HomeMy WebLinkAboutCLE201900045 Action Letter 2019-04-03Application for Zoning Clearance
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check #r, Date:
Receipt # 3= 4 r Staff:
PARCEL INFORMATION (.p 153 -7- p
Tax Map and Parcel: 045C / 61-123 Existing Zoning Planned Development Shoppirn
Parcel Owner: Rio Associates Limited Partnership
Parcel Address: 606 Albemarle Square City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Susan Karageorges
Address : 6081 Whippoorwill Drive City Warrenton State VA Zip 20187
Office Phone: (__) Cell # 703-929-2583 Fax # E-mail susan.karageorges@redcross.or
APPLICANT INFORMATION
Check any that apply: X Change of ownership Change of use X Change of name New business
Business Name/Type: The American National Red Cross - Blood Donation Center
Previous Business on this site Virginia Blood Services - Blood Donation Center
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:
R-,!;inQr.s I ISS dr, A Blood Donor Center, with 4-6 arnployses, and approximately 5-6 Nam
clanors at any one time, Qnl�—
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*'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 best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
,( Digitally signed by
^e/� susan.karageorges@redcross.org
Signature oo U Date: 2019.022609:4951-05'00' Printed Susan Karageorges, Project Manager, RES Oper
APPROVAL INFORMATION
[q 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:
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) 972-4126
Revised I 1 /02/2015 Page 2 of 3
Intake to complete the following:
Y /(9N
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y / N
Will there 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 p blic water>
If private well, provide Health -Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appl*
Is parcel on septic or., ublic sewer
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: OLIJ
Y/N
Permitted as: Make4k
Under Section: e5 -A .
Supplementary regulations section:
Parking formula: l
Required spaces:
Y/N
Item o be verified in the field:
Inspector : Date:
Notes:
Violations:
Y/N
If soy List:
(�i R
Prof 11
Y N
If so, ist:
riance:
Y/N
f so, List:
1�-1(A--314 1galcl - a, 7
Sp1s:
N
so. List:
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Clearances:
SDP's
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Revised l 1/1/2015 Page 3 of 3
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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, G t'C' t�
was provided to
[County application name and number]
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
Z�f Hand delivering a copy of the application to
the owner of record of Tax Map
by delivering a copy 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]
on
Date
to the following 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].
Signatur of Applicant r
16 J 't1 A V-4
Print pplicant Name
Date
Business use is a Blood Donor Center, with 4-6 employees, and approximately 5-6 blood donors at any
one time, only one shift, hours vary based on day of the week, earliest staff may arrive is 5:00 am,
latest staff might be on site is 9:00 pm, this site is in a shopping center, so there is ample parking to
accommodate the 12 spaces that we would require at any one time. Currently, there are no Red Cross
owned vehicles housed at this location. Please note that American Red Cross purchased Virginia Blood
Services and assumed the lease in the transaction. Use of the facility has not changed.
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