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HomeMy WebLinkAboutCLE202200059 Application 2022-05-02 litk Albemarle County Z Zoning Clearance Application Community Development �_ 401 McIntire North Wing wFief w. 4S Charlottesville,VA 22902 4 �F Phone 434.296.5832 FOR OFFICE USE ONLY Clearance Number: C\eaoaaCOO Ct Fee Amount: $61.36 Date Paid: as By: lac\e,8h Guaira. Application fee:$59+Technology Surcharge:$2.36 Receipt#: q $48�V Check#: P% By: Applicant- Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: Harleigh Gauna E-Mail Address: pwpermits@peiwei.com Mailing Address: 6191 N. State HWY 161, Suite 300, Irving, TX 75038 Phone#: 972-457-9386 Tax Map and Parcel 365 Merchant Walk Square, Suite 500 Zoning: number and/or Address Charlottesville, VA 22902 Staff will fill out if unknown of the Business: Parcel Owner: Dan Tucker/5th Street Station Ventures, LLC Owner's Address: 365 Merchant Walk Square,Suite 500 Charlottesville.VA 22902 Check any that apply: X New Business I I Change of Use I I Change of Ownership Change of Name Business Name: Pei Wei Asian Kitchen Description of Business: Describe the business including use,number of employees,number of shifts,availability of parking,and any additional info. Restaurant, casual dining, limited service. Previous Business on Site: n/a 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 1,634 (of 4,270) for the Business: Is the Parcel Zoned LI, HI, or PDIP? Yes X No If yes,fill out a Certified Engineer's Report(CERI Will there be food preparation? I XI Yes No If yes,provide Virginia Department of Health approval Is the Parcel on public water or private well? -X Public Private If on private well,provide Virginia Department of Health approval Is the Parcel on public sewer or septic? X Public I I Septic If on septic,provide Virginia Department of Health approval Will you be putting up any new signage? X Yes I I No If yes,obtain appropriate sign permit and list permit#below Will there be new construction or renovations? Yes X 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. Harleigh Gauna Signature 22 C���(J(/r\� Printed Date 4/ / 22 2 Albemarle County Z Zoning Clearance Application ��_ Community Development 401 McIntire Rd,North Wing Charlottesville,VA 22902 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, Albemarle County, E201901410AC clearance number provided by Staff or business name to Dan Tucker/5th Street Station Ventures, LLC the owner Name of landowner on record of Tax Map and Parcel Number 76M1-2 by either delivering a TMP 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) I I Hand delivering a copy of the application to the owner identified above on Date x Mailing a copy of the application to the owner identified above on Date 4/25/2022 to the following address: 5 SW Broad St. STE B, Fairburn, 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 Lorne Goldberg Date 4/25/2022 3 For Albemarle County Staff Review Only Proposed Use: Permitted: I I Yes I ] 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 CoD Existing Total Square Footage of the Use: Required number of parking spaces: Associated Clearances: Variances: Violations: Is a site inspection necessary?: Yes No 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 Denied n 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. 7 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 1100k Albemarle County Z Zoning Clearance Information .. Community Development M . 401 McIntire Rd,North Wing V A 4$ Charlottesville,VA 22902 Phone 434 296 5832 What is a Zoning Clearance? A Zoning Clearance is verification from Albemarle County that a proposed use, whether it is a new business or other activity (see Zoning definition of"Use"), satisfies all requirements of the Albemarle County Zoning Ordinance and ensures public health and safety. A Zoning Clearance Application is reviewed by the Zoning Department, Building Inspections Department, as well as any other applicable departments or agencies. A Zoning Clearance is Required in the Following Circumstances • Opening a new business • Changing or expanding an existing business • Buying an existing business • Moving a business to a new location or changing its name • Before natural resource extraction • Any uses listed in Section 5 of the Albemarle County Zoning Ordinance as requiring a Zoning Clearance Items Required to Apply for a Zoning Clearance Before filling out a Zoning Clearance Application ensure you have or have done the following: Tax Map and Parcel number or Address of the property. Include suite/unit/floor number, if applicable. Description of the proposed business/use. Include any and all relevant information such as a description of the business, the number of employees, number of shifts, availability of parking, etc. ❑ A Floor Plan. A sketch or an architectural drawing of the total square footage of the use. If using less than the entire structure, note the location within the structure. Note the square footage of and use of each room. Provide notice to the owner if the applicant is not the owner. Within ten days of applying for a zoning clearance, the applicant, if they are not the owner of the parcel and/or structure, shall inform the owner that they have applied for a Zoning Clearance. Please fill out the form on page 3. • Other Approvals/Documents if applicable. • A Certified Engineer's Report is required if the parcel is zoned Industrial (LI, HI, or PDIP). • Health Department approval is required for food preparation or if the parcel is on private well or septic. • Bakeries require USDA approval. • Any additional approvals the Zoning Administrator may require including Department of Social Services and Fire + Rescue. • If you have any questions feel free to contact Staff at(434) 296-5832 Submitting an Application Once you have all the required information provided above: 1. Fill out an application. Please complete page 2 in its entirety. 2. Submit an application. Bring or send a completed application to Albemarle County Community Development at 401 McIntire Rd, North Wing, Charlottesville, VA 22902 3. Pay. The application fee can be paid for in person or online. If paying online please attach a copy of your payment re- ceipt. A Zoning Clearance Application will not be processed until payment has been received. 4. Notify the Owner. If you are not the owner of the property please fill out page 3. 1 CODES AND APPLICABLE STANDARDS } 1 STRUCTURAL GENERAL NOTES i j r ` i I 1 b1SwRGwAc m rnO cone 3 I i uls.c .F. yNcwDF C rows.,mow- 201S V WG.E A NECFANICN COOS § pI,«,roN,laFclncAl rnDE L a CONCPEE WEE.,DEa GN eMMUMCOwfBSIVESTISINGM WDABS. I 1 I I I S � nON I.NTE%OR S...$ON°PAW ._ •...” 1 20IS V RGwAENEROOR .DE �•` 0410E0 RDWORCes0 AESORADER01__ .-10-4.Es PS. 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