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HomeMy WebLinkAboutCLE202000003 Action Letter 2020-01-08APPROVED by the Albomade County Community Development Departrmnt Applica� n_far Zoning Clearance ��RCINIP PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # CC— Date: l Receipt # Staff: G PARCEL INFORMATION Tax Map and Parcel: 046132-01-00-002D0 Existing Zoning Planned Hslm Development Parcel Owner: Hollymead Professional Center, LLC. Parcel Address: 1524 Insurance Lane, Suite C City Charlottesville State Virginia Zip 22901 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Tim Durrer or Dan Shuemaker Address : 1524 Insurance Lane, Suite C -CityCharlottesville State Virginia Zip 22911 Office Phone: (434) 984-0700 Cell # 434-202-9184 Fax # 434-984-1211 E-mail tdurrer@communitygroup.com APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name X New business Business Name/Type: Associa:`Community Group (homeowners association management firm) Previous Business on this site Investment Firm 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: -HnmQc)%A1PQ.rs; employeas op 1 shift 1�41nnday_ Friday, 6 available parking spaws. *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 certi iat I own or have the owner's permission to use the space indicated on this application. I also certify that the information provided ns of approval, anj_I understand them, and tha will abide by them. is true andUZAG= Signature Printed APPROVAL INFORMATION pQ 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 l I 1 LQzo 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 / Is us r LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y nN Will ere 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 ? 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 applies Is parcel on septic or p ►c 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 followin : Reviewer to complete the following: Square footage of Use: SF 1 � l Z /N ff 'mitted as: �T�� Le-5- Under Section: 2 D ' 4 . Supplementary regulations section:N / A Parking formula: 1 f 24� /VS4� 1 �iV �GrULS Required spaces: 0 5- Y/N Item be verified in the field: Inspector: Notes: Date: Viol ns: Y/ If so, ist: NO .i it Prof s: Y/ If so, ist: Var' e: Y/ If so, st: 1 e SP's: Y/ If so, Est: Clearances: SDP's Revised 11/l/2015 Page 3 of3 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, [County application name and number] was provided to Hollymead Professional Center, LLC. the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 046132-01-00-002D0 manner identified below: by delivering a copy of the application in the Q Hand delivering 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 Mailing a copy of the application to Hollymead Professional Center, 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 11/20/19 Date to the following address: PO Box 8147 Charlottesville, Virginia 22906 [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 4.11Igllq Date :t n� . r 7 § }& $ i m � f�7 § q / § » � - > q ^ �� .cl g p - �k/k { . :IT .