Loading...
HomeMy WebLinkAboutCLE201900243 Application 2019-10-18AG3G1�V `�-lb��CJw Application for Zonin Clearance CLE # i r OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # G Date: Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 07800-00-00-031JO Existing Zoning PDMC Parcel Owner: PJP Building Six, LC Parcel Address: 650 Peter Jefferson Parkway Su.iTf-City Charlottesville State VA Zip 22911 (include suite or floor) 8 aj10 PRIMARY CONTACT Who should we calt/write concerning this project? -13 ao, b 14,n T t=i_ Address:—oo rA"t.c..cr4E2 brztvc SLLirf City G1-R-LaTrEt'y F- State V+'a Zip XLqo3 �o Office Phone: 177- 47 / 1 Cell # Fax # Eanail 3 r�l+u Nz£R �, G 4LC"5Pr LE . C0^1 APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: � t Previous Business on this site 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: %l01019,6 54VCG S%i 4$ 7-1 t.�wPi�owCt3 ; PA-n.kcWt araly A.aYea a 1 arircc. 0&& wee K �; *This Clearance will only be valid on the parcel for which it is approved. If you change, intensity or move the use to a new location, a new "Zoning Clearance will be required. 1 hereby certify that 1 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. 1 have read the conditions of approval, and I understand them, and that will abide by them, Signature GU b Printed RokY, 4 ML fldbw (VP CA-;,,AIASP P- AP ,ROVA INFORMATION [Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or cturent 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 /0— 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) 9724126 Revised 1 1,102/2015 Page 2 of 3 I3Z-00- 02-5'f3 Intake to complete the following: PMN Y Is 4K, m LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y Wi elf re 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 Ebl If private well, provide H ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic or lic Reviewer to complete the following: Square footage of Use: -2�C D C Prmi ted as: Mc(_y, ( �t(6t� Under Section: Zlr, z c ( —) Z3 r Z, (L2) Supplementary regulations section: Parking formula: Required spaces: IL Y/N Items to be verified in the field: i Y/N Will you be putting up a new sign of any kind'? If so, obtain proper Sign permit. Permit # Inspector Notes: WiK there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to complete the following: Viola Y / If so, ' t: Proff Y If , ist: Vari c : Y lbv If so, List: N Do, List: _ 2 D S t S i�1 �T Clearances: /qi — Z3 20l _�, ( SDP's 2-003-UOI 20o6-35, 2-60 2-00-62. Ze10 -i t,ze��� o -Zit,—1 —1 � 2ooS -S o GF l/ZG 7o(, C '2 (� icI Zp © —D' ( Revised 11/1/2015 Page 3 of 3 CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER This form mast ucconrparry wrrirr ; applications (Ilorne Occupation, Zoning Clearance, Zoirir 4 Administrator- Determinations or Appeals, Sign Permits, Building Permits) if the application is not rite owner. I certify that notice of the. application, cu 2-017- ZLI 3 [County application name and number] was provided to P a i> P,>VLI LINk" V StX , 4e- the owner of record of Tax Map [natne(s) of the record owners of the parcel) and Parcel Number 0 *goo - (W - 0.0 - o 3 110 manner identified below: Hand delivering a copy of the application to 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] ME Date Mailing a copy of the application to EM 4 t_q 96AS LEq r �IWI t.IvN ?�oP /tTIGS [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] Oil l0 J S 7.019 to the following address: Da to f 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). mtNLraA""'"� signtat re of Applicant 1 AhzLP M W 10IA1�+ ✓P CAS A%VSPie- Print Applicant Name j0/1511q Date £ m z s o° z n D n o° °D °- nv v gm v n pi o c n m c m 0° 00 op om on z m� 2 0 m I. ° 0 22 20 Z2 ZO 'a u A N 3 3 3 3 C Ll m 0 > 1x > y° O �,2 0 o; a i g o o m Z y$ yn y� y n SS n � m A l V ° m 's °a v m o T zz vn m'� "0 i mg i oiL s D x m m D c o 0 ^ ° o y 6, 0 0 g o 'm z m A v v j x x m f~ti 3 F M, -I M m M z o° Z ° `. m D mg' mm ms up 3 0' o m -n 0 o m o 0 D f o z Z. C '°" < , 0 - m m N 0 m mm' A (n M M /n'1 k'm. 9 GTA 2 u �� T mo s� p - m p m z X? 0 c s w� ^ �m °' ZZ T m P 8 o zd �S C. IF s Dr a n R° o m O _ 0 f gii 3 u n 3 Rid 3 4 N o m N m D D g $ D $ D 3 m _ D ' m a3a �a urns 3d��F� -fib a 88xS�8�8gza."�i. m d s s��a��8's"qqua 3 g Q�211gjad ., m lei, a'� g�gS �a 3�5�3 gxRba3 3� E �a ima�3�-m;E es. IIn \ Ig x$ Spa° b$$$ p - m m m- a 4 n 3 I m c g z =m i I i Ng$ D o m o e 0 s Q a �n N pR ^m �c ( � � 2 � ; r...._ IR cn _ // } cn �\ I ( . ° ! � § � \(i§��\� - 1fi22!! lo v |\ ! 2 Irn } / \� \ _ . . �\§ < 6 ._\ ���� s � /\� ; ;q;� � |y s : m _o w= m -, o ---- -- ..., j °gycz x IL I x•� x00 I � ��� woo Sv 1] 7/240/B' 13'VERIFY f f " --- ----- --- ---- - ----' an � • I i - I a 'DO i I a x z �C)ci I' °mmm ocn �I � I . ---------- - ---------------- P ----- �� •g; 0 4 � R m I nR� 8 0 6 I - - i g a a 1 S $ 3 $$ $ 50 8 1 $ �a 10 ; m �N mp o; 3N xx v e o C a o a i2I ) | / I / [� cn � � 2 � ƒ ©- �% }`r!| ! , § � ' *«zm**ze IF i\ \ \ } 6.d E\#; ,[. | ■ $ CI 0`1 \.`) \\;�\ !; & ;