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Home My WebLink AboutCLE201800190 Approval - County 2022-06-28APPROVEP r-,rle County �_l Application for Zonnst ga.__.earance �%flCIN\P OFFICE U E QNLY PLEASE REVIEW ALL 3 SHEETS Check #,a Date: Receipt # S[afP: PARCEL INFORarcel- TI Tax Map and Parcel: ( [ m � t A�rl Existing Zoning PD-MC I a I A��t� Parcel Owner: 5th Street Station Ventures, LLC Parcel Address: 365 Merchant Walk Square, Ste 142p City Charlottesville State VA Zip 22902 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Dan Tucker Address: 5 SW Broad Street, Suite B City Fairburn State GA Zip 30213 Office Phone: (770) 692-8300 Cell # (434)245-4909 Fax # (770)692-8302 E-mail dan@sjcollinsent.com APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: Mochiko Hawaiian Eats/Assembly A-2 Previous Business on this site New tenant - Unoccupied Suite Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide: This is a 1 2nn SF Whilebox in Bing 1400 *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 Printed AP OVAL INFORMATION [ Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117. [ ] 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. Notes: Building Official Date 3 Zoning Ocial ffiDate Other Official 3 Date County or Atoemarie Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296.5832 Fax: (434) 972-4126 `z( !�S — a(3 I-:�, i", C / Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Y Is us LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. yN Y ill there be food preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on private well ublic wat If private well, provide He ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that a Is parcel on sep ' or public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/N Will there be any new construction or renovations? If so, ob 'n tl e o r P it Permit #t , I01 Zonim! to complete the following: Reviewer to complete the following: Square footage of Use: Y/N Permitted as: 0/1, Under Section: ;i , a . I Supplementary regulations sectign Parking formula. - Required spaces: , Y(N/ I[e to be verified in the field Inspector : Date: Notes: V1010�ioions: YrN) Ifs tst: Proffers: Y/N If so, List: '�ooa-1 Variance: Y/N r If so, List: �I / �I SP's: Yp Ifs List: Clearances: l 3 SDP's G] �F9i€ar a`J (07 wott1 17 - n ai/, — A-73 all AolnI ttl& 17f , r 7 8, �� I ' Revised 11/1/2015 Page 3 of 3 CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the owner. I certify that notice of the application, Application for Zoning Clearance - Bldg 1400 [County application name and number] was provided to 5th Street Station Ventures, LLC - Dan Tucker the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number manner identified below: by delivering a copy of the application in the Hand delivering a copy of the application to [Name of the record owner if the record owner is a person; if the owner of record is an entity, identify the recipient of the record and the recipient's title or office for that entity] MJI Date QMailing a copy of the application to 5th Street Station Ventures, LLC - Dan Tucker [Name of the record owner if the record owner is a person; if the owner of record is an entity, identify the recipient of the record and the recipient's title or office for that entity] on 08-13-18 to the following address: Date 5SW Broad Street, Suite 13 [address; written notice mailed to the owner at the last known address of the owner as shown on the current real estate tax assessment books or current real estate tax assessment records satisfies this requirement]. Signature of Applicant Print Applicant Name Date 6af UFflIWR ff i caaim wNLrrto PBPi/PS ff�iPWI wxwp NDVSR 6KK cy� rLcoR ' CDMFII i 181 SFi ,q �� b E1nan l j$� i ¢CYIp! NTDHFN t� i 1998E _ fFM L® M d SWK Hio N'SIEYM BIMNFA IaI arouranoiiEN a muoDic UBI£iOVHEATLvw+ �1.Dn DWIRW WIOSWIt sff = (Zoo r4� In Cooperation with the Stale Department of Health Phone (434) 972-6219 Fax (434)972-4310 January 7, 2019 Riki Tanabe 473 Rolling Valley Court Charlottesville, VA 22902 COMMONWEALTH ®f VIRC3INIA Thomas Jefferson Health District 1138 Rose Hill Drive P. O. Box 7546 Charlottesville, Virginia 22906 Re: Mochiko Cville, 365 Merchant Walk Square, Charlottesville, VA ALBEMARLE CHARLOliESVILLE N OVANNA COUNTY WALMYRA, GHEFNL CGUNi i STARARDSI'RI L LOUISA COUI! 1 v LLOUI6AI NEI :llN Cul iNr V 11 nVINGSTOUp Thank you for submitting a plan review application for your restaurant: Mochiko Cville. The plans submitted for your new location appear to meet compliance with the Virginia Food Regulations and as such are approved. A pre -opening inspection and approval by this department is required before permitting. Your permits (hotel and food establishment) will be issued after the final inspection by our office. Please call or email me at the below contact information in advance of your opening. You are responsible for submitting all other applicable applications and meeting all other state and local codes (i.e. building, zoning, fire safety, etc.). Email: Stephanie.Yard@vdh.virginia.gov Office: 434-972-4318 Sincerely, Stephanie Yard Environmental Health Specialist Steohanie.Yard@vdh virainia eov 434-972-4318 Page 1 of 1