Loading...
HomeMy WebLinkAboutCLE202100086 Application 2021-09-14LZoning Clearance Application FOR OFFICE USE ONLY Clearance Numbercia03 / —� Fee Amount: $ 54 Date Paid: a I By: Receipt 4MB51 � 5I IJck #: By 0 lr } OF Albemarle County _}. Community Development 1 401 McIntire Rd, North Wing ? Charlottesville, VA 22902 yRGtMP Phone 434.296.5832 Applicant - Fill out the entire page below And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: Adam Brown E-Mail Address: adam-brown@gnc-hq.com Mailing Address: 1300 Sixth Ave. Pittsburgh PA 15222 Phone #: 412-288-4778 Tax Map and Parcel number and/or Address of the Business: 250 MERCHANT WALK AVE STE200 CHARLOTTESVILLE, VA 22902 Zoning: Staff will fill out if unknown /� 9f /—` 1 f/ 4 Parcel Owner: S.J. Collins Enterprises Owner's Address: 15 SW Broad Street Fairburn, GA, L Check any that apply: E New Business ❑ Change of use ❑ Change of Ownership © Change of Name Business Name: Description of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info. Retail sales of health and wellness products. 3 employees, mall parking Previous Business on Site: GNC, name change only. No change in structure or use 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: 1070 Is the Parcel Zoned LI, HI, or PDIP? ❑ Yes Rj No If yes, fill out a Certified Engineer's Report (CER) Will there be food preparation? Yes 0 No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? V Public ❑ 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? ❑ Yes RI No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? R Yes Q 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 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 A lie 94 atl( lL PrintedAdam R Brown Date 6/29/2021 y OF �?� rn. Albemarle County Zoning Clearance Application � � 40 WlZir Rd, 401 McIntire Rd, Notlh Wing Charlotlesville. VA 22902 �rRGiN�P Phone 434.296.5832 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, to GNC Holdings, LLC LL C 2-&LI S.J. Collins the owner of Tax Map and Parcel Number ;HANT WALK AVE STE 200 CHARLOTTESVILLE 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 0 Mailing a copy of the application to the owner identified above on Date 7/6/2021 to the following address: P.O Box 214Fairburn, GA 30213 (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 .A�u.�,i-rL � �2ertrri Adam R Brown 6/29/2021 3 r' For Albemarle County Staff Review Only Proposed Use: 5 eG IQ (A00 Permitted: UwrrEj No Permitted by Section: �� ,� Z 2, 2, I C6 Supplementary Regulations: r--- Applicable Special Use Permit (SP): Applicable Rezonings(ZMA): Applicable Site Plans (SDP): 2-01: u' ZD t7— i)Z Parking: If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some Parking Formula: Y 5 ! B(rp q5 Defined by: Site Plan ❑ Zoning Ordinance ❑ CoD ❑Existing Total Square Footage of the Use: 070 Required number of parking spaces: ` 1�5 Associated Clearances: Variances: Violations: Is a site inspection necessary?: ❑ Yes o Site Inspection on (date): To Confirm: Notes: Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees Approval Information Approved as proposed ❑ Approved with conditions I 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 Zoning Officia Other Official Date Y-L County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4