HomeMy WebLinkAboutCLE202100005 Application 2021-01-26=yam "tRF,
, Albemarle County
9 "' r Community Development
Zoning Clearance Application =i-"' m 401 McIntire Rd, NMh Wing
Charlottesville, VA 229U
Phone 4M2%58M
FOR OFFICE USE ONLY Clearance Number3oal _,t)
Fee Amount $ 54 Date Paid: Il By: J Y-) Vw I)r Unk
Receipt#: l z lVljj Check#: By: )
Applicant - Fill out the entire page below
And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
1S�1n 0.r Acr un
E-MailAddress:
s Uf�l�e MM�
Mailing Address:
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Phone #:
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Tax Map and Parcel
number and/or Address
of the Business:
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2:291 SamiAO%t Lln•
r LoWewAlt, Y A A-2- O
Zoning:
Staff will fill out if unknown
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Parcel Owner.
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Owners Address:
2 Yv►Af r
Check any that apply:
New Business Change of Use ❑ Change of ownership Change of Name
Business Name:
WE
Description of Business:
Describe the business including use, number of employees, number of shifts, availability of parking, and any additional into.
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cirinAh f 1 Empiciil
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Previous Business on Site:
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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:
Is the Parcel Zoned LI, HI, or PDIP7
Yes VNo If yes, fill out a Certified Enoineer'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 Heath 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 El No If yes, obtain 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:
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 i e and accurate to the best of my knowledge. I have read the conditions of approval, and I understand
them, and that I wi bi a by them. 1
Signature Printed �uAvis JAw d�
!r Ll
Date V
.t' /y ',202-I 2
�2 �i —' Albemarle County
Zoning Clearance Application °= 401mMClntireCRQ North Wing
Charlottesville, VA 22902
Zin,...nP Phone 434296. 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,
TUAe- 561(1
to 1Azrlmatnu•3 LLC, the owner
of Tax Map and Parcel Number 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)
❑J Hand delivering a copy of the application to the owner identified above on
Date 1, 7 •a202i
❑ Mailing a copy of the application to the owner identified above on
Date
to the following address:
(Written notice to the owner and last ow address on our record books will satisfy this
requirement. Please see staff for Ip d ermining this information if needed)
Signature of Applicant
Applicant Name Printed er Liv\JK
Date ) % „20a f
3
For Albemarle County Staff Review Only
Proposed Use:
Permitted:
Yes ❑ No
Permitted by Section:
ZL1r Z i I ( 51) CG /ll
Supplementary Regulations:
Applicable Special Use Permit (SP):
�-
Applicable Rezonings (ZMA):
Applicable Site Plans (SDP):
2 D00— 15
Parking:
If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some
Parking Formula:
I3/`p cc 42
Defined by:
❑Site Plan Woning Ordinance ❑ Coo [_]Existing
Total Square Footage of the Use:
Zf Po U
Required number of parking spaces:
'Z� S LiS :SS 5 fit, - cL 1 e
Associated Clearances:
Variances:
1pp?o
lee p D
J�rJ
Violations:
Ivit
Is a site inspection necessary?:
❑ Yes h o
Site Inspection on (date):
To Confirm:
rt
Notes:
Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas Trees
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Approval Information J I
❑ Approved as proposed proved with conditions
❑ Denied
❑ Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4611 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 Officia
Date 71
Z' Z _ Z
Zoning Official
Date /
Other Official " p r ` I`� �l �'U(
Z 2
Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4
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