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HomeMy WebLinkAboutCLE201900129 Action Letter 2019-06-24APPROVED w tl-.r e , ,mnr'... (r%i in'. Application for Zonin ,.. learance_�`°�`� CLE # PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY q Check # Date: I� ! Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 061 W1-02-003-00 Existing zoning Commercial CL Parcel Owner: Psychological Testing Services, LLC Parcel Address: 1411 Sachem Place, Suite 3 City Charlottesville State VA Zip 22901 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Allison Anderson, Ph.D. Address : 1411 Sachem Place, Suite 3 City Charlottesville State VA Zip 22901 Office Phone: 4( 34) 806-6510 Cell # same Fax # none E-mail aandersonphd@gmail.com APPLICANT INFORMATION Check any that apply: X Change of ownership Change of use Change of name New business Business Name/Type: Psychological Testing Services, LLC Previous Business on this site Richey -Sachem LLC 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: Professional and mental health offices *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 pe is ion to use the space indicated on this application. I also certify that the information provided is true and accurate to the best my knowle . I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed I L 1'S O /) 41!1 ��iSDn 10N APPROVAL INFORMATION 54 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 ✓"�`� G ' Date 4,ky� Zoning Official Date % / z¢ (2-0/ Other Official Date a.uunty of AiDemarie impartment 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 6 Intake to complete the following: Y 0 Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y /(: 2re Willll 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 ubli=water?D 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 ap Is parcel on septic ok1public sewer? Y / 9 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. P v'�' 51 G n Permit # A @k+ 'f-o door- 0- Y CorlcA O 4r tAAC-ft Wil re be any new construction or renovations? e1C� t1�• CJ If so, obtain the proper Permit. Permit # j,S O Mf I d 5 -�icc .. +.. ..•.,lntn thu fnllnwina• Reviewer to complete the following: Square footage of Use: I I © � � " v °"�j k1 :1 N iitted as: 0� C t^ Under Section: 22-Z -t Supplementary regulations section: A.1 Parking formula: I�Z00rVSF Required spaces: Y / Item be verified in the field: ti! 0'W— Inspector : Notes: Date: Villll 4V \.V lla Viola 'ons: Y/14 If so, ist: Prof Y/ If so, st: n 'o ,,� Varce: Y/la, iNJ If sost: SP's: I'/ If so, i ist: Clearances: 0IC SDP's Revised 11/1/2015 Page 3 of 3 !4 F4 • ,-7 ;• 7-\ RECEIVED JUN I 1 1t119 COMMUNITY DEVELOPMENT