HomeMy WebLinkAboutCLE201900276 Application 2019-12-10APPROVED
by the Albemarle Catmry
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pU ation fir Zoning ClearanFilece°
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PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL INFORMATION�yv,yneU"
Tax Map and Parcel: 061 W-01--1 Existing Zoning 061-W--a f-ft— Ee e -
Parcel Owner: Cox Properties LLC
Parcel Address: 1416 Greenbrier Place City Charlottesville State Virginia Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Marla Webb
Address : 1416 Greenbrier Place City Charlottesville State Virginia Zip 22901
Office Phone: (434) 979-4516 Cell # 434-234-7301 Fax # 434-220-1010 E-mail Maria@VirginiaPregnancy.org
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Yes Ohange of name New business
Business Name/Type: Charlottesville Pregnancy Center DBA Pregnancy Centers of Central VA DB omen's Healthcare of Central Virginia
Previous Business on this site Pregnancy Centers of Central Virginia L G L E 2 O l6 -3( )
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 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 m''yllkno��wle//dge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature WaA",, N. Printed Maria N. Webb
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, xl17.
[ ] 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 11/02/2015 Page 2 of 3
Intake to complete the following:
Y 13
Is use to LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
Wil 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 o ublic r?
If private well, provide H rtment 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 sewer?
r
Y)/ N
Reviewer to complete lthe following:
Square footage of Use: d 0 d2
Y/N Permitted as: Tj 1l�i ,Q
Under Section:
Supplementary regulations section: r`
Parking formula. 1
Required spaces: `
Y/N
Items to be verified in the field: u� e-9 X-C
OG S Ike
-Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # 13 zoi� `f�2$6 t_S Inspector
Y / N Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
ZoninE to complete the followinE:
Date:
Violins:
Y//N/
If so, ist:
Prof s:
Y/N
Ifs , ist:
Var' ce:
Y
Ifs ist:
SP's:
Y//
If sot�ist:
Clearances: GL `3 e�
SDP's Z�-3
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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, B2019-02869
[County application name and number]
was provided to Cox Properties LLC the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 061 W-01-OA-7
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]
on
Date
Mailing a copy of the application to Irvin Cox, Cox Properties LLC
[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 October 31, 2019
Date
to the following address:
528 Rookwood Place Charlottesville, VA 22903
[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
Maria N. Webb
Print Applicant Name
11 /25/2019
Date