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HomeMy WebLinkAboutCLE202000039 Application 2020-02-18APPROVED - by theAfbernarle County Commmunity Devejoprnent Department Date File 6I�-H-65�7cvFDD4-3 4q3G Application for Zoning Clearan t -` CLE #—L� 2© �I J . L OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # Date: (( _ Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 06100-00-00-15400 Existing 'Zoning NMD Parcel Owner: Senior Center, Inc Parcel Address: 540 Belvedere Blvd City Charlottesville State VA Zip 22901 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Charlie Sallwasser - Project Manager, Gropen Address : 1766 Scottsville Rd City Charlottesville State Virginia Zip 22902 Office Phone: 4( 34) 295-1924 Cell # Fax # E-mail csallwasser@gropen.com APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name x New business Business Name/Type: Center at Belvedere:tentara Family Me Previous Business on this site n/a Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles and a y a itiona information t t you can rov' e: r Lt *This Clearance will onl be valid on the par el for which6o 4proved. 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. have read the conditions of approval, and I understand them, and that I vill abide by them. Signature 2.Printed 1 .. AP OVAL INFORMATION Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 9774511, 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 t " Date "9 0 Zoning Official Date 2— 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 1 1/0212015 Page 2 of 3 Z�zo-00l,`f� �S Intake to complete the following: Isl Is u n LI, HI or PDIP zoning? If so,.give.applicant a Certified. Engineer's Report (CER) packet. Y ViWi ere be food. preparation? If so, give applicant a Health Department. form.. Zoning review can nat begin.uhtil we`receive.approval from Health Dept, FAXDATE Circle the one.that applies Is pareel on. private wdlt.t i . �epa,?jtmen�t If private wellprovide He orm, Zoning.review.can.no.t;lieginuntil we receive, approval from Health Dept. FAX DATE Circle the'one that app.�-blk i Is parcel on Septic o se . Y/N ill you be putting up.a new sign of.any kind? If so, obtain proper Sign permit. Permit# YyN -Will there be any new construction or renovations? If so,.obtain t e proper Permit. Permit # 'Lig �V l G - P L r5� ,X1k Y-Zz-F Zonine to. complete the followfur.. Reviewer to complete: the following: Square footage of.Use! j/2-to as; Under Section: I" R 0 c c.01 0/ Supplementary regulationssection: Parking. formula! �r2- t9OD Required spaces: [3 YIN 2 -33 �'� cJt Items.to be verified in the Reid: � - p, .�j � 5ni� zor�3-3a Viol • Y/N If so; T ist:- 0v etc)—yi offers: T o, List: 7YA 2p )G( —0`7 Vari e: Y/ Tf. s� t: SVs• Y v � If sfst: Clearances: �- OL q 2� i � SDP's �L Q _ 3 20 — 2 t 2©l7_ b 3 Revised.11/i/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 Cleurarzce, Zuriir:g Ailrninistrator Deterininadons or Appgals, Sign Permits; Bitilding Perniits) if the application:is not the owner. I certify that notice of the application; Zoning Clearance C c 2 [County application name and number] was provided to The Center, Charlottesville the.owner of record of Tax Map [name(s) of the record owners of.the.parcel] and Parcel Number 06100-00-00:1,5400 by delivering a copy of the application in the manner identified below: 0 Hand delivering a copy of -the application: to [Name of the record owner if the record owner is .i identify the recipient of the record'and the recipient's person; if the owner of record. is, an entity, title or off ce:for. that entity] on Date.. t ^ l Mailing a copy of the application to. The Center, Charlottesville - Peter Thompson, Exec. Director [Name of the record owner if the record o vvner 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 thatentity] on 2/1112020. to the following address: Date -peter@thecentertviII6.org [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 Charlie Sa►fwasser Print Applicant Name 2111/2020 Date : i airr". _ .v! I6 tT;''..-],,1: �, :,! ,^, (fir i yyy� Z!vt ��' � b+ a'F i i°Sfczy: F•'.:,j:; c:'ct; .� � ic--1-%;lil cis' i !..j�; by 'i!rr;-; !•: I'r+;r.: -�:" ,7 i 5.t� ;, :1:1: :��. 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