HomeMy WebLinkAboutCLE202100051 Application 2021-04-22Zoning Clearance Application
FOR OFFICE USE ONLY Clearance Number: lJ -fofO' —5
Fee Amount: $ 54 Date Paid:
Receipt #:5 S(j5X\k n)6gAe Chi` e 1
Applicant - Fill out the en%tireeppaggee below
And return to Community Development 401 McIntire Rd, North Wing
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Albemarle County
Community Development
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401 McIntire R4 North Wing
Charloge5vi8e, VA 22902
HrHCItiIP
Rhone 434.296.5832
By: APPROVED
by the Albemarle County
By unity Development Department
File LSE Lezl 5L_
Charlottesville, VA 22902
Name: =HINA
QURESHI
E-Mail Address:
dochina3l @hotmail.com
Mailing Address:
1941 GLENWOOD STATION SUITE #103
Phone M
434-284-2809
Tax Map and Parcel
number and/or Address
of the Business:
061YO-00-OC-10300
Zoning:
Neighborhood Model District
Parcel Owner:
GLENWOOD C-3 LLC
Owner's Address:
1 941 GLENWOOD STATION SUITE #103
Check any that apply:
Pr New Business e Change of Use V Change of Ownership
El
Change of Name
Business Name:
PRODIALABORATOR1ESr
Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info.
Description of Business:
LABORATORY SAMPLE COLLECTION AND TESTING FACILITY. NUMBER OF EMPLOYEES 1-3
Previous Business on Site:
Dr. Gretchen Beck, MD -Allergy & Immunology Specialist
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:
2,121 SF
Is the Parcel Zoned LI, HI, or PDIP?
0 Yes 0 No If yes, fill out a Certified Engineers Report (CER)
Will there be food preparation?
❑ Yes 12 No If yes, provide Virginia Department of Health approval
Is the Parcel on public water or private well?
�1 Public [j Private 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
p p p Department of Health approval
Will you be putting up any new signage?
Yes ® 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:
N/A
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.
a
Signature Printed Hine Qureshi
Date 03123 / 2021
J
02�4 ��� Albemarle County
Zoning Clearance Application °1MciniimRd, North n 401 Mdn9re Rd, N229 Wing
Phone 43,29 VA 22902
h$GP'hA Phone 434.29fi.5fi32
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,
HINA QURESHI MD & LF ZOz ( - 5(
to GLENWOOD C-3 LLC
of Tax Map and Parcel Number
061YO-00-OC-10300
the owner
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 03/23/2021
❑ Mailing a copy of the application to the owner identified above on
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)
4
Signature of Applicant
Applicant Name Printed Hina Qureshi
Date 03/23/2021
3
Doc ID: 7545f3f9fa8fid7a464bec07707241267978a941
For Albemarle County Staff Review Only
Proposed Use:
c
Permitted:
Yes ❑ No
Permitted by Section:
rr Z
�l0
Supplementary Regulations:
Applicable Special Use Permit (SP):
® 2
Applicable Rezonings (ZMA):
O
Applicable Site Plans (SDP):
O/a
�O
Parking:
If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some
Parking Formula:
19
Defined by: I
Wte Plan ❑ Zoning Ordinance ❑ CoD ❑Existing
Total Square Footage of the Use:
Required number of parking spaces:
y�y
� RLBi 55'YC l� r $9 {%%�i ✓ S020,0_Z? ✓
Associated Clearances:
gq7,�(c,•'itl
If ` C egmc 611 of i'e - µ,c 4Ge A9 - 2 - 2 I/ ��
Variances:
k—1 hoe tc,,1'AwjP,61 Y-oc
Violations:
Is a site inspection necessary?:
Elyse o
Site Inspection on (date):
To Confirm:
Notes:
d�
o Oc u� col(gL sac 6"
Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas 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:
BuildingOfficia
Zoning Official
Date
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
Doc ID: 7545f3f9fa8fld7a464bec07707241267978a941