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HomeMy WebLinkAboutCLE202200047 Application 2022-04-14 s OF A(N, rl Albemarle County ZoningClearance Application =oMCommunity Development hottsile Wi ng �,l 401 McIntire VA 22902 `2RGIT�P Phone 434.296.5832 FOR OFFICE USE ONLY Clearance Number:( .GE.2,2-471 Fee Amount: $61.36 Date Paid: 4I Ict By: SePSOnS dr Chancip_ Application fee:$59+Technology Surcharge:$2.36 Q`" Receipt#: ig,S I a,S Check#: 3O1 By: DC()a.:La.S-s.SULJ\N_r- b Applicant- Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: SEA,Sp,uS CF'CHA,c),E,L.L.CAtA,QtMD•VF E-Mail Address: �C-hS•DOS d(rC114 2@AA61-.COM Mailing Address: diD%3 0HtUA40561'd HWe,ALDIE, Zo oc Phone#: (703)927- 27/8 Tax Map and Parcel Zoning: number and/or Address 04, 1 - `OO O�Q O ZO� Staff will fill out if unknown I of the Business: w Parcel Owner: GU; CH EN Owner's Address: II9S Sorioe(.E T (/etweioitaik Check any that apply: New Business Ei Change of Use Li Change of Ownership Change of Name Business Name: SeASAOS OFC4A.066, LLC Qeiiq IL. F12tuo€k s Description of Business: Describe the business including use,number of employees,number of shifts,availability of parking,and any additional info. -rot QeTAIL SAik. OF A. APPQoUsD R-12EWoku u514)6 A 8 Xi/O ' '5 i m.E c 5kz S (0,01-A . i ci'vl 4123 - 2022 , �5.9aie sEruio 45 /leeV/evs '.t S Previous Business on Site: Othfelv7-3vi0L6- Pokie,< •-epooto/jlEti T 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: 3z o SQ Fr. Is the Parcel Zoned LI, HI, or PDIP? Yes vj No If yes,fill out a Certified Engineer's Report(CER) Will there be food preparation? I I Yes I 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 approval Is the Parcel on public sewer or septic? Iblic Septic If on septic,provide Virginia Department of Health approval Will you be putting up any new signage? I I Yes vt<o If yes,obtain appropriate sign permit and list permit#below Will there be new construction or renovations? Yes �o 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. Signal /1 Printed NVt L G• 5/tilo v23 Date if- 4 7 2 Z 2 Jw M Albemarle County Zoning Clearance Application 8# Co mMmcuIneityvilDRedveNlopome9Wnt Charlottesville,VA 22902 ing t iRcts‘. Phone 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 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, clearance number provided by Staff or business name to rev; CHEJU the owner Name of landowner on record of Tax Map and Parcel Number 04o I W002 0400200 by either delivering a IMP number of 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) Pl 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 y 25.22 to the following address: figs" $fniwoi %wit Clb9etorsolk / ✓� . (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 D4A./ L &, Sited JD Date y• 0 7 Z Z 3 For Albemarle County Staff Review Only Proposed Use: Permitted:_ [ I Yes No Permitted by Section: Supplementary Regulations: Applicable Special Use Permit(SP): Applicable Rezonings(ZMA): Applicable Site Plans(SDP): Parking: 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 Formula: Defined by: Site Plan Zoning Ordinance n CoD [ 'Existing Total Square Footage of the Use: Required number of parking spaces: Associated Clearances: Variances: Violations: Is a site inspection necessary?: Li Yes No Site Inspection on(date): To Confirm: Notes: Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees Approval Information I I Approved as proposed I__I Approved with conditions I__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. Li This site complies with the site plan as of this date. Conditions: Additional Notes: Building Official Date 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 ui c�-cr_rru ci.c-r u� CH UIv5 .''FIObb�'fCCl PAGE2 F,ea-'t V1kW FI R E W .R KS - - rtAzs 1�11�uba�3 SAS S+�t�E s yv,.Ubow wV MrO $� WI�ow w��2+o�J 410 ) 'T"H 15 is A S'X LID' T LSG4k Ca 1, M) u.?Ft1CH WILL. B U FOR'THE DF CCAss"C. , APPRo 04b . "ii is is 114E San' c:F Com-i'Oct) 5 Vat)IT ust. ►N POV 1 ovS 1r'E 5 (a? Tit IS 1_oc d J. 5ibE VIEW 2xq (') tE PLAcri t i3 ovate() ij £aJ- Dotesisc-coeo4 LAWAY0 MEcNAN'SM nn S )1.dam did dr 1.11. ` , 7 • 1-kvan. ti q e 5/31/2E111 13:04 7033969E164 . . . ... ...