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HomeMy WebLinkAboutCLE202200131 Application 2022-09-28Zoning Clearance Application FOR OFFICE USE ONLY Clearance Number: Fee Amount: $ 61.36 Date Paid: By: Application fee: $59 + Technology Surcharge: $2.36 Receipt #: Check #: By: Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 OF At8 Albemarle County 02 rli£T sry community, Devekigrent -1-' 401 MGMire Rd, Nath WM �' Cha lieswille, VA 22002 �2aGINFP Plwne 434 295.5632 Name: Vav1a1- Connell E-Mail Address: david'connel) @ 4twe •COM Mailing Address: 25b- y rir,s LglChsrl willcItIAZZgoI Phone#: 41M-40 1 -91 q 2- Tax Map and Parcel number and/or Address of the Business: fpe -3 ,?70l",rtr Rel Cl 11f I*W>vdkt V,4 229O 1 Zoning: Staff will fill out unknown Parcel Owner: N 4(rs NI.0 R.: 6eo3D/Owt I-L-e- I Owner's Address: �po 1 oe-t,)s- vc •It 3 2Z `- Check any that apply: New Business ❑ Change of Use Charge of Ownership Change of Name Business Name: Cen}rclt Fed odor}ies I Q.C• Description of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info. Deq+lJ+-Fndod,,,o4c+ SeveA efiplaw (v1-Tt 2-5 Previous Business on Site: 277 Rd S+e ADS ch&rlJ-�4e,vf/le ()4 229ol 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: 2Z�� Is the Parcel Zoned LI, HI, or PDIP? Yes �o If yes, fill out a certified Enaineer's Report MR) Will there be food preparation? Yes ® 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? © 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 penult #below Will there be new construction or renovations? M Yes ❑ 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, antl a by them. A Signatu Pnnted T IJeutK �a AAP11�, Date La4 27 202Z OF KA Z�yD�9 Albemarle County Zoning Clearance Application R Community Development 401McIntire Rd,U WingChadottesnlle, VA 22902 ��BGIT:P Phore 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, C I,v:- A'i- .".) P.c, clearance number rovided by Staff or business name to A,Af%uU- wt.l LL-G the owner Name of landowner on record of Tax Map and Parcel Number 6o F-5 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) Rr Hand delivering a copy of the application to the owner identified above on Date pgJZ7 �lo�Z ❑ 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 Applicant Name Printed ,It Date D9 Z711202- R3 For Albemarle County Staff Review Only Proposed Use: Permitted: ❑ 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: I ❑Site Plan ❑Zoning Ordinance ❑ Col) ❑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 ❑ 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: 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 u— rn Z tN -1 Cj m Zn m _-4 D C 2 4Ni m 7�C '� Nm 11 m 0,0 Ar m�U Z rn m X N z H < 14'-3j" D qlN N 02021 HENRY SCHEIN INC. THE INTEGRATED DESIGN STUDIO IS PROVIDING THIS PLAN AS A PROFESSIONAL SERVICE AND IT a w IS NOT INTENDED FOR CONSTRUCTION. PERMIT DRAWINGS ARE THE RESPONSIBILITY OF THE ARCHITECT. THIS PLAN MAY NOT BE USED OR REPRODUCED WITHOUT EXPRESSED WRITTEN CONSENT OF HENRY SCHEIN INC. AND FULL PAYMENT OF j m ANY ASSOCIATED DESIGN FEES. IT IS THE ARCHITECT AND/OR CONTRACTOR'S RESPONSIBILITY TO VERIFY THAT ALL CODE RESTRICTIONS AND CLEARANCES ARE MET. N � LL N LL WN �m 'D �p