HomeMy WebLinkAboutCLE201900043 Action Letter 2019-03-12Application for Zon'ng Clearance
CLE # JO1 CJ '
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PLEASE REVIEW ALL 3 SHEETS
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Check # � Bate:.
Receipt ## Staff:
PARCEL INFORMATION
Tax Map and Parcel: 055EO-01-3C-000AO Existing Zoning NMD
Parcel Owner: Old Trail Heights LLC
-Parcel Address:5405 As111ar.Ave., Suite 100 City Crozet State VA Zip 22932
(include suite or floor]
PRIMARY CONTACT
Who should we call/write concerning this project? Reid Murphy
Address: 400 Locust Avenue, Suite 3 City Charlottesville State VA Zip 22902
Office Phone: ( 434) 977-6400 Cell # 434-825-1560 Fax # E-mail reid@bmcholdingsgroup.com
APPLICANT INFORMATION O W vw- oy-, 4 eK a nt--
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Waterstone Mortgage Company
Previous Business on this site None
Describe the proposed business including use, number of employees, number=of� shifts,tavailable parking spae s nurnberof
�Rce_ i-
vehicles, and any additional information that you scan provide. 3 �� o GG� S�► '}-'
00 th-w� - ', C�a v►-, ar1� _Sp ctc eS
Irva r e. Inc a f c � S c e
*This Clearance will only be vand on t e 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 of my knowledge. I 1 e read the conditions of approval, and understand them and that I dvil.l abide by them.
Signature - Printed Reid A. Murphy
APPROVAL INFORMATION
KApproved as proposed [ ] Approved with conditions [ ] Denied
[ ]13ackflow 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:
Building Official '� ���1 Datei
J
Zoning Official Date -ZC2 / q
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 11/02/2015 Page 2 of 3
Intake to complete the following:
Y/N
Is us LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/
Will Oe 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 pstrel on private well or ublic water`'
If private well, provide Health pa orris.
Zoning review -can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or ublic sewe .
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:
f''crm,cd as:C 15 61 UG�—
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y / N (2
Item o be verified in the field:
Z?
2c�i ti
Inspector -
Notes:
Date:
Viol 'ons:
Y/N
If so, i st:
offers:
/N
so, List:
.Z
Vari ce:
Y
If so, ist:
SP's:,�
If so ist:
Clearances:
SDP's
.,
Revised I I/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,
was provided to
[County application name and number]
fnamne(s) of the record owners iof the praroei]
and Parcel Number
manner identified below:
Q Hand delivering a copy of the application to
the owner of record of Tax Map
by delivering acopy >of the application in the
[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
[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]
10111
Date
to the fol lowing .address:
[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].
Si nature of Applicant
A�, • I " 1 v, �.
Print Applicant ame
3 I � 201
Date
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