HomeMy WebLinkAboutCLE201900292 Action Letter 2020-01-08N��
APPROVED
by the Albemarle County
Community Development Department
Date
Applica io rfor Za-ning-Clearance
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M
CLE # DEC--),
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OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # Vo Date: t2� r1
Receipt # Staff: —44
PARCEL INFORMATION Tax ��A I _ oA� �-Oo
Map and Parcel: Existing Zoning
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Parcel Owner:
Parcel Address: � 2 C /� i� �l City C W State V ? N Zip tot
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Christopher Tompkins
Address :1020 Carrington Place Suite #100 City Charlottesville State Virginia Zip 22901
Office Phone: (434 ) 977-9847 Cell li Fax # 434-977-2809 E-mail CTompkins@depaulcr.org
APPLICANT INFORMATION
Check any that apply: Change or ownership Change of use Change of name X New business
Business Name/Type: DePaul Community Resources / Non -Profit Social Service Orgnization
Previous Business on this site Unknown
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:
Community Resoupces it a pon-profit licanned chi d agancy. The Charlottesville braRGh operates—
placing -local
. a 1 Mn c+r.,.a c„t+o Inn f h-rt„++nr„iva k/A "Cinj tnt,,cicshi&r nm KA, nel� +t,� n+,
*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 b onsWTcTst:, f have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Christopher Tompkins
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 9774511, 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:
JJ pp 7
Building Official 2 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) 9724126
Revised 11r02:2015 Page 2 of
Intake to complete the following:
Y N Is u in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
kjN
Will 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 water.
If private well, provide Healt epartment form.
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Circle the one that ap
Is parcel on septic o 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, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to compl to the fol�owi g: �, vsf
V,Ii� 3-rcS
Square footage of Use: r " S j
Y rmitted as:t <<'�
Under Section:
Supplementary regulations section: N I A
Parking formula: �O %o J � I / Zoo b5F
f, Ol[tcr, of
ID P
Required spaces: 1 S P 4 LS
Y / (N J
Items be verified in the field
c r!-Oqe
pcco-tl art S lug. No CI-e?- ter
V,l a c(t 1,1 rA s of vsc
Inspector Date:
Notes:
Viol io
Y/N
If so Li
Proffers:
Y/N
If so, List:
M A 20 ( OLKJ® 3
Var' C.
Y/N
If so,
S 's:
N
o, List:
�L
�1--
Clearances: % j 1
SDP's0
Revised 11/1/2015 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
77tis form ►►►r►st accompany zoning applicatio►ry (Horne Occupation, Zoning Cleurarrce, Zoning
Ad►rtinistrator Deter►tti►tations or Appeals, Sign Permits, Building Permits) If the application is not the
ofv►ter.
) 1
I certify that notice of the application,
[County application name an number]
was provided to i / ( ,.r�; ,_ A�� r of record of Tax Map
[ a�f the record owners of the p• rcel]
and Parcel Number
manner identified below:
by delivering a copy of the application in the
Hand delivering a copy of the application to r ' t r ✓��t�c �� .m f PUcf,
[Name of the record owner if fhe 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 f ,iZh 711 !
Date
Q 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
r 14 /'u�2
to the following address:
� fro
Ile, Kl�
[address; written notice mailed to the owner at the last known address of the owner as shdwn on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Date
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