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Home My WebLink AboutCLE202000074 Application 2020-04-27APPROVED by the Albemarle County Community Development Department Date File7 7; TY Application for Zoning Clearance CLE# aO�0000 1" OFFICE USE ONLY Date: PLEASE REVIEW ALL 3 SHEETS Check # --- Receipt # '/W"070c0g7r Staff: PARCEL INFORMATION 3v_>- Tax Map and Parcel: '� b M 1 — Existing Zoning pl(v,� ,vim OeWIR?kyat 560 Parcel Owner: �^ `J.i t.�Q ,i..:.l Dr\y, j : , s S LLC Parcel Address• ,: uo rc.lnvk AU2., e . 100 City C(no,t I *Psy;1(Q., State Zip ZMN- (include suite or floor) PRIMARY CONTACT f Who should we call/write concerning this project? L:,yw& Address: (�SQ Ala 64DW5 U. ��e. �20 City State V-4 Zip 2,ZS 7� Office Phone: (JCS Cell # Fax # E-mail 1C, rh n �n .yJeuer) APPLICANT INFORMATION Check any that apply: Change of ownership Change of use _Change of name New business Business NamelT)rpe: --- -J--- Previous Business on this site 2 ' Cat P 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: "This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move theme to anew location, a new Zoning Clearance Ail] be required. I hereby certify that 1 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 uYthe best of my kilo ledge. ( have read the conditions of approval, and I understand them, and that I will abide by them. Printed t t' Signature �� ..� ` � _.�'��,"�n� �� 1`' APPROVAL INFORMATION i ( ] Approved as proposed [ j Approved with conditions [ ) Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xi 17. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [ I This site complies with the site plan as of this date. Notes:— — Building Official Date Zoning Official Date—� Other Official Date County of Albemarle Department of Uommuntty 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 tkC.4dLI, HI or PDIP inning? If so, give applicant a Certified Engineer's Report (CER) packet. Y N W I t rc 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 public wa If private well, provide H rtment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applie Is parcel on septic or p lic sevymr� it N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit #ZD2D fOt�O�Z S Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zonine to complete the following: Reviewer to complete the //following: Square footage of Use: 2,6500 Y/N O'f �' i ea/ CfC�J Pt'rmitted as: (G� tk.li c cat Under Section: 2- 5, 2 , [ C L) Z 3, -2 i ( C Z) Supplementary regulations section: , Parking formula: `T 51t �&O L Required spaces: (-2- 5 IG'4C�S Y/N ' Items to be verified in the field: 2 / DO vbv a �(�{ e(/ S 19 20 —Z Inspector : Notes: Date: lyf, 7-5 ers: NViofList VS0., : hodt-DL .26 ' 7� - Var' If so; fist: 2o( 6 - 02 w SP'st Y/ Ifs L' Clearances: SDP's ZOiZ-oz �G�-z5 Revised 11/1/2015 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 Clearance, Zoning Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the owner. I certify that notice of the application, Or1 Cq Nw- ce, 6�f 7 [Cotmty application name and number] was provided to S as o 'r r t l—LC� the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number manner identified below: by delivering a copy of the application in the 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 Ale cN 1"� '��a. [Name of the record owner i ie reco 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 �� ry.l� 4' E to the following address: Date LE [address; written notice mailed to the owner afthe last known kidress of the owner as shown on the current real estate tax assessment books or current real estate tax assessment records satisfies this requirement]. - f Signature of Applicant Print Applicant Name Date __ EXHIBIT A SITE PLAN It is understood and agreed that the site plan attached hereto is merely for the purpose of showing the general layout of the Shopping Center and the approximate location of the Premises and is not to be deemed to be a warranty, representation or agreement on the part of Landlord that the Shopping Center will be exactly as depicted therein or that tenants depicted therein (if any) are now in occupancy or will be in occupancy at any time during the Lease Tenn. The site plan is not final, is not to scale and is subject to change without notice to Tenant. Nothing contained therein shall be deemed to limit or restrict Landlord's right to change, alter or expand the Shopping Center, any buildings thereon, the land area, any improvements thereon, the parking areas, the Common Areas or any other part or parts thereof. \ PRIMARY�EYECARE o Premises \ �k, STH STREET 1(f STATION e�~" � y-•• 4YA Page 1 of I of Exhibit A 3267335-4 11505.0024949 8 `.19cq £ga HE :,gta4 7gag89 i> s? g :ce::>g�585 ilaecii$i�g 'pt�g, =ii�3g gig i it sss1• 6�! gy Ett _4i 1g ISg2'� Sg?js:�iiara OWINDOW ELEVATION O WINDOW ELEVATION I/4 _1'.0, I/4._I.0. . �. W ;o sm d owe O QQO S x9Q�w�� D�WYb9 ° "s?H11 WAKE DIMENSIONAL PLAN THIS DRAWING IS FOR VISUAL REPRESENTATION ONLY. THIS IS NOT TO BE USED AS A CONSTRUCTION DOCUMENT. Io„ozo A-1 CREATE • B U I L D INSPIRE if MEM11151 MEN W. 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