HomeMy WebLinkAboutARB200300038 Application 2021-06-30` 4
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Zoning Clearance Application I_ Albemarle County
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G';atlonesMle. VA Z2902
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FOR OFFICE USE ONLY Clearance Number: APPROVED
CiE2AZ1 1. byftAlbernarleCounty
Fee Amount: $ 54 Date Paid: � By cornmi lff DeVelo
I� 11 r� -�(; p 1 ' ZI \G� prnent Department
Receipt#: Kf I C�3,TI FIV6-39 �eck#. C LC r By: J Date }0-2-,�
Applicant - Fill out the entire pagetelow
And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
David Mitchell, Const Mgr Great Eastern Mgt Co.
E-Man Address:
david@southern-classic.com
Mailing Address:
2619 Hydraulic Road, Cville Val 22901
Phone #:
434-566-8299
Tax Map and Parcel
Blue Ridge Shopping Center
Zoning:
number and/or Address
of the Business:
5221 Rockfish Gap Tpke,
staff .11fiaoutifunknown
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IRA
Charlottesville, VA 22903
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Parcel Owner: (Ground
Lease Holder) Blue Ridge Investors Owner's Address: 2619 Hydraulic Road, Cville Va 229011
Check any that apply:
', New Business Change of Use Change of Ownership
g P Change of Name
Business Name:
_
rgent Care Iand Primary Care
Desch a business including use, number of employees, number of shifts, availability of parking and any additional info.
Description of Business:
Expansion of existing outpatient medical clinic, employees 9 -10, 1 shift. Will utilize existing parking.
Previous Business on Site:
Hair Cuttery, Pizza Hut, Burrit-OH �—
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 Bus! ness: 4.346 sf (Including the existing 816 sgft Augusta Space)i
Is the Parcel Zoned LI, HI, or PDIP? Yes No if yea. fin out
a
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 Health i
Is the Parcel on public sewer or septic?
approval
f Public septic If on septic, Virginia
provide Department of Health approval ;
Will you be putting up any new signage?
/ Yes No
_.....____.
If yes, obtain appropriate sign
g Permit and list permit a 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 f s:
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--•••••a F=vrCw carurot oegln unol the application above is complete and all applicable forms and fees are submitted.
location, a new Zoning Clearance will be required.
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
1 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.
iignalure
)ate 1-14-21
O.rvp MrtUell, Cons: Mq Great Eas:mm My; Cn. Managb o! We¢ "o' Invax!ms, "I (GmuM Labe HWep
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Albemarle County
Zon1 ng Uearance Application Chad teth, 1m R0 22902 y
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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,
ct'CE z-o 4 - 12
clearance number provided by Staff or business name
to (99 yr Ground Lease Holder) Blue Ridge Investors, LLC the owner
Name of landowner on record
of Tax Map and Parcel Number _ 5s-„o—,q by either delivering a
TMP number of properly
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 1.14-21
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 Na
Date
3
For Albemarle County Staff Review Only
Proposed Use: Z Q �C
Permitted:
es No
Permitted by Section: ,Z r LZp
Supplementary Regulations:
-�'—
Applicable Special Use Permit (SP):
Applicable Rszonings(ZMA):
Applicable Site Plans (SDP{:
p(�`
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 oj Development.
Parking:
Parking Formula:
Defined by:
Site Plan offing Ordinance _ COD ,Existing
Total Square Footage of the Use:
Required number of parking spaces:
Z DZ
Associated Clearances_.__
Variances:
I✓ c t
Violations:
Z- /l 0 2,00 _ 2-1 Z Cc 5
I
Is a site inspection neeessaryl:
_
Yes VfAo
Site Inspection on (date{:
��
To Confirm:
Notes:
--
Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas Trees '..
Approyal Information
_Opproved 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 Officlar,filfifQW, Date
Zoning OfficialI
Other
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville. VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4