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HomeMy WebLinkAboutCLE202000153 Approval - County 2020-11-23Zoning Clearance Application FOR OFFICE USE ONLY Fee Amount: $ 54 Receipt #.jV16gLfKG00 7L4 Lf V Clearance Number: o-E )-bo oo 153 Date Paid: W I W' Q Check #: Applicant - Fill out the entire page below And return to Community Development 401 McIntire Rd, North Wing, Albemarle County Community Dwebpment 401 Mclnfim Rd, NOM Wing r' Chadotle.Wle. VA 22902 ITRCINy1' Phone434.296.5632 By: /KI CkCLt 1 5(CJS By. KZ APPROVED by the Albemarle County Community Development Department CharlottesviW A 22902 tiia3w MlI Name: Michael Spatz E-Mail Address: mrspatz@sentara.cOm Mailing Address: 500 Martha Jefferson Drive 22911 Phone #: 434-654-7038 Tax Map and Parcel number and/or Address of the Business: 606000-00-00-03800 Zoning: Staff will fill out 9 unknown Parcel Owner: 246-2248 Ivy Road LLC 2nd floor owners Address: P10 4th St. NE Charlottesvill ly: New Business ❑ Change of use ❑ Change of ownership ❑ Change of Name pPrimar!y;Care Sentara Blueridge Internal Medicine ness: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info. ysician Practice Previous Business on site: tory House Real Estate 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: 165 sf Is the Parcel Zoned Ll, HI, or PDIP . ❑ Yes 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? 10 Public ❑ Pnvate 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? RI Yes No If es, obtain a ❑ ❑ y appropriate sign permit and list permit #below Will there be new construction or renovations? Yes ❑ No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit #s: C 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. MicGtae-G S�iia.#z, Signature Printed Michael R. Spatz Date 11/9/2020 2 a oe aL 2� Albemarle County Zoning Clearance Application 4 ` '' Community Development Wi99 k• Charmlesville, VA 22902 ! GINIn 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, Sentara Blueridge Internal Medicine clearance number provided by Staff or business name to 2246-2248 Ivy Road LLC the owner Name of landowner on record of Tax Map and Parcel Number 06000-00-00-03800 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 Mailing a copy of the application to the owner identified above on Date 10/9/2020 to the following address: 310 4th St. NE Charlottesville, VA 22902 (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) A17 Signature of Applicant Mic�ia e-(, S t-����" Applicant Name Printed Michael Spatz Date 11/9/2020 3 For Albemarle County Staff Review Only Proposed Use: Permitted: Yes ❑ No Permitted by Section: $ - 95 -A. 1. I 1 Supplementary Regulations: —. Applicable Special Use Permit (SP): pi — % _ TA. I �I Applicable Rezonings(ZMA): 00 _(5 icr T—`IG11,4 Applicable Site Plans (SDP): 2015/ — ` 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: Defined by: ®Site Plan ❑Zoning Ordinance ❑ CoD ❑Existing Total Square Footage of the Use: S; Required number of parking spaces: SOP 5FnI5-(d2_ Associated Clearances: 19' Variances: Violations: Is a site inspection necessary?: ❑ Yes 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 ❑ Backf low 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_ Date/a(] Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4