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CLE202200107 Application 2022-08-04
Zoning Clearance Application FOR OFFICE USE ONLY Fee Amount: $ 61.36 Application fee: $59 + Technology Surcharge: $2,36 Receipt M Clearance Number: Date Paid: gv: Check #: By: Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 oe v�- �4 J2� Albemarle County Community Del Mdntlred. N,0 Wing R^ Ch Cha,loltosville. A229 e. VA 22902 r�8CIx1�P Gh.o 434.N6.5832 Name: 'PH(LIP A, CL_At2!( E-MailAddress: altrI.c(aric,Z$�tZQ /,�µ� Mailing Address: PO BOx 1pol, 5lanavd5vi((e, VA ZZgi3 Phone#: 4-3 _24Z_'7&4ci Tax Map and Parcel number and/or Address of the Business: r{.pZr{ WALNl4T" CREEK PAP-K N(p NTH G A "F N � VA 2-2959 Zoning: Staff will fill out if unknown Parcel Owner: AL13CmAIQLE cm(NiTY Owner's Address: Check any that apply: ❑ New Business ❑ Change of Use ❑ Change of Ownership ❑ Change of Name Business Name: WEST FOINT SOCIE?y OF MONTICI;LI.O Description of Business: Describe the business including use, number of employees, number of shins, availability of parking, and any additional info. �H/tk`t-+fktjl.t (IcvhNIyzATIOW 5UFPOPNTIN6 h(LIT-AA-Y AWS) VETERA-NS, (uo EMPt.0 Es (ALI— Vo kNTEER). THIS tS FOP, 5ET (Af Of: AN WFLATA3LE (`OUNCE HPUSE") AT A ONE -DAY EyF:NT; Previous Business on Site: I (me C({A-NaE Floor Plan: Please attach either an architectural drawing or a sketch of the proposed business Indicating the location of uses. the juses of rooms, the total square footage of the use, and any additional Information. Total Square Footage Used i I xo FT, I for the Business: �bG x 20 Is the Parcel Zoned LI, HI, or PDIP? ❑ Yes No If yes, fill out a Certified Engineer's Report fC Rl Will there be food preparation? ❑ Yes No © If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? Q 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 No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes © No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit f1s: (gyp ME) I coning t;Iearance review cannot begin until the application above is complete and all applicable forms and fees are submitted. j 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 1 location, a new Zoning Clearance will be required. 1 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. I Signature pj Printed N V P A Date 7-0 Z 2_ 21 Zoning Clearance Application �y+OFA 8 � sty "`m .� Albemarle County 401W.WeRd,Nofthr 49t Mdntlrc ed A 229Ming Charlottesville, VA 22992 �RGINVP 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, Wi5 i FC (NT 560 ET`/ 07 M@N I ICE(—L,0 clearance number provided by Staff or business name to ALGENAALE COUN—tY the owner Name of landowner on record I of Tax Map and Parcel Number VJALNV7- CFeE(< (9 RK 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) Hand delivering a copy of the application to the owner identified above on Date j ® Mailing a copy of the application to the owner identified above on Date 3 AUG 20 ZZ- to the following address: ALOENARLF CCU(NTY F"} K5 & t2ECREAi jCJ, 4pi McJN-) iRE P D C jYfkC(IE50U, VA -2Z1OZ (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 F 4 l i t 16 A, Cf_ +KK Date 3 AuG zoz2- El 0 A -% SUNDRY AUGUST 28TH 4200 - 1500 at thek WALNUT CREEK PARK 4024 WALNUT CREEK PARK NORTH GARDEN, VA 22959 .101bi US FOR: 4 Fishing in Walnut Creek 0 Family friendly entertainment 0 Picnic catered by Mission BBQ 41-lelp build Charottesville's veteran friendly community GUEST SPEAKER @ 1300 Jeffrey Boecker "Nickel for Your Story" 0 Connect with Veteran Support Organizations within Our Community FOR I-AOS AND TO REGISTER: EIS: ACPR AL9DWLE MMTY PARKSAMEATIUN https://cville-seasthedav-2022.eventhrite.com MISSION BBQ' � - ��� The American Way. � c �rioN ef'l� G/F Fin-NoVicei �0 ChOME TOGIEi DEEP i�E1-E13RAi E e SEAS THE DAY INTERNAL REVENUE SERVICE P, O. BOX 2508 CINCINNATI, OH 45201 Date: AM I f 4 M-1A WEST POINT SOCIETY OF MONTICELLO PO BOX 5083 CHARLOTTESVILLE, VA 22905 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 45-4257118 DLN: 17053276316043 Contact Person: CUSTOMER SERVICE ID# 31954 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 509(a)(2) Form 990 Required: Yes Effective Date of Exemption: January 9, 2013 Contribution Deductibility: Yes Addendum Applies: NO We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 0£ the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. Please see enclosed Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, for some helpful information about your responsibilities as an exempt organization. Enclosure: Publication 4221-PC Sincerely, �0*""" 7xoeo t�C/ Director, Exempt Organizations Letter 947