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HomeMy WebLinkAboutCLE200800149 Legacy Document 2013-01-17n Application for Zoning Clearance Building Permit# J B2009- 00539AC Zoning Clearance = $35 PLEASE REVIEW ALL 3 SHEETS OFFICE USE ON Y p CLE # Z/ —N � E (�1 Date: , D' Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 32 -19J Existing Zoning PDIP Parcel Owner: University of Virginia Foundation Parcel Address: 1001 Research Park B1vdity Charlottesvilthe VA Zip 2291 (include suite or floor) Suite 120 PRIMARY CONTACT Who should we call /write concerning this project? Todd Marshall Address: P.O. Box 400218 City Charlotte svilitete VA Zip22904 Office Phone: CA3� 982- 5304Ce11# 531 -3644 Fax #982 -4852 E- mailstm7y @virgin.i.a.edu APPLICANT INFORMATION Delta Bridge, Inc. Business Name /Type: Previous Business on this site None escribe the proposed business, including use, number of employees, number of shifts, available parking spaces and any additional information that you can provide: office Space *This Clearan6e 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 ttM s of m ow edge. Jhave read the conditions of approval, and I understand them, and that I ill abide by them. Signature 1 Printed APPROVAL INFORMATION �[ 7 Approved as proposed [ ] Approved with conditions [ ] Denied ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, x119. [ ] 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 Z r ii 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 5/1/06 Page 2 of 3 4218 Intake to complete the following: ❑ YES ❑ N Is use in LI, HI o PDIP zoni If �so, give applicant a Certified Engineer's Report (CER) packet. ❑ YES X NO Will there 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 ❑ YES ❑ NO Is parcel on private well or lx is wat r? If private well, provide HealthDGpaftment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE ❑ YES ❑ NO r—� Is parcel on septic or ublic selver? ❑ YE S 0 Will you b putting up a new sign of any kind? If so, obtain proper Sign per f t. Permi ❑ YES ❑ NO Will there be any new construction or renovations? If so, obtai the pro er Permit. Permit # 7/-%C- Zonin Tech to complete the following: Violations: ❑ YES If so, List: IVI NO Variance: ❑ YES If so, List: [P NO ��,�A-JTMP Reviewer to complete the following: Square footage of Use: YES ❑ N��' l�Lt Permitted as: n u Under Section: Supplementary regulates section: Aq Parking formula: J /n & O A !^_ Required spaces: f -k e l a,r, v p- 9 ❑ YES ❑ NO Items to be verified in the field: Pro M s: W YES ❑ NO If so, L'��! /c1 -1 Sp� ❑ ; YES ❑ NO If so, 'st: ` 141-:5 C Os^#•P . a4 4 J 511106 Page 3 of 3