HomeMy WebLinkAboutCLE201100140 Review Comments Zoning Clearance 2011-08-18J
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A pplication for Zoning Clearance
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CLE #
OFFICE USE O
I k Date: ZCl
PLEASE REVIEW ALL 3 SHEETS
Check #
Receipt #'_'"6'-_5 —7'!)LD . Staff:
PARCEL INFORMATION D Fnp o
Tax Map and Parcel: 07800-00-00-05500 Existing Zoning p 17 M C
Parcel Owner: Luxor Office Park, LLC
Parcel Address; 1430 -202 Rolkin CT City Charlottesvi$thoa VA Zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Grace Ha s
/
Address: a`3 3 Do l%Q{ (a s a y,< City V`�o �sv, C,tate Zip
Office Phone: : Cell # yrJ' t�l L��� `� Z E -mail I V I D ��e Vy1Qr
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name _X_New business
Business Name /Type: BodyLogic Therapeutics
Previous Business on this site None — new business
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
'Pt
vehicles, and any additional information that you can provide: 11D 41D h l f2
e - e. , 1N10 n T 8 S o v+t 1° .' ear 1,; e k- "Op-
-IA V- -v � c_._ MASScc g. a ktv,ary i r a 6.:::. v /Juv« v ✓�
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*This Clearanc 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 r ay knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signatur - 7" Printed Grace Hays
AP OVAL INFORMATION
[ Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Bacicflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, xl 17.
[VNo 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
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
COQ
Intake to complete the following:
Y N
Is us LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y N
Wi 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 p lic Ovate .
If private well, provide Health rtment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic or ublic sewer?
Y I N (6D
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. j �S n n Permit
Y/N
ll tl'fe
Wire be any new construction r renoWtions?
If so, obtain the proper Permit.
Permit #
Zonine to com lete the followin :
Reviewer to complete the following:
Square footage of Use: � `o
J,/ N
permitted as:
Under Section:
Supplementary regulations section:
Parking formula: Rr -zo-nue OX -0
Required spaces:
Y/N
Ite e verified in the field:
Vio ti s: f
fro ers:
N li -1a
I
Var'�arrei e: s
s:
Clearances: S
SDP's C
C ^
lJ� OK-
1/1/2011 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form inust accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner. 9611 J ( D
I certify that notice of the application, Q -o @ �, '1 c% L G
jj [Co't lty app ication name and number]
was provided to e C.P —hi V' k LLC— the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number T�-' 55 I by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to �tL� eAL LLy
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
Oil
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on to the following address:
Date
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies .
this requirement].
Sign •e of Applicant
�nrCQG
Print Mplicaut Name
— ,9---
Date