Application for Fairfax County Land Development Services Project Management Services

Please utilize this form to request support from the LDS Operations Division Project Management Program. Further information on the program can be found at https://www.fairfaxcounty.gov/plan2build/project-management-program If you require assistance in filling our this form, please call 703-324-3013.

Project Name*

Project Description*

Please provide a brief summary of (a) The scope of work (b) Where you are at in the land development process (c) Key milestones in the project schedule

Tax Map No.(s)*

Address (if Available)

Entitlement Case number(s), if Applicable

Site Plan number(s), if Applicable

Building Permit Number(s), if Applicable

Owner/Developer's Agent Point of Contact*

Phone*

Email*

Please check this box if your project is located in a Commercial Revitalization District or Area.

Please check this box if the applicant or owner of this project is a Nonprofit organization.

Long Term or Troubleshooting*

Please indicate whether you are requesting project management services as either (a)Long-term support; or (b)Troubleshooting. Long term support provides direct involvement of a project manager in developing schedules and tracking project status through project completion. Trouble-shooting support is provided to assist in resolving specific challenges that typically involve multiple stakeholders.

Long-Term

Troubleshooting

Unsure - please recommend for me

Application Justification

1a) How has your team demonstrated strong motivation to complete this project?*

1b) Which of the following are true for your project? (select all that apply)

Select or enter value

2) How will this project benefit the community?*

Please explain the benefit this project will provide to the community.

3) Have you received a referral?

Please let us know if you've been referred to us by a District Supervisor, County Executive, or Fairfax County Economic Development Authority (EDA).

4) Participation in Economic Incentive Program

Is this project included in the Department of Planning and Development's Economic Incentive Program (EIP)? If so, please explain.

5) Is this a public project?

If publicly funded, what benefit can a LDS project manager provide that the public agency’s project manager cannot provide?

6) Have you utilized the Project Management Program in the past?

Applicants who have not previously received project management services will receive priority over repeat applicants. Please explain any previous experience your team has had with the PM program.

7) Ensuring equitable access

Would project management support improve your team's equitable access to the land development process, as articulated in the One Fairfax policy? https://www.fairfaxcounty.gov/topics/one-fairfax. If so, please explain

Please attach a plan or sketch that illustrates the project scope*

Drag and drop files here or

Agreement

By submitting this application, the Applicant agrees to the following as part of the project management program: - Commitment to high quality submittals - Prompt responsiveness to comments, questions and requests from reviewers and the project manager - Working collaboratively with all stakeholders to resolve issues - An understanding that the project management program does not imply expedited processing or guarantee approvals - Diligent pursuit of the timely execution of the project described above. Significant changes to the project scope of work or scope of project management services may require submittal of a new application

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