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Home My WebLink AboutCLE201900018 Approval - County 2019-06-17APPROVU., ny� tt,, c��i�G n;11'�� f ,n�.1nty I Application for Zoning Clearance CLE # � l I �Y a"k PLEASE REVIEW ALL 3 SHEETS OFFICE USE QNLY Check # Date: Receipt # "' Staff: ANI PARCEL INFORMATION Tax Map and Parcel: L)TON _00 Existing Zoning PD-MC Parcel Owner: 5th Street Station Ventures, LLC Parcel Address: 365 Merchant Walk Square, e St-- 2Q City Charlottesville State VA Zip 22902 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Dan Tucker Address : 5 SW Broad Street, Suite B City Fairburn State GA Zip 30213 Office Phone: ( 770) 692-8300 Cell # (434)245-4909 Fax # (770)692-8302 E-mail dan@sjcollinsent.com APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: Mochiko Hawaiian Eats/Assembly A-2 Previous Business on this site New tenant - Unoccupied Suite 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: This is a 1.200 SF Whit box in Bldg 1400 *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. Signature Printed AP ROVAL 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. Notes: Building Official Date Zoning Official Date Other Official J Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 k �s — , F�, c,_ /' Revised 1 ] /02/2015 Page 2 of 3 Intake to complete the following: Isu Is us LI, Hi or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. YyN ill 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 ��wate If private well, provide Herm. Zoning review cannot begin until we receive approval from Health Dept. FAX DATE Circle the one that a Is parcel on sep • or public 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, ob 'n the o r P �it Permit # i; Zoning to complete the following: Reviewer to complete the following: Square footage of Use: Y/N Permitted as: l91-r; i Under Section: Supplementary regulations section: Parking formula: Required spaces: Y(Nj Iterieto be verified in the field: Inspector: Date: Notes: Viola*ons: Y '( _' ` ) If sd� ist: Proffers: Y / N If so, List: Variance: Y / N If so, List: �1 1 SP's: y If s List: Clearances: 3 SDP's i 430 V l-7 3 a 6, 14 1 ). ' 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, Application for Zoning Clearance - Bldg 1400 [County application name and number] was provided to 5th Street Station Ventures, LLC - Dan Tucker [name(s) of the record owners of the parcel] and Parcel Number manner identified below: 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 5th Street Station Ventures, LLC - Dan Tucker [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 08-13-18 to the following address: Date 5SW Broad Street, Suite B, Fairburn, GA, 30213 [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 Date GREASE TRAP BENEATH 3COMP SINK STOCKPOT BURNER WALL Mq w POT FILLER ALTo- sHaAM 24 STEPUP BURNER (4) 24'CHARBR0IFw 2f GRIDDLE MR TABLETOP HEAT LAMP fEY HOOD (A V) DROP IN HAND SINK g.ff = j`7Oct s� COMMONWEALTH of VIRQ1NIA In Cooperation with the T1toiiuts ./C'J,C'/'SO/f He(lllll I)l.�ll'IC'! State Department of Health 1138 Rose Hill Drive Phone (434) 972-6219 P. O. Box 7546 Fax (434)972-4,110 Charlottesville, Virginia 22906 January 7, 2019 Riki Tanabe 473 Rolling Valley Court Chariot tesville, VA 22902 Re: Mochiko Cville, 365 Merchant Walk Square, Charlottesville, VA ALBEMARLE-CHARLOTTESVILLE FLUVANNA COUNTY WALMYRAi GREFNECOUNT YfSTANARDSVILLE, LOUISSACOUNi f(LOUISAr NF I ',0N C(A IN rY It OVINGS MN) Thank you for submitting a plan review application for your restaurant: Mochiko Cville. The plans submitted for your new location appear to meet compliance with the Virginia Food Regulations and as such are approved. A pre -opening inspection and approval by this department is required before permitting. Your permits (hotel and food establishment) will be issued after the final inspection by our office. Please call or email me at the below contact information in advance of your opening. You are responsible for submitting all other applicable applications and meeting all other state and local codes (i.e. building, zoning, fire safety, etc.). Email: Stephanie.Yard@vdh.virginia.gov Office: 434-972-4318 Sincerely, Stephanie Yard Environmental Health Specialist Steph)nie.Yard@vdh.virginia.gov 434-972-4318 Page 1 of 1 Application for Zoning C earance�� CLE # 9,� I �� GC)O I I�N1A PLEASE REVIEW ALL 3 SHEETSCheck OFFICE USE ONLY # Date: d'.G� ' Receipt # Staff - PARCEL INFORMATION Tax Map and Parcel: 365 Merchant Walk Square Suite 300 Existing Zoning Parcel Owner:5th Street Station Ventures, LLC 5 SW Broad Street, Suite B Fairburn, GA 30213 Parcel Address: 365 Merchant Walk Square Suite 300 City Charlottesville State VA Zip 22902 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Riki Tanabe Address :473 Rolling Valley Court City Charlottesville State VA Zip 22902 Office Phone: Cell # 434 806-7867 Fax # E-mail riki@mochikocville.com APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name x New business Business Name/Type: Mochiko Cville - Restaurant Previous Business on this sitenew construction 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: Hawaiian fusion restaurant serving lunch and dinner. Five employees five vehicles excess parking spaces in the shopping center *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 lmowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature — --'' PrintedRiki Tanabe 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 site plan. existing [ ] This site complies with the site plan as of this date. Notes Building Official Date Zoning Official Date Other Official Date ••`r � ni •� cyal uuCut ul %-ummunliy Levelopment 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 ww''r q Oj� ' Q D Revised 11/02/2015 Page 2 of Intake to complete the following: Reviewer to complete the following: Y / N Square footage of Use: Is use in LI, Hi or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / N Permitted as: Y/N Will there be food preparation? Under Section: If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Supplementary regulations section: Dept. FAX DATE Circle the one that applies Parking formula: Is parcel on private well or public water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE Y/N Circle the one that applies Items to be verified in the field: Is parcel on septic or public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Inspector Date: Y / N Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zonine to comDlete the following: 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 11/1/2015 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, 1 [County app ication name and number] was provided to [name(s) of the record owners of the parcel] and Parcel Number manne identified below: IV I 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]. Signature of Applicant Riki Tanabe Print Applicant Name "?/ 9 Date