HomeMy WebLinkAboutCLE200800248 Legacy Document 2013-03-18Building Permit #
B200800936NC
Application for Zoning Clearance
CLE # Zb08 — Z9 0
U � �
Alp
Zoning Clearance = $35
OFFICE USE ONLY
Check # J Date: m d �% g
PLEASE REVIEW ALL 3 SHEETS
Receipt # 2 5 Staff:
PARCEL INFORMATION
Tax Map and Parcel: Tax Map 32 - Parcel 6A Existing Zoning PDIP
Parcel Owner: University of Virginia Foundation
Parcel Address: 1670 Discovery Drive City Charlottesville State VA Zip 22911
(include suite or floor) (Adjacent to Emerging Technology Center One In UVA Research Park)
PRIMARY CONTACT
Who should we call/write concerning this project? Todd Marshall
Address : P.O. Box 400218 City Charlottesville State VA Zip 22904
Office Phone: 4( 34 ) 982-5304 Cell # 531 -3644 Fax # 982 -4852 E -mail stm7v @virginia.edu
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name /Type: Modular Vivarium
_
Previous Business on this site None
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: modular vivarium, rodent research facility
*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 accurate best of my owledge. 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
� _nackflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -45111 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 I f
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 04/28/08 Page 2 of 3
o` - - - N0
Intake to complete the following:
-YIN
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / 11G/
Will Yiere 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 lie tent If private well, provide Health a form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or public sew ?
Y/&
Will you be putting up a new sign of any kind?
Sign permit.
Permit #
If so, obtain proper
_]�)/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # c�_i
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use:
V/ N — --�
Permitted as:
Under Section:
Supplementary regulations section:
s2 2 . I
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector:
Notes:
Date:
Violati ns:
Y/(
If so, List:
Proffers:
6/N
If so, List:
Variance:
Y 1
If so--, ist:
SP's:
Y/
If so, ist:
Clearances:
C �
SDP's
Revised 04/28/08 Page 3 of 3