HomeMy WebLinkAboutCLE202100099 Application 2021-09-09�i-a3-GI) - exol;led'A `ovum
i
Zoning Clearance Application
FOR OFFICE USE ONLY Clearance Number: apa.l - C'
Fee Amount: $ 54 Date Paid: v30 _.z t By:
Receipt M OAR60`f 82 Fp. 50107 yq Check #: 0It f;K e By:
?2 nil. rr
Albemarle
Oe"levm nt
U
401 McInlottesre rid ng
.; �•
229orth 2
Charlottesville, VA 229p2
r rRGINIn-
Ph.. 434.20,5832
ck"k- ��� PROVED
by" i�emarle County
CoMMUnd?,,lopment Department
to 2
Applicant - Fill out the entire page below File c LE 20Z i
And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
144"08 4 �1$1%OR$ Of ilir a e•F ✓,*
IE-Mail Address:
I (d &1117 R1/ir f is
Mailing Address:
fl d ✓Jd?( DD )jLpffe5✓I LL&hone
#:
Q8 2 -S 14)
Tax Map and Parcel
number and/or Address
of the Business:
D1%00.00.0o•0.5In✓
Zoning:
stafrwillslow ifunknown
Ft?— ptc
Parcel Owner:
?-P NOPCO (Ld—
Owner's Address:
0ol CO✓Yl✓Y eii St,
Check any that apply:
�✓' New Business Change of Use Change of Ownership Change of Name O.Zi:AiO;;%
Business Name:
Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info.
Description of Business:
d i6al CLlnic v1dinq 0mOne h f
C '0✓M6c _ re
Previous Business on Site:
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:
,' g, TlO
Is the Parcel Zoned LI, HI, or PDIP1
❑ Yes ❑ No
If yes, fill out a Certified Engineers Report ICERt
Will there be food preparation?
Elyes [?-�o
if yes, provide Virginia Department of Health approval
Is the Parcel on public water or private well?
Republic ❑ 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 Department of Health approval
Will you be putting up any new signage?
as No If yes, obtain appropriate sign permit and list permit # below
Will there be new construction or renovation ?
Yes No If yes, obtain appropriate building permit and list permit # below
Please list any applicable Building Permits:
��✓q ro,� �N6r�u� RaM l9 �OMOL�T
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.
Date
Printed ^ VLU, 6r 0j tz/ A
/►� 50C I-Lr T)IAECm2GoR �e1K9_ 2
;O
a2 -,, . ;II. , Albemarle County
r' Zoning Clearance Application !1} CommunUre Rd,
- ; t 491 M tesWl Rd. N229 Nhng
Chatl011esNlle, VA 22992
r rRGiN{�' Phone 434.2%.5832
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,
CLt2-02-1-'2q
clearance number provided by Staff or business name
to RV PAtW16 Vll L,L(?, the owner
Name of landowner on record
of Tax Map and Parcel Number D-TSoo•po• 60.O I lib by either delivering <
TMP number or 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 I. 151 207-) to the following address:
JAT�,6H,4 V61)J6, rr 1c W�� 100 �GEtNoat7 A�/&TILI� �6
(Written notice to the owner and last known address on our record 606iks wilt
requirement. Please see staff for help determining this information if needed)
Signature of
Applicant Na
Date
Y. 16, p21
A66ocra4c D(v-e- JvR -FDA L&-sf�cg
`l & L EA,o k � Leas ie) , e✓vfcCS
For Albemarle County Staff Review Only
Proposed Use:
p Ovi Cf -1l
Permitted:
Yes ❑ No
Permitted by Section:
7_5 A, -)-
Supplementary Regulations:
—
Applicable Special Use Permit (SP):
L7-C 2
Applicable Rezonings (ZMA):
Applicable Site Plans (Sop):
c / J
ZQv SI-.ISD 2Q05-1/22 > 2oolr-f0 (A 41ere`// c Q✓,Y
3(7
Parking:
If there is an approved Bile plan associated wi h the parcel, the parking requirements will be defined by the SDP. Some
parking requirements are determined by a ZMA or by an approved Code of Development.
Parking Formula:
/Z-0,9 4ct Defined by:
I Vit. Plan ❑Zoning Ordinance ❑ CoD ❑Existing
Total Square Footage of the Use:
'Ly 0 'to
v L
Required numberof parking spaces:
t
72 2-$ 2 iov gel- Sh Z�p$- f 50
Associated Clearances:
t
2{}/Q'-Lr 1 �I/-' zC Z`���I Ze(,n$-, Z/� -ZlQ
Variances:
—
Violations:
-�
Is a site Inspection necessary?:
❑ Yes ❑ No
Site Inspection on (date):
To Confirm:
Notes:
�/ZiEF: 02-4Pzj-016Y' ,
h 51 i lat' "A' of si tq T-AV Z8-NT
Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas Trees
App�oval 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
( Z
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