-,:7,-::•-I • , - . • • , __---:•-• - . • ,..,-.sr. 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's• • fith. ,�' ^ ;ao is-uxa qg v.t;:q1 l'i,'' 4 15.8 a1• 0 pQ !$� a PIA' � L •• ,q R • T i n I LEASE AGREEMENT This agreement of Land Lease is made this / t day of AP2/L , 2 0 22 between Gv i WHEN ,(LESSOR) and EASO,OS OF Gi+q ,E .+C ,(LESSEE) for the Property described as an area at the front of 1 I/5 J¢M i uol. . TRAIL. ,more specifically Described on the attached site plan. LESSOR and LESSEE agree that for and in consideration of the sum of ( ) Paid by check to the LESSOR at the signing of this document or prior to the commencement date of said Lease, LESSEE may land lease the site indicated on Exhibit A here to during the period of 41 a Tow ills ZcZz . LESSEE agrees to obtain the necessary permits from CovanY Of- a 1. AAL L . for the purpose of selling t6%. itfitrv¢D FitkivclL 5 during this period. LESSEE agrees to provide a certificate of insurance to the LESSOR providing coverage during the above dates,naming Go; C r+E& as additionally insured. LESSEE agrees to remove all stands, merchandise and refuse from the leased area by IS , 2OZZ. And shall restore the area to the same condition it was before the lease began. In addition, LESSEE agrees to hold Gu• CHEA1 and owners harmless of any and all accidents; etc. LESSEE will be responsible for all activities on leased premises related to their business operations. LESSOR: G : CrtEN SIGNED: WITNESS: DATE: $O/•2 2 LESSEE: 5EAsoAs OF atiumc ,I..LC SIGNE • ir+.� WITNESS: DATE: t' 't Z Z ® A�R.� CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD/YYYI) 2/11/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Britton-Gallagher and Associates, Inc. PHONE One Cleveland Center, Floor 30 uvc.No.Ext):216-658-7100 FAX No):216-658-7101 1375 East 9th Street ADDRESS: infoabrittongallagher.com Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC INSURER A:Everest Indemnity Insurance Co. 10851 INSURED 18166 INSURER B: Fireworks Over America of South Carolina, Inc. 916 Rosewood Drive INSURER C: Columbia SC 29201 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:611643658 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLTYPE OF INSURANCE INSR SUER POLICY NUMBER M/DDY/YYYY) (MM/DD/YYYY) LIMITS LTR INSR WVD A GENERAL LIABILITY SI8GL00655-211 12/31/2021 10/1/2022 EACH OCCURRENCE $1,000,000 DAMAGE TO X PREMISES Ea RENTED occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE X OCCUR MED EXP(Any one person) $ X $2500 Deductible PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS HIRED AUTOS AUTOSO ED PROPERTY DAMAGE (Per accident) $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS , ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Stand Owner, Property Owner and Others listed below are named additional insured's. Property Owner: Gui Chen Stand Owner: Dan Simone DBA Seasons of Change Location: 1195 Seminole Trail,Charlottesville,VA 22901 Dates: 6/1/22-7/7/22 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Seasons of Change ACCORDANCE WITH THE POLICY PROVISIONS. Dan Simone 40463 John Mosby Hwy AUTHORIZED REPRESENTATIVE Aldie VA 20105 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD