HomeMy WebLinkAboutCLE201100055 Review Comments Zoning Clearance 2011-05-24Application for Zlonin Clearance.t'���`
OFFICE US � O . p
Check # `� -I Date:
PLEASE REVIEW ALL 3 SHEETS
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Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 07800- 00 -00- 05500 Existing Zoning pJ,rC
Parcel Owner: Luxor Office Park, LLC
Pai-eclAdclress: 1430')Ro(lkYMr Cf(rrEiuite 302 City CharlottesvilleState VA Zip c)11
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Ray Gaines
Address: P. 0. Box 6255 City CharlottesvilleState VA Zip 22906
Office Phone: (434) 979 -5245 Cell# 760 -7974 Fax #979 -9126 E -mail rgtect @thegainesgroup.c
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Cliange of name New business
Business Name /Type: The Gaines Group, 'PLC — architectural firm
Previous Business on this site Not applicable —new construction
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: 4 employ, 4 ears
*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 in no. zj e'`ITave onditions of approval, and I understand them, and that I will abide by them.
Signature _ r Printed Raymond E. Gaines
APPROVAL INFORMATION
Approved as proposed Approved with conditions [ ] Denied
[ :+] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x117.
[ ] 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 (, (l'
Zoning Official Date 14
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 1/1/2011 Page 2 of 3
1. }
Intake to complete the following:
Y /
Is us m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will iT here be food preparation?
If so, give applicant a 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 private well or(ki blic w
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 a is seweeb
Y /(T:)
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
D/ N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit# 21010_0242MC
7.AI-kyri T fn rnninlAtn thn fnllnwinor.
Reviewer to complete the following:
Square footage of Use:T�
N �ky
ermitted as: /� n
Under Section:
Supplementary regulations section:
Packing formula:
Required spaces:
Y/N
Items to be verifieN in the field:
Inspector : \ Date:
Notes:
Violations:
Y N
If so, List:
I Mrs:
Y N
so, List:
Variance:
Y/N
If so, List:
's:
Y N
so, List:
Clearances:
SDP's
LA��
Revised 1/1/2011 Page 3 of 3