HomeMy WebLinkAboutCLE201700246 Application 2017-11-03Application for Zoning Clearance
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Check#Date:
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 06100-00-00-13100 Existing Zoning Mercantile
Parcel Owner: Attp s6oppine, (011c7 ko(106 yo Simon VeRcr'1e110
Parcel Address:.1636 Rio Rd E, Ste 1412 City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Nima Ghedami, Project Manager
Address : 5999 Savoy Dr City Houston State TX Zip 77036
Office Phone: (713) 634-4087 Cell # Fax # E-mail nima.ghedami@charmingcharlie
Co r-1
APPLICANT INFORMATION
_
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Charming Charlie LLC / Retial of Women's Clothing, Custom Jewelry, and Accessories
Previous Busines-s on this site n/a
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:
sites Ctot#ia, Csir�t� �e�u®tr,-aad A�crrassinumber of employees! 0 V stor4i opening
"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 Printed Rob Adamek, CFO 10/26/2017
APPROVAL INFORMATION
[ (,,}°Approved as proposed [ ] Approved with conditions [ ) Denied
] B kflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
[[ 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:
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� _/W1 VO4rDate �r /
Building Official
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
Revised 11/02/2015 Page 2 of 3
Intake to complete the following:
Y
Is u in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y
Wi re 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 o ublic wate
If private well, provide Healt 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 o ublic sewer
Y
W it ou 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 #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: b
OermN
itted as: r401 Lk�
Under Section: L , Z • 1 ( I
Supplementary regulations section:
Parking formula:
y.�S��b�O {�� 5�toP�1✓iu1 (Ch��
Required spaces:
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Y1(Nj
Item -so be verified in the field:
Inspector : Date:
Notes:
Violations:
Y/N
If so, List:
Pr rs:
Y/N
Ifs% , ist:
Variance:
Y
if st:
s:
Y,'N
o, List:
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Clearances:
Clad 7-o -7- 7-4q 143 11f 103 16Z
SDP's
1609-- 37
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9 t 91- 11 7
Revised I I/l/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, Zoning Clearance
[County application name and number]
was provided to Washington Prime Group _ the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 06100-00-00-13100
manner identified below:
Hand delivering a copy of the application to
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
LZIMailing a copy of the application to Washington Prime Group, Eric Stock, VP Leasing Counsel
[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 October 26, 2017 to the following address:
Date
Washington Prime Group, c/o Eric Stock, VP Leasing, 180 E Broad St, Columbus OH, 43215
[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
Rob Adamek, CFO
Print Applicant Name
10/26/2017
Date
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