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HomeMy WebLinkAboutCLE202000086 Application 2020-06-03of Ay8 rti Albemarle County Zoning Clearance Application Community Rd, o i �' 401 McIntire Rd, North Wing ?� Charlottesville, VA 22902 r'IR�KSA"� Phone 434.296.5832 FOR OFFICE USE ONLY Clearance Number: t'!�`' �� t Fee Amount: $ 54 Date Paid:,�X03b By. FY _l- - ;V ' N i`l« J �, 13TWU V I DT�IE41belmarle PROVED Receipt #: ' �t Check #: �� By:. County Applicant -Fill out the entire page below Common sty 4ev eloprrtent Department C*6— — z-e And return to Community Development 401 McIntire Rd, North Wing F14ia -22902 - Name: Rhett N Willis Jr E-Mail Address: Rhett.willis@gmail.com Mailing Address: 930 Bing Lane, Charlottesville, VA 22903 Phone #: 912-604-9598 Tax Map and Parcel number and/or Address of the Business: I O3 1 Zoning: Staff will fill out if unknown RAkE� Parcel Owner: Tony Valente Owner's Address: 2237 Wingfield Rd., Cville, VA 22901 Check any that apply: IV New Business Change of Use Change of Ownership ❑ Change of Name Business Name: Charlottesville Plastic Surgery Description of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info. Plastic Surgery office/clinic. 1-2 employees, sharing space with Charlottesville Internal Medicine (currently occupying space) M-F 9a-5p., Plenty of parking Previous Business on Site: Will be sharing clinic space with Charlottesville Internal Medicine Floor Plan: Please attach either an architectural drawing or a sketch of the proposed business indicating the location of uses, the uses of rooms, the total square footage of the use, and any additional information. Total Square Footage Used for the Business: ��oOsry 8 `1 Is the Parcel Zoned LI, HI, or PDIP? Yes 11 No If yes, fill out a Certified Engineer's Report (CER) Will there be food preparation? Yes No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? Public Private If on private well, provide Virginia Department of Health approval Is the Parcel on public sewer or septic? Public Septic If on septic, provide Virginia Department of Health approval Will you be putting up any new signage? Yes No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes IV No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit #s: Zoning Clearance review cannot begin until the application above is complete and all applicable forms and fees are submitted. 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 Date 05/20/2020 Printed Rhett N Willis Jr 2 SOFA Albemarle County PtIW. Community Development Zoning Clearance Application A 401McIntire Rd, North Wing Charlottesville, VA 22902 �BG1N7� ` Phone 434.296.5832 Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either informed or are going to inform the owner of your zoning clearance application. CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER I certify that I will provide (or have provided) notice of this clearance application, Charlottesville Plastic Surgery r cr-- 2d Z. o- $ 6 to clearance number provided by Staff or business name Tony Valente Name of landowner on record the owner of Tax Map and Parcel Number l - —U .3 _ 10 t by either delivering a TMP number of property copy of the application to them in person or by sending them a copy of the application by mail. (Please check one of the following below) ❑ Hand delivering a copy of the application to the owner identified above on Date V Mailing a copy of the application to the owner identified above on Date 05/20/2020 to the following address: Tonyvalente@comcast.net and 2237 Wingfield Rd., Charlottesville, VA 22901 (Written notice to the owner and last known address on our record books will satisfy this requirement. Please see staff for help determining this information if needed) Signature of Applicant /r/-/t/) GIJ4� Applicant Name Printed Rhett N Willis Jr Date 05/20/2020 C For Albemarle County Staff Review Only Proposed Use: P q.4t r Permitted: LKYes ❑ No Permitted by Section: 20 t y, Z �� 2 �� Supplementary Regulations: Applicable Special Use Permit (SP): .� Applicable Rezonings (ZMA): Applicable Site Plans (SDP): Parking: If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some parking requirements are determined by a ZMA or by an approved Code of Development. Parking Formula: , Zbb Defined by: I ❑Site Plan ❑ Zoning Ordinance ❑ CoD [—]Existing Total Square Footage of the Use: Sop Required number of parking spaces: Associated Clearances: Variances: Violations: ---- Is a site inspection necessary?: ❑ Yes [i�'No Site Inspection on (date): To Confirm: Notes: Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees Approval Information Approved as proposed ❑ Approved with conditions ❑ Denied ❑ Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117 ❑ 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. Conditions: Additional Notes: Building Official Date_ Zoning Official 0e, ® \ (rl { Date _ �© Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 ,i r-t'N V V to by lne Albemarle County . ': rt�frtUtt OQV t Applflcan'®r d'i Iearance m OFFICE US ONLY VICd'),6 PLEASE REVIEW ALL 3 SHEETS Check # iDate: Receipt # 0 Staff: PARCEL INFORMATION Tax Map and Parcel: _6 6 1 Z 0` 03 " d -- 16110 ExIsting Zoning Parcel Owner: 4n+in0L.i Volle_ +e,ESc� P,D.BOX 791 Charlo44eSyillC -45ty0l6 Parcel Address: S N i -!- e_ 9-0 5 .A City C k a r I o-+- + t: 5v i 1 Mate VA Zip (include suite or floor) PRIMARY CONTACT Who should v call/write concerning this project? R- r. H o e P! 5 Lt e r M Address : ot- 1i O `}- DaVe_v1+Y'Y L• vi City C h o v, I o-i 4 a 6v; I %bite VA Zip a a q! I 4 3 Office Phone: L_) Cell # 1? �,05 - 5 `i 55Fax # E-mail _ re 0 e e -f 'i SC APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name 1 _ / New business Business Name/Type: C� 4 w 1 o ++ r- s✓ i I I C. I h 4 c v V1 I l M� d I C I v} e- a A. t V'I 6 10 0 o vt c In o v N a ei I -+- ,care PLC, Previous Business on this site r vvt i 6 y. 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: P11yesbaleivi 's r i c. e 5 t: t.ut to c a Opyvt $—JpPaOPI-1 i c Brctv,Ghlc�n Pyo�c ,�taviotl zvt¢�,� '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 R r^ c t: F j s e, k e.. v APPROVAL INFORMATION .pkpproved as proposed [ ) Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl 17. 'r,-- 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 Date C tiIV •.Y.,. Zoning Official -- �G6� Date 2 / I Z Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126 Revised 1 1/02/2015 Page 2 of 3 CVLJI I-r