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CLE202000180 Application 2020-12-17
Zoning Clearance Application "�""`° ceps e ebPmenl 401 manure na Norm vn FOR OFFICE USE ONLY Fee Amount: $ 54 Receipt *'(PN)06f ?VA0413 7- §' cnadonem➢e, VA 229M Phone 4a4.29esM2 dol�,�r the�,i'h>;a'ta s r::oLinty t aGir, Oy Oe- alcritrnont Department Applicant - Fill out the entire page below And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Clearance Number: G L< 201G Date Paid: �a�/a /2 o By: Check #: \ By Name: Mailing Address: Wawa #8667 260 W Baltimore Pike Wawa PA 19063 E-Mail Address: Phone #: nancy.m.daly@wawa.com 610-358-8029 Tax Map and Parcel number and/or Address of the Business: 820 Pantops Corner Way Charlottesville VA22911 07800-00-00-005AO Zoning: Stafiwill6nautifunknown U� l I Parcel Owner: Rebkee Partners Panto s LLC P Owners Address: Check any that apply: New Business ❑ Change of use Change of ownership p D Change or Name Business Name: Description Of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional into. Convenience store, beertwinelfueling station Previous Business on Site: None Floor Plan: Please attach either an architectural drawt 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: 6•049 sq. ft. — Parcel Zoned LI, HI, or PDIP? Yes V No If yes, fill out a certified Engineers Report (CER) food preparation? ® Yes ❑ No If yes, provide Virginia Department of Health approval on public water or privet® welt? pthaParcel 10 Public u Private If on private well, provide Virginia Department of Health approval on public sewer or septic? Public uSeptic If on septic, provide Virginia Department of Health approval utting up any new signage? ✓0 Yes No propriate ppropriate sign permit and list permit # below --_� If es, obtain ap Will there be new construction or renOVatfOrlS? yj Yes Lj No If es, obtain ap propriate ppropriate building permit and list permit #below Please list any applicable Building Permit ffs: B2020-00743 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-T Date 4&7 For Albemarle County Staff Review Only Proposed Use: _ I Permitted by 8ectfon: Z� 2.' J l Supplementary Regtdations: - 51 r zo Applicable Special Use Penult (SP): Applicable Razonings (AAA): 2D 13-oz Applicable Site Plans (SDP): .Z C'4 Parking: If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some Parking Formula: Total Square Footage of the Use: Required number of parking spaces: Associated Clearances: Variances: Violations: Is a site Inspection necessary?: Site Inspection on (date): Notes: Conditions of Approval: Defined by: I [Q8ite Plan ❑ Zoning ordinance ❑ COD 5D,' 2,-)17 To Confirm: Additional conditions of approval apply to Fireworks and Chfistmas 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 /--2z—/7/�u. Zoning Official Date I ` ZL% Other Official V U ' P,,7 Date Z ZG) County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 229D2 Phone: 434.296.5832 Fax: 434.972.4126 4 #�&49T a Zoning Clearance Application a Cl Mrnt de County Community Development Ch MGntlre Rd, N 9 2 ng Charlo 4U.2e, VA 229p2 Ptia,e <34.296.5832 Applicant - If you are not the landowner, please fill out the entire page below, confirming that you have either informed or are going to notify the owner of your 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, Wawa#8667 GLE 2,02--( p� to Rebkee Partners Pantops LLC the owner of Tax Map and Parcel Number 07800-00-00-005Ao by either delivering a 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 12/16/2020 to the following address: 2800 Patterson Avenue, Suite 200, Richmond VA 23221 (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 Name Printed Date 3 w .. 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