease Rate:$
Brokerage:
Broker Contact:
Broker Phone:
Broker Email:
Owner:
Owner Phone Number:
Owner E-Mail:
Total Acreage: acres
Acreage Suitable for Construction: acres
Largest Contiguous Acreage: acres
Subdividable: Select Yes No
Range of Site Sizes:
Build to Suit: Select Yes No
Outside Storage: Select Yes No
Describe Existing Structures:
Zoning Classification(s):
Zoning Restrictions and/or Divisions:
Comprehensive Plan Designation:
Topography:
Phase I Environmental Audit Available: Storm Water Management Plan: Plat/Survey: Site Plan/Master Plan: Signage:
Primary Electric Provider:
Voltage:
Phase:
Amps:
Gas Provider:
Distance of Gas from Property: ft.
Gas Line Size: in.
Gas Line Pressure: psi
Water Provider:
Distance of Water from Property: ft.
Water Line Size: in.
Total Capacity of Treatment Plant: gpd
On-Site Treatment Plant:
Available Capacity to Property: gpd
Well Capacity: gpd
Water Tank Capacity: gpd
Sewer Provider:
Distance of Sewer from Property: ft.
Sewer Line Size: in.
Septic System Capacity: gpd
Primary Telecommunications Provider:
Other Providers:
Fiberoptic available: Select Yes No
Distance to Fiber: ft.
Other (T-1 lines, POPs, etc.):
Redundant Routes:
Sonet Ring:
Wireless Broadband:
Broadband Speed Level: Select Low (under 2Mbps) Medium (2-6 Mbps) High (6 Mbps & up, excluding Satellite)
Distance to I-81: mi.
Distance to I-64: mi.
Distance to US 29: mi.
Distance to US 33: mi.
Distance to Charlottesville-Albemarle Airport: mi.
Name/Route Number of Highway or Street Serving Property:
Please use the space below to provide any additional information or comments about the site:
Please enter below information for the person to whom a copy of this submitted form should be emailed and who should be contacted if there are questions pertaining to this site:
Contact Name:
Contact Phone Number:
Contact E-Mail:
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