HomeMy WebLinkAboutCLE201700260 Application 2017-11-21Application f r Zoning ClearanceN&
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CLE #
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OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff.
PARCEL INFORMATION
Tax Map and Parcel: 78-17D6 Existing Zoning P95(,
Parcel Owner: Woodward Properties
Parcel Address: 260 S. Pantops Drive City Charlottesville State VA Zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Scott Lancey
Address: 801 Hopeman Pkwy City Waynesboro State VA Zip 22980
Office Phone: 5( 40) 943-6675 Cell # 540-461-2171 Fax # 434-234-0241 E-mail scott.lancey@scouting.org
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: Boy Scouts of America/Non-Profit Youth Organization
Previous Business on this site
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:
Ghristmac Tree In+ aAd racks, zgfo employees, 19 12 velt1r}teers
*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. 1 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 Printed Scott M. Lancey
APPROVAL INFORMATION
[Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Ba flow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x 117.
[ 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 C'l/G �:�G�/ Date ZZYM-1-2
Zoning Official Date l l l 21 1
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/N
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 r;p�ublic water
If private well, provide He epartment 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 blic sewer?
Y/N
Will you be putting up a new sign of any kind?
Sign permit.
Permit# 16.hAP kff
If so, obtain proper
Reviewer to complete the following:
Square footage of Use: 1st'
Fetmitted as: 2�11 G A) SCIi es
Under Section: _ a-41 MI of i A
Supplementary regulations section:
Parking formula: }
Required spaces:
Y/N
Ite to be verified in the field:
S Zu17-(l� rli I Inspector:
Oere
be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to com lete the followin :
Notes:
Date:
Vio ions:
Y/N
Ifst:
offers:
(YJN
so, List:
riance:
Y N
o, List:
SP,
Y N
If so, List:
Clearances:
SDP's
'LG ii t�4
2.140
Revised 11/1/2015 Page 3 of 3