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CLE201000164 Review Comments Zoning Clearance 2010-09-08
Application for Zoning Clearance�`AL`,y CLE # I'p2GIN�, OFFICEY © Zoning Clearance= S35 Check # Date: (y PLEASE REVIEW ALL 3 SHEETS .; Receipt # i Staff:, 4 PARCEL INFORMATION Tax Map and Parcel: 32 -19G - Existing Zoning PDIP Parcel Owner: UVA Foundation Parcel Address: 1000 Research Park Blvd., Suite 106 City Charlottesville State VA Zip 22911 (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Jim Wilson Address : P.O. Box 400218 City Charlottesville State VA Zip 22904 Office Phone: 4( 34) 982 -4842 Cell # (434) 531- 1940 Fax # (434) 982 -4852 E -mail jmw6w @virginia.edu I APPLICANT INFORMATION Business Name/Type: Stanley Associates Previous Business on this site Landlord Space 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: Federal Contractor *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 algo certify that the information provided is true and accurate to the best of my kn o %wledge. h e read the conditions of approval, and I understand them, and that I will abide by them, Signature Printed 74"0-f /W, �/l� /o.•� [VJ'Approved as proposed, [. ]Approved with conditions, i. [ JDenied [ ] Backflow prevention device and /or current test :data needed for this site. Contact ACSA, 977 - 4511, x119 [' ],Nonphysical 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: County of Albemarle Department of Community Development - 401 McIntire Road Charlottesville, VA''2296iVoice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 04/28/08 Page 2 of 3 Intake to complete the following: Y, /N s use in LI, HI or PDIP zoning? If o, give applicant a Certified Engineer's Report (CER) packet, /t sD `(,fg Imp 116 Y J Wil ere be food preparatio If so, give applicant a Hea Department form. Zoning review can no egin until we receive approval from Health Dept. FAX DA Circle the one that applies Is parcel on private well o ublic water? If private well, provide Healt Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applie Is parcel on septic o ublic sewer? YIN Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YIN Will there be any new construction or renovations? If so, obtain the prope Permit. Permit # Zoning to comnlete the following: Reviewer to complete the following: .Square footage of Use: f � 1513 G Y N i 1 s ermitted as: t✓ Under Section: Supplementary regulations section: — ----- Parking formula: <60y6 is 53 oi0C5 law net f 166y, Required spaces: 5 Y;'/ N Items -to be verified in the field: Inspector: Notes: Date: Viola io s: Y/ If so, ist: offers: /N If so,- List: MA —0 Variance: YIN If so, List: Y/N If so, List: LT Clearances: C' 9010 jig TASU SDP's qq I Revised 04/28/08- Page 3 of 3 `_ -- Stanley Associates Town Center One 1st Floor, Suite 106 o q q q 4 )1 1. c