HomeMy WebLinkAboutCLE201200137 Legacy Document 2012-07-12- - - - -- A:pplication -for- -Zorn - Clearance--- - - - - --
CLE # Zb i
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OFFICE USE NLY
PLEASE REVIEW ALL 3 SHEETS
Check # — a te:
Receipt # taff:
PARCEL INFORMAT ON ,i
`� Existing Zoning (ybfnfd�Cvi G� �1� C
Tax Map and Parcel:
Parcel Owner: i y y f&-Um
pp r
Parcel Address: 'zM0 Old 1 t( yz4 City U �' �� State V Zip
(include suite or floor)
PRIMARY CONTACT /
1 Va t✓Y lG NO Y 1V1 [
Who should we call /write concerning this project? f/�/l (�V1 V l Shrth��/►
/� �tRe-
Address : 22d p ('�o� �V N FM la I City�IGtV ID eSVI I�CState Y7\ Zip y�j�
Office Phone: Cell # I Fax # E -mail V
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change of usel Change of name New business
Business Name /Type: @Ye- Etvye
Previous Business on this site
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: 171L/ t VP nA ecS
*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 accur a to the best of y knowledge. I I v e read the conditions of approval, and I understand them, and that I will abide by them.
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Signature Printed V'�( I z:�'V i6 M0 V m
PPROVAL INFORMATION
[I& 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 ( Y
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 7/1/2011 Page 2 of 3
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--- Tntake to complete thefollowing:-----------_---Reviewer-to-
complete- the - following:--- .------ - - - - --
j
Y / ('
Square footage of Use:
Is use I LI, FE or PDIP zoning? If so, give applicant a Certified
6 / N
Engineer's Report (CER) packet.
I , 11�
Permitted as: ;Jo. r �4 � S y ��i o
Y.
Will there be food preparation?
Under Section: Z> 2
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept, FAX DATE
Circle the one that applies
Parking formula:
/a <A �� A4� / N of�Q" NAnr tJY p�9 Yl
Is parcel on private well o�=ra ter?
tement form,
J
-If private well, provide
p
Zoning review can not begin until we receive approval from Health
Required spaces: 6-
Dept. FAX DATE
Y/N
Circle the one that W '
Items to be verified in the field:
Is parcel on septic or p 1p blic sewer.
-
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Inspector : Date:
Notes:
A.IVIL 1Ar2 V %"Vlll 1— llav 1
Violations:
Y / -
If so,Zist:
Proffs:
Y /Lf
If so, st:
Varr ce:
Y
If so, List:
S 's:
/N
``` f so, List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
7
4
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CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.. -
I certify that notice of the application,
[County application name and number]
was provided to the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
by delivering a copy of the application in the
Hand delivering a copy of the application to Pa Yc ,illI/Vl_ coa V � �C V! f! LAC
[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 le I I I 112,-
Dat
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
Date
to the following address:
[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].
r .17 I
Signature Applicant
Print Applicant Naive
D to
4
COUNTY OF ALBEMARLE
Department of Community Development
401 McIntire Road, North Wing
Charlottesville, Virginia 22902 -4596
Phone (434) 296 -5832 Fax (434).972 -4126
May 11, 2012
Carolyn Shears j
314 East Water St.
Charlottesville, Va 22902
RE: SP201200001 Ivy Forum
Tax Map 60 Parcel 46C
Dear Ms. Shears:
On May 2, 2012, the Albemarle County Board of Supervisors took action on the above noted
special use permit to allow an indoor athletic facility on the above noted tax map parcel in the
Jack Jouett District. This special use permit was approved based on the following condition:
1. The indoor athletic facility use shall not exceed two thousand (2,000) square feet.
Please be advised that although the Albemarle County Board of Supervisors took action
on the project noted above, no uses on the property as approved above may lawfully
begin until all applicable approvals have been received and conditions have been met.
This includes:
• compliance with conditions of the SPECIAL USE PERMIT; and
• approval of a ZONING COMPLIANCE CLEARANCE.
In the event that the use, structure or activity for which this special use permit is issued is not
commenced within twenty -four (24) months from the date of Board approval, it shall be deemed
abandoned and the permit terminated. The term "commenced" means "construction of any
structure necessary to the use of the permit."
If you have questions or comments regarding the above -noted action, please do not hesitate to
contact Rebecca Ragsdale at 296 -5832.
Sincerely, , ,
V�
V. Wayn Cilimberg
Director of Planning
CC: Ivy Forum LLC
314 East Water St
Charlottesville Va 22902
Email CC: Tex Weaver, Rebecca Ragsdale, Elise Hackett