HomeMy WebLinkAboutCLE201100003 Review Comments Zoning Clearance 2011-01-24Application f ®r Zoning Clearance
OFFICE USE O�yLY
a6 I M/1
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # i Staff:
PARCEL INFORMATION
^ _ _
Tax Map and Parcel: 04(o l�a _0.1 --0U '-0y of AP Existing Zoning ►JL t)
Parcel Owner: 144 S PRO PERTI. E S L LC-
Parcel Address: )S-2
v� L:1 wravte - La.,e City �fttsly Irv,, State Lam, Zip 29//
(include suite or floor) (� 1 1
7 29 S, 6-,
S�
PRIMARY CONTACT
State !(We( "to,
Who should we call /write concerning this project?
Address: «5 1`1 V&A � d:)nI City 1�1i�y�'��e State V' zip _22cj %
Office Phone: W) W -T ILF/ Cell # 4-45_95' Fax 35)4 E -mail �%L�511ti(�j�rn /{vL • Caa�
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use of name New business
Business Name /Type:
Change
Previous Business on this site Lu.,^ry �, {Vl; j er 1 106-
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: lti -c;axi c� src� - }�l It r
s
-J6.0d {).lip . S'�Qi^s � �+1y � �'c�'�'j c� S ." � ' V_ &_ 7 S%�ec�s Gcvca t%4 h/e
*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 accuyPte to the best of my knowledge. IIhhave read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed _<,'715 P/4L`L) M,
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ •) Backllow prevention device and /or current test data needed for this site. Contact ACSA, 977-45 1 1, xl 17.
[ ] 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—( t [oh(
Zoning Official Date /� &
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 1/1/201 1 Page 2 oh3
Intake to complete the following:
Reviewer to complete the following:
Y /CN3 Square footage of Use: (�
Is use in Ll, I -11 or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet. O'N
p ) mitted as: /'M' ' iu!/
Y /� Z
Will there be food preparation? Under Section: `2D
Ifso,give applicant a,Health Department form.
Zoning review can not begin until we receive approval From Health Supplementary regulations section:
Dept. PAX DATE
Circle the one that applies
Is parcel on private well of ublic water?
If private well, provide 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 septic or nubwv -9
Y /O
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /0
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Parking formula: n
Required spaces:
Y/N
Items o be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y /L
If so'", ist;
Proff s:
Y /
if so, ist:
Variance:
Y /�
If so, List:
SP's:
Y /('>
If so,`` ist:
Clearances:
Revised 1/1/201 1 Page 3 o0
EXHIBIT A: Floor Plan & Improvements
ARVIND MADAAN, M.D.
1532 Insurance Lane
Approximately 1,728 SF*
I i
'.8' .. I' -T 7' IT -7 31V a'-9 VB
3 Ir STAFF 9 DR.
ROOM OFFICE JAN
6's sDac
Wr WPR M
ELECTRIC
SERM
l
3'-0 UP REPLACE 80af
✓' WIiR 6.
PAIR. DOOR
L O V EXAM
6' t PATIENT \�
H. I STAFF
® MIXING
ROOM 9'40 U8'
CED
91-5 Vb• - 31-8 Ur
. 0 I3�
EXAM
A I WutJ rC�
V"" F 81.8 I? ION °L
13'-5 ur
9' EXAM
F. n b,
Ur TESTING ( 8' P'-6•
ROOM 21-3 ur COUNTER
LM
CA811ET
COLW ER
!I O'-�solu
WAITy'� OT FL
q•.ap ROOM oat ROOM
a0'-2 Ira• 6
i1
* The measurements on this floor plan are believed to be accuarate but are not guaranteed.. /
Page 2 of 2 pzz
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