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Home My WebLink AboutCLE202100081 Application 2021-11-15Zoning Clearance Application Albemarle County L � �i Community pevelopmenl hng ChAldn9ro e, A 229 2 Lhatlollesvlle. VA 229@ r 2Ret9\:/ Phone 434. 2965832 FOR OFFICE USE ONLY Clearance Number: 2o2t _g 1 APPROVED Fee Amount: $ 54 Date Paid: by the Albemarle County e 6 v CCor munity Development Department nalip Receipt#: FP70orE n7AO096 Check#: G, 6 t By: 71'S 14-( 5-2-' Applicant - Fill out the entire page below And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: Medusa Too LLC E-Mail Address: dave.carlton@greatclips.net Mailing Address: 11938 Red Cross Bill Way, Providence Forge VA 23140 Phone IN: 804-874-4490 Tax Map and Parcel number and/or Address of the Business: 265 Merchant Walk Ave Building 1000, Suite 200 Charlottesville VA Zoning: Staff will fill out ifunknown I Parcel Owner: 5th Street Station Ventures, LLC Owner's Address: Check any that apply: Now Business Change of Use Change of ownership Change of Name business Name: Medusa I oo, LLG dba Describe the business including use. number of employees. number of shifts. availool,ty of paiking. and any additional into. '., DESCrlpt100 Of Business: wnir Colnn 9n mm�lnvnne u,hnn fidh. nMFfn,J +. minnlh. 4 e. L.:F+e. Previous Business on Site: Vacant Space 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: I 1212 Is the Parcel Zoned LI, HI, or PDIP? Yes X No Will there be food preparation? Yes No Is the Parcel on public water or private well? X Public Private Is the Parcel on public sewer or septic? X Public Septic Will you be putting up any new signage? ves No Will there be new construction or renovations U yes No Please list any applicable Building Permit #s: If yes, fill out a Certified_ Engineer's Renort LCERI If yes, provide Virginia Department of Health approval If on private well, provide Virginia Department of Health approval If on septic, provide Virginia Department of Health approval If yes, obtain appropriate sign permit and list permit If below If yes, obtain appropriate building permit and list permit # below 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 /e/by/them. 00, Signature � !/( Printed David L. Carlton Date 6/7/2021 2 Zoning Clearance Application ' �/ Albemarle County 401McI;bretRd`NMhAl-in9 Lhatlotlesnlle. VA 22902 I � eVt� / i Pttonc 434 296 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. rCERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN l PROVIDED TO THE LANDOWNER I certify that I will provide (or have provided) notice of this clearance application, GLEac/zl-81 clearance number provided by Staff or business name to 5th Street Station Ventures, LLC the owner Name of landowner on record of Tax Map and Parcel Number 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) X Hand delivering a copy of the application to the owner identified above on Date 6/10/2021 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 David L Carlton Applicant Name Printed Date 7, 2021 3 For Albemarle County Staff Review Only Proposed Use: Permitted by Section: 6IA4-e /� 4 � 'Z �� rv'Z ( Permitted: Yes No Supplementary Regulations: ^ Applicable Special Use Permit (SP): Applicable Rezonings (ZMA): Applicable Site Plans (SDP(: 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 of Development. Parking: Parking Formula: �1 r/ 1 OOd Defined by: site Plan Zoning Ordinance CoD�, Existing Total Square Footage of the Use: 1Z Ffi 5 •LIES LjZOO plpz0(g� Required number of parking spaces: Associated Clearances:�1 -- gQJ — 1 g Variances: ' n 2g f b `V 2— C �c 1 . t� Violations: l�r�t ZV( B 2- a'7-2-6 C No —fit O Is a site inspection necessary?: Yes //K5 — (ZL Oii1 I 1/1� 1 ,LL ll� Additional conditions of approval apply to Fireworks and Christmas Trees I IiC lit yLCiiJii Lii (dull l: Notes. Conditions of Approval: ---- Approval Information V 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: 14 Building Officia f -A zz Date ✓ Zoning Official Date Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.6832 Fax: 434.972,4126 4