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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 LI' i <e,I a� C� 3 O South Hollymead Drive O V C � � C can J GJ E V O U- 21 bA O ®p✓� u . cn .°J 4--d ►� �„� O 1 O v +°-d p O I� ��•••{ r� �, ray' r�/.� ctt O u A� O b.0 o V C � � C can J C E V L U- 21 N n i i i i i n m y C 4 v JO_ 1y Em � CQ � Z71U o L� i5 \JQM Z-0 C e m North Hollymead Drive �4-4 v v C40 � O a3cn C6 v bO N P�.4 ¢, c 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 X: ii •I C� v Q a �o 0 N W m Ln v u c� a to N m a.� U �w cn m H N � m L a