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CLE201800180 Approval - County 2018-11-20
Application for Zon iing, Clearance ' "`'� T PLEASE OFFICE U E ONLY 103 REVIEW ALL 3 SHEETS Check# Date:'l Receipt # Q Staff: PARCEL INFORMAT N c ^� Tax Map and Parcel: la a (� b (j [ / Existing Zoning ea fit, �ttrrloef Parcel Owner: Parcel Address: 7f�oZS �or-4ers City on �- State (10 ICA Zip (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Dr. polore-5 Carr Address : _P o, hco( `7903 City L hllf-,1p-kVil le State f) / L, Zipc&a U Office Phone: Cell # & Fax # — — E-mail 1Jo)© &f ►',4VJd&_-yd 1e, ocq APPLICANT INFORMATION Check any that apply: Change of ownership Change ofuseChange of name New business I � —�' Business Name/Type: F r j iCt,�t-�on �1�Cti'1.7��('ma0. on l jp p17're Previous Business on this site Describe the proposed business including use, number of employees, nu her of shifts, availab par ing spaces, number of information � kraf- vehicles, and any additional that you can provide: er' V i Scho e ,q 5` _ y —�--�— �icx�rs - r7u.rry �rr1; g -h `4�ar-kl,n , SD0. s *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 I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accurate to the my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed 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, x117. [ ] 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. G&.&e W4,Iwz l Notes: Building Official Date %~ 1 ' 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) 972-4126 Revised 1 ] /1/2015 Page 2 of 3 Intake to complete the following: Y/N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y Will 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 w If private well, provide Healt�epaRni form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic o ublic sewer I N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. . Permit # r 9/ N ill 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: Y/N Permitted as: Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector : Date: Notes: Violations: Y/N If so, List: Proffers: Y/N If so, List: Variance: Y/N If so, List: SP's: Y/N If so, List: Clearances: SDP's Revised I I/1/2015 Page 3 of 3 -WNW .04* Alaz 04 06 0 E 0 -Z Q) 4� L- ai ay L) -�v as t—: (U u :3 Lo LLJ n k< D 0 0 cr z (Ir ui w uj ILL: ra 5Tn I cv MY -&!_ ; 0H Education Transformation Centre (ETC) Yancey Community Center 7625 Porters Rd, Esmont, VA 22937 ETC as of 8/9/18 has (6) classrooms. Four classrooms will be divided in half. All classrooms have electric, lighting and air condition; currently no additional wiring is needed. Light fixtures will need to be changed in the rooms that are divided. The square footage is approximately, 4,925. We plan to use the cafeteria/kitchen, gym and outside playing fields/area. Door v 5' 22' Director Room 12 Executive Assistance Offices Space (4) Part-time Employees No Walls Room 9 I ►0