HomeMy WebLinkAboutCLE201100127 Review Comments Zoning Clearance 2011-07-18?6aa_t cad I WEm anfli -
Application for Zoning Clearance
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PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff: /
PARCEL INFORMATIO
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Tax Map and Parcel:
�L+el isting Zoning
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Parcel Owner: S�/iOQC ND SSICy1LL1J L-L c-
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Parcel Address: 1S 4 Ir%L5� & ZIT City VI�. State ZipZZ /f
(include suite or floor) N`
PRIMARY CONTACT
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Who should we call /write concerning this project? 1 � V c _ I/N,rI.(..�1�/
Address: I � 2tygo—se-Nib VV • city i"aLL C state VA- ZiM
Office Phone: Cell # �— Fax # M10- E -mail y LGSM tL7MN _Q[J� •
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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Business Name /Type: U1,�SL�i.� t� t)lsabf_Q! C 71L�L
Previous Business on this site �'� Mck 3 & P I AIST I rV
Describe the proposed business including use, number of employees, number of shifts, available parking s pacep, number o
informatio that t
vehicles, nd any additional you can provide:
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*Thi Clearance will only te valid on the parcel fCMhich it is approvect. Tr you c ge, intensify or move the use t anew ocation, 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 tqpe est of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature / Printed
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
Zoning Official Date
i
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
4
of 3
VV A 51,5,F
Intake to complete the following:
Y /2N)
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /
Wile 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
Reviewer to complete the following:
Square footage of Use: - 6 L4 s
Y/N
Permitted as:
Under Section:
Supplementary regulations section:
Circle the one that applies
Parking formula:
Is parcel on private well r public water9
If private well, provide Hea epartment form.
Zoning review can not begin until we receive approval from Health
Required spaces:
Dept. FAX DATE
Y/N
Items to be verified in the field:
Circle the one that ap
Is parcel on septic o public sewer
Y
Wi u be putting up a new sign of any kind? If so, obtain proper
Clearances:
Sign permit.
Permit #
Inspector • Date:
Y VN
Notes:
W be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Violations:
Y/A
If s ist:
Proffers:
Y /tq
If so, List:
Varia
Y /N'
If so, List:
SP's:
Y/
If so, ist:
Clearances:
SDP's
Revised 1/1/2011 Page 3 of 3
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154 Hansen Road Building A
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2,519 SF
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2,706 SF
Charlottesville, Virginia
Current Floor Plan
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2,896 SF
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8,091 SF
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Second Floor
12,208 SF Gross
10,987 Office Space Net
910 Common Area
Virginia Land Company of Charlottesville, Inc.
195 Riverbend Drive, P.O. Box 8147, Charlottesville, VA 22906
Office (434) 979 -8181 - Fax (434) 296.3510