HomeMy WebLinkAboutCLE201300184 Legacy Document 2013-08-09Application for Zoning Clearance
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CLE #
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OFFICE U LY
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PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL INFORMATI�O1N
i- I;xis tin Zonin
Tax Map and Parcel: ((��((yy�� !! - 2 g g
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Parcel Owner Ai di' l�S m
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Parcel Address: (boo r. Rib KU.• St Afe % -0� City CB2, 1f,&114lIe State A
Zip Z v
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? �/1.�� T l`I U) `4
Address : 134 gtL1K'C6iDr, City V State A
Zip 2
Office Phone: (_� Cell ON —'s0 - 244ax # E -mail 9
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name
New business
Business Name /Type: Ulea/tI Man . 4"Saare
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: A20 p-Ainl
*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 to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide
by them.
Printed oau), w vim' l°4- °
Signature
APPROVAL INFORMATION
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
Zoning Official Date
Other Official Date
County of Albemarle luepartment of k:ommunity meveivpmeut
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1/2011 Page 2 of 3
Intake to complete the following:
Y/(N)
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /(N J
Wil 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 orawblic walel?
If private well, provide 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 septic or p blie sewer .
Y/N
Will u be putting up a new sign of any kind?
Sign permit.
Permit #
If so, obtain proper
Y
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zonin to complete the following:
Reviewer to complete the following:
Square footage of Use: IM
1' /N '/
Permitted as: _ ate - /4t )�9 Use
Under Section: 1
Supplementary regulations section:
Parking formula: Si
Required spaces:
Y/N
Items to be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y/N
If so, List:
Proffers:
Y/N
If so, List:
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
C
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
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below;
Hand delivering a copy of the application to
the owner of record 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]
on
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
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].
Signature of Applicant
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Print Applicant Name
V � //; _ -
Date
-n
9
MON°
Project DaM
SEARS
103.946
BFLK'N
120,448
[TENANT NAME] -Under Construction
JGPENNEY
SEWS'
Total Department Store GLA
96.052
60,707
381,153
Charlottesville Fashion Square
ffTENANT NAMEH- NFR Unit Center Plan
1600 East Rio Road
Total Small Shops GLA
188,933
Charlottesville, VA 22901
1
0 30 60
Total GLA
570,086
CORP# 4661
Modified: December 26, 2012
9
MON°