HomeMy WebLinkAboutCLE202100049 Application 2021-04-08 (2)q � C 1, *",VV2�1
j Zoning Clearance ApplicationAlbemarle CountyCommun io gevelo " W4g1 MOlnriree, NOM Wing
Chatlotlesville, VA 229g2
Phone 434.2g&S9
FOR OFFICE USE ONLY Clearance Number: CLi_ Xc� l — 11_'N
Fee Amount: $ 54 APPROVED Paid: 3(dq�a� By: by the Albemade County
Receipt #: a�}I Co UMCj IS)i V Check #: C tC By. �� Munity Devellopment Department
_atApplicant - Fill out the entire page below Fite 2_0
And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name: John Thier
E-Mail Address: john@turner-enterprises.com
Mailing Address: PO Box 521, Charlottesville, VA 22902
Phone #:
Tax Map and Parcel 330 Claremont Lane, Crozet, VA 22932
number and/or Address
Zoning:
of the Business:
Staff will fill out if unknown A f h ii
Parcel Owner: Old Tr it Medical Arts LLC
Owner's Address:P Box 521, Charlottesville, VA 22902
Check any that apply: New Business f] Change of Use Change of Ownership ❑ Change of Name
Business Name: linical & Educational Services, PLC
Description Of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info.
ACES is a family -focused clinical practice that provides psychiatry and diagnostic, consultative, and therapeutic services.
11 employees, 1 shift (8AM-8PM)
Previous Business on Site: N/A
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 the
of use, and
any additional information.
Total Square Footage Used
3,067 Net SF
for the Business:
Is the Parcel Zoned LI, 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? Public Lj Private
If on
Is the Parcel on public sewer or septic?
private well, provide Virginia Department of Health approval
Public 11Septic
If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
as No
Will there be new construction or renovations.
If yes, obtain appropriate sign permit and list permit #below
Yes El No
Please list any applicable Building Permit #s:
If es, obtain ap
propriate ppropriate building permit and list permit #below
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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 'jam - Printed John Thier
Date 3/24/21
pFA p_
J22 I•IIL. Albemarle County
Zoning Clearance Application yr, 401Mdo eDRd, North Wing
Char etlesvilie, VA 22902
r /RCtNI`� Phone 434296.5e32
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,
clearance number provided by Staff or business name
to the owner
Name of landowner on record
of Tax Map and Parcel Number 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
to the following address:
(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
Applicant Name Printed
Date
3
For Albemarle County Staff Review Only
Proposed Use:
�tW L
Permitted:
Yea ❑ No
Permitted by Section:
N f
Supplementary Regulations:Applicable
Special Use Permit (S,/AcApplicable
Rezonings(ZMA):�
zQOg—�Applicable
Site Plans (SDP):
U
Parking:
approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some
irements are determined by a ZMA or by an ap roved Code of Development.
Parking Formula:
c iebt
Defined by.
ite Plan ❑Zoning or❑ coo ❑Existing
Total Square Footage of the Use:
3,00
Required number of parking spaces:
/ I $ Qc'—_i( T 1 1°r c��ryl 2o2 � C
CamJyI d
Associated Clearances:
_ f t 7
Variances:
Violations:
ZVI V Zo t d -k 6f
Is a site inspection necessary?:
❑ yes ❑ No
Site Inspection on (date):
`0-0
To Confirm:
t?
Notes:
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Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas Trees
Approval Information
proved as proposed ❑ Approved with conditions
❑ Denied
kflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117
r
physical site inspection has been done for this clearance. Therefore,
it is not a determination of compliance
h the existing site plan.s
site complies with the site plan as of this date.
Conditions:
Additional Notes:
Building Officia
Date
Zoning Official
Date / j�
Other Official
Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126
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