HomeMy WebLinkAboutCLE201800205 Application 2018-10-04APPROVED
by the Albemarle ('minty
l"bf, ,
Applica � or bi'' `� ' earance
,,CLE
� 4
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY,
Check# Date: C .
Receipt # ` C Staff:
PARCEL INFORMATION
Tax Map and Parcel: 07800-00-00-015C4 Existing Zoning Commercial
Parcel Owner: ALBEMARLE LAND OFFICE BUILDING LAND TRUST
Parcel Address:198 Spotnap Rd, Suite A-1 City Charlottesville State VA Zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Theresa Veraa
Address :408 E Market Street, Suite 208B City Charlottesville State VA Zip 22902
Office Phone: 4( 34 ) 984-1118 Cell # Fax # 434-984-1917 E-mail tveraa@josephandmische.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Joseph & Mische, PC (Attorney)
Previous Business on this siteunknown
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide:
attorney office, 3 employees, regular business hours 8am-5pm
*This Clearance will only be valid on the parcel for which it is approved. if you change, intensify or move the use to a new location, a new Zoning
Clearance will be required.
I hereby certify that 1 own or have the owner's permission to use the space indicated on this application. 1 also certify that the information provided
is true and accurate to th est f my knowledge. I have read the conditions of approval, and I understand them, and that I u�ll abide by them.
ASignatur PrintedTheresa Veraa
APPROVAL INFORMATION
[ ] Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl 17.
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
r
Building Official Date
Zoning Official Date
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
Revised 11/02/2015 Page 2 of 3
Intake to complete the following:
Y /Ni
Is u. in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
W i ere be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well or puOwater?If private well, provide Healthorm.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applCbfic
Is parcel on septic or pwe.
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
if so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: i 370
Y / N �- (n� a,l d t tC
�/ _
Permitted as: �[ i G/1
Under Section: , J,
Supplementary regulations section:
Parking formula:
1lVO
Required spaces: ^
O
Y / N
Items to be verified in the field:
Inspector Date:
Notes:
Viol ii s:
Y/
If so, List:
Proff
Y N
If so, ist:
Varia e:
Y /r)
If so, ist:
SP's:
Y /
Ifs List:
Clearances:
1 - -it,
2.016 -A54 ;oi 4 -
SDP's
14—
114 - q!�
—
17
1 - 0 6 -4�
Revised 11/l/2015 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, Z (`�n�(�� ON YCV n
1 [Coup pplication name and number]
A\ was provided to bema �(1,, � the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number (b-1 �S W — C3D - ''D\SC9 by delivering a copy of the application in the
manner identified below:
0 Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application to �\\ocf na (L r� -n
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on Qj lO� 06' to the following address:
Date
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Signature �of Applicant(
Print Applicant Name
q\ No \%
Date
Wd OVSUZ SIOZI6/Zi 'Z3MP's+eid+ umsewpe" deuMdS 96t1MP AI+aWJd 1e7tmb1 'd IL7 ?l1SYs dflad peJnZ-#) WJV0J