HomeMy WebLinkAboutCLE202000170 Application 2020-12-04Clearance Application '" y� Albemarle County
r Cammurn pave ment
,m ChehoeeeAle, VA 22902
� I�RC3N3�Phoea 03C196.6632
- O N L Y Clearance Number: C LcZ ? o ej 6— 0 0.1
a.c� 1@fJVED
Date Paid: yr� /1/a /2 � By: b&e r�tbtenprle County
,�f0�62 jt lll�a3-I Y check M 7 ojii. zunrytleivelnpment Department
,.cant - Fill out the entire page below
.ad return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Mailing Address:12421 Ivy Rd, Suite 200, Charlottesville, NC
Tax Map and Parcel
number and/or Address
of the Business:
Parcel Owner:
Check any that apply:
Business Name:
12CO
lers of Charlottesville
New Business u Change of Use
E-Mail Address:
Phone #:
Zoning:
Steil will fill out if unknown
I Owner's Address:
Change of ownership A
11.11 vrner(gaol. com
14-951-9119
M' Rd, Suite 200 Charlottesville, NC 22906
Inge of Name
Description of Business: Describe the business including use, number of employees number of shifts availability of p2rlung and any additional info
Bowling Venue
Previous Business on Site: ]Bowling Venue
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: �,5i �/��i
Is the Parcel Zoned LI, HI, or PDtP?
Yes No
If fill
Will there be food preparation?
Ej Yes Ej No
yes, out a Cgnified Encine s Reoort (r al
If
Is the Parcel on public water or private well?
� Pudic ❑Private
yes, provide Virginia Department of Health approval
If
Is the Parcel on public sewer or septic?
on private well, provide Virginia Department of Health approval
Will you be putting Up any new signage?
,{ Public Septic
tic
If on septic, provide Virginia Department Partment of Health approval
Will there be new construction or renovations?
Yes No
If Yes, obtain appropriate siermit and list Y9n 0 permit If below
Please list any applicable Building Permit #s
® Yes No
If es, obtain ap
propriate ppropriate building permit and list permit #below
B2020D01471$ /—DI 713='3
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 o them, and that I will abide by them. f approval, and I understand
Signature Printed Tom Romer
Date 8/3/2020
2
Zoning Clearance Application '? N CommuntyDevelPmty
401 McIntire Rd, Norm Wing
Chedohesvdie, VA 22M2
6 �S Rhone 03C.2%.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,
Bowlero C-LfZoze- I %
dearance number provided by Staff or business name
to Keglers of Charlottesville the owner
Name of landowner on record
iof Tax Map and Parcel Number 04e00-00-00-112CO 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 8/3f2020 to the following address:
email: tomromer@ao.com
(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 /a„
Applicant Name Printed Tom Romer
Date 8/3/2020
3
For Albemarle County Staff Review Only
Proposed Use:
B
lit.
Permitted:
Yes ❑ No
__.
Permitted by Section: Supplementary Regulations: d^
Applicable Spacial Use Permit (SP): fro n
(7 l`t
Applicable Rezonings (ZMA):
.--1,
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:
4CcS Vte
Deaned,by:
[]Sits plan ❑Zoning Ordinance ❑COD xisting
Total Square Footage of the Use:
Z4fx9
Required number of parking spaces:
Associated Clearances:
�C G.7 GCF.CI' 4/f
l��I P-Y— " �u n ,�1 Sya,O` ?z'
1
Variances:
.�•
Violations:
Is a site inspection necessary?:
❑ Yes o
Site Inspection on (date):
Notes:
(�, To ConRrm:
pa v t e- C U tit ye- Cry, kej(ef�
Conditions of Approval:
Additional conditions of appreval apply to Fireworks and Christmas Trees
Appr,9�val Information
Approved as proposed ❑ Approved with conditions ❑ Denied
Li 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
w the existing site plan.
This site complies with the site plan as of this date.
Conditions:
Additional Notes:
r /
Building Official Date�- 7t��
Zoning Official Date l /( Z -2-0
Other Official Date
t—�
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126
4