HomeMy WebLinkAboutCLE201200228 Legacy Document 2012-10-25Applicati ®n for Zoning Clearance
OFFICE U
c, LY
PLEASE REVIEW ALL 3 SHEETS
Check #
{Q`1 Date: -
Receipt #
Staff:
PARCEL INFORMATION
Tax Map and Parcel: T14: 45; P: 109 -C3 Existing Zoning C1
Loupe LLC, 848 Woodlands Rd, Charlottesville, VA, 22901
Parcel Owner:
3317 Berkm City State Zip ar Dr Charlottesville VA 22901
Parcel Address:
(include suite or floor)
PRIMARY CONTACT
Vinnie Paladino
NI'ho should we call /write concerning this project?
Address: City State Zip
Office Phone:(540) 432 -5523 Cell # Fix f/ E-mail vinnie.paladino@ricoh -us
APPLICANT INFORMATION
Check any that apply: Change ofnownership Change of use Change of name New business
Business Name /Type: t Co t l ti U M
i `I
Previous Business on this site_ ::Q <wQ U CE, tic Sv �1 16}. S
Describe the proposed business including use, number of employees, number of shifts, available parkings paces, number of
Vehicles, and ally additional inforillation that you call provide: 06Fw'4e vto .�t d
''This Clearance hill 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 owl or bave the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate o• lti U st of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed1C�ni%"
APPRO L FORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, 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 (late.
Notes:
Building Official `'° - Date
Zoning Official / Date > ZaI
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
coal
Intake to complete the following:
y /
is °l
use i ► LI, FIl or PD1P zoning? If so, give applicant a Certified
Engineer's Rcport (CER) packet.
Y / N
Will 1 ere 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 public Iva 0
If private well, provide IIeal h-D r ment form.
Zoning review can not begin until we receive approval from Flealth
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or n►blic sewe •?
V l N
l you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
5' /(Nj
\Vitt here be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7.nninu to cnmnlete the fnlimvinu-
Reviewer to complete the following:
Square footage of Use: _ 3 SF fx tee- -, ( '-'�ILt7
IN N
Permitted as: dt,,T�cc� DY
Under Section: -1-1— - Z• 1
Supplementary regulations section:
Parking formula: ko 4
Required spaces: �^
Y �J
Items to be verified in the field:
Inspector : Date:
Notes:
Violations:
Y/&
If so, List:
Proffers:
Y/
If so, ist:
Vail. ice:
y
If so, List:
SP's:
Y/
If so, ist:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This farm must accompany zoning applications (Home Occnpalion, Zoning Clew -once, Zoning
A(lministratol- Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
1 certify that notice of the application,
was provided to
[County application name and number]
Loupe LLC
[name(s) of the record owners of the parcel]
and Parcel Number TM: 45; P:109 -C3
manner identified below:
Hand delivering a copy of the application to
the owner of retort( of Tax. Map
by delivering a copy of the application in the
[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]
rem
Date
X 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]
ml
to the following address:
Date
848 Woodlands Rd, Charlottesville, Va, 22901
[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].
Sit ature of Applicant
innie Paladion
Print Applicant Name
9/19/12
Date
ShowImag.ashx (JPEG Image, 800 x 600 pixels) http:// gisweb. albemarl e. org/ GISWeb/ ShowImage .ashx ?t= k &f= S0000174...
A) 1256W1ST FLOOR
B) 819W COVERED PAROLING
C) 1825W2ND FLOOR
D) 49ftz BALCONY
1 of 1 3/28/2012 12:52 PM