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HomeMy WebLinkAboutCLE202000010 Application 2020-01-31APPROVED by the Albemarle County 1communi Development Department Application for Zoning Clei�ra=_ev CLE# 15b15` 01X12701535� _ A/ PLEASE REVIEW ALL 3 SHEETS PARCEL INFORMATION Tax Map and Parcel: 003200-00-00-41 D1 Parcel Owner: Timberwood Commons LC Parcel Address:1622 Timberwood Blvd., Ste 112 (include suite or floor) OFFICE,USE ONLY Check #j C L' Date: Zl z Receipt � Staff: µ ef- Existing Zoning PDSC City Charlottesville State VA PRIMARY CONTACT f Who should we call/write concerning this project? /�iI )<-el Ca4' f r 64 Zip 22911 Address: �7�d//lc�i, l��a't /'t'�""7 City _ &atiW%101�t -State '7� Zip Office Phone: ha) �1 5-7 Cell # / Fax # E-mail/�f/�e��ii1�'f �//�/(tic(". c- APPLICANT INFORMATION �Ch�eckany apply: Chanee of ow Business Name/Type: I ehab SEPT, LLC / pediatric physical th of use Change of name X 'New business Previous Business on this site None -this is a new tenant in a new space 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: 2,974 sf of professional office, 53 parking spaces on site (207 across all parcels), 4-6 employees, 1 shift *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 my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Q"`�"' Printed APPROVAL INFORMATION [ qj kpproved 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: <�Y✓V Z0,1-Z —LLf Building Official Date %""?M159 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 z D 1 - 0 3 26/ 3 S Revised 11 /02/2015 Page 2 of 3 �201?—o21Z6-AC 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, Zoning Clearance for 1622 Timberwood Blvd, Ste. 112 [County application name and number] was provided to Timberwood Common LC the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 03200-00-00-041 D 1 by delivering a copy of the application in the manner identified below: Hand delivering a copy of the application to Timberwood Commons LC [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 12/29/19 Date ® 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 to the following address: [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]. 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