HomeMy WebLinkAboutCLE202000060 Action Letter 2020-03-10LA
APPROVED
by the Albemarle County
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Applic *ion-Zmmn-g--C-learance
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # Z �`t G,-' l Date: �� C't
Receipt # Staff: C_.._
PARCEL INFORMATION
Tax Map and Parcel: 06000-00-00-024EO Existing Zoning Home For The Elderly
Parcel Owner: UNIVERSITY OF VIRGINIA FOUNDATION
Parcel Address:100 Colonnades Hill Drive Ste 138 City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Susan Polatz
Address: 55 Public Square Ste 1180 City Cleveland State OH Zip 44113
Office Phone: 4( 40) 600-1592 Cell # Fax # 888-793-7372 E-mail license@salonps.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: salon within The Colonnades, senior living community, for residents 3 Z
Previous Business on this site salon within The Colonnades, senior living community, for residents
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:
We will operate existing salon providing hair & nail services
Wed 9-2 pm, 1part-tome employee
*This Clearance will on y 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 o is permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to the b7t of e. ave read the conditions of approval, and I understand them, and that I will abide by them.
i
Signature ! Printed John Polatz
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, x117.
[� o 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 ��
�f
Zoning Official /� Dat 12y
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/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will t 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 public water?
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 public sewer?
Y Wil u /5�
be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y N
Wil ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
ZoninLy to complete the following:
Reviewer to complete the following:
Square footage of Use: 330 S f
permitted as: C{ ����Or) CiS S �S�"eC� �v. ��
Under Section: I l 3 . 2 Z i'`' "1 / e�,Cox o"
Supplementary regulations section:
,�-.( I
Parking formula:
Required spaces:
Y N
Ite a verified in the field:
Inspector: Date:
Notes:
Violations:
Y I(K'j,
If so, ist:
ffers:
Y N
-4"o, List: Z
0000 �
Iariance:
/ N
f so, List: l �� G S f S Z e.
SP's:
Y if/NJ
If sist:
Clearances:
f i� 201
SDP's
.5OP2oat `71
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Revised 11/1/2015 Page 3 of 3
see attached Agreement.
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,
was provided to
[County application name and number]
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
Q Hand delivering a copy of the application to
the owner of record of Tax Map
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
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
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].
Signature of Applicant
Print Applicant Name
Date
M 0
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