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CLE201300210 Legacy Document 2013-09-20
Application for Zoning Clearance CLE #_U125-2_16 � "�RGiNIP OFFICE USF� ONLY Check # I �I Date: PLEASE REVIEW ALL 3 SHEETS Receipt # C12LAD Staff: PARCEL INFORMATION G I �( — �, - Existing Zoning I�P/�q��htiYh ,� {tXJIV� Tax Map and Parcel: Parcel Owner: i- Parcel Address: JJJ �JQAlwo(79) SYA T, . # 2p' 1 City C State V,4 Zip 22a D 1 (include suite or floor) PRIMARY CONTACT /write this FF Pb M P F D Who should we call concerning project? Address: 9t') 6ts"Wt"D 4 Zoy City C', lei State ✓A Zip Z2901 Office Phone: y(� q0q , l q N S Cell # q0cl • l 9 5' Fax # E -mail SC • p APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name V, New business ( Business Name /Type: 1' D C u f T 5 D i c 5 r.) C ," f�9r(��> Previous Business on this site C�'7 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: *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 h e owner's permission to use the space indicated on this application. I also certify that the information provided is true and accura o knowledge. I have read the conditions of approval, andd I understttaand them, and that I will abide by them. Web Signature Printed V s�T�� ✓ APP ROV'A'L 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 a Zoning Official 9 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 Intake to complete the following: Is/ 1s us m LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / Will sere 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 r publ.ic wate . If private well, provide parhnent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that �r'�Iic li Is parcel on septic Y iON Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # WiOtere be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to complete the following: Reviewer to complete the following: Square footage of Use: 00 Termitted as: CM� Under Section: GV Supplementary regulations section: Parking formula: IMOD (` Required spaces: (5� Y/ Item e verified in the field: Violations: /.1T� If sks st: Q-f &Ardt£ -PA& +- j Y N so, List: DOD Variance: Y/N If so, List: 's: )Y /s so, List: � VM Clearances: � 9 � � Q1 3a SDP's Revised 7/1/2011 Page 3 of 3 I 1w 4' PocketSonics I Home At PocketSonics, we're changing the way you think about Page 1 of 1 ultrasound.our unconventional engineering approach challenges the limitations of traditional ultrasound technology and has brought forth innovations that deliver tremendous benefits: dramatic cost reduction, extreme portability, single hand usage, and intuitive image formation. Our flagship product, the Sonic WindowTM is an ultra - portable, pocket sized imaging device, with an integrated transducer array and display, that uses innovative beamforming technology to render intuitive C -Mode images, acting as a "Window Through the Skin ". The Sonic WindowTM will provide both experienced and novice ultrasound users with simple image guidance for challenging vascular access in children, obese, elderly, and other populations. This means the first caregiver can begin the procedure at the patient Point of Care. Ancillary uses are numerous, including foreign body detection, initial injury assessment, and more. The technological advances will allow the Sonic WindowTM to be sold for significantly less than the bulky, tethered portable imaging systems currently available today. The device will follow the relatively expedient and low cost FDA 510(k) premarket notification regulatory route. According to a 2007 report by Klein Biomedical Consultants, the Hand Carried Ultrasound (HCU) product segment is the fastest - growing segment within the global ultrasound market, and generated 2007 global sales of $565M. The HCU segment is expected to exhibit a compound annual growth rate of 22% to reach $1.2 Billion by 2012. Early market studies on the Sonic WindowTM concept have been overwhelming positive, specifically due to the device's ease of use, dramatically low cost, extreme portability, adaptability to other non - needle- guidance applications, and existing CPT code reimbursement opportunity. PocketSonics, Inc. 941 Glenwood Station Suite 204 Charlottesville, VA 229oi 434 - 202 -40o8 Contact us © 2013 PocketSonics, Inc. All rights reserved. Disclaimer. http: / /pocketsonics.com/ 9/13/2013 W � a l.Ji1 O O F- ❑ ❑ m W a 0 L LU W Z ~ W S Q U � Z❑ iii vi W O Z 7 z U F y Zd ¢ w U >' O Q U U q a COD tn a o g 0 --� Y O W Z Z a S m U O Z y YO = E Z r O U W y ❑ O LL d a a w a o z a V1 U) z O W Z = z O Z, co 0 Z ❑ to j 7Z`p� Q W LOU I Z m U w m W z N a U LMLI O U O O 2 N < � Lil o O Z W ss O LL 7 ❑ O m m J ❑ s _ < C7 o >. 72 °o W WW O o m U OF U - u m t m U Z LSS Z O W W In W W J w H U � y COL w 2 F ❑ w U W m 0 Z LL O W W X W 0 Z J z z Z O U Ca cn o 2 H N J w m U �2 W w r W Z O O Q O N Z � y W (n oa w w Fn 0� a 00 o W O O m m O Q Z ❑ ❑ W J 0 m X U W m a W O Q � W W X m y Y U z 1--- w ui = J U m Q N =) W Q N � O °D v rni CO VIN LL z O O Y W U m Z uj a m LU ui w U O (G � r O � :� rn im_ , � �• ,,� 2 � � yWgr C7 U f' j SAS rF W W i r„r� +5 # :,i„� ,•4 y n±�, s2 iJ } t. LL '• YYYYi�y NN `W; Z m is Z ,W-�14 -, a a U -'� m. tcg vi u xn .rn in fp w rn ui to �m y, • v, F3 G izoll +A. .d Z3 `� I ELU in. rn tm n va U! U U w � O CV N -CO: 'C1 l'7 f7 1� '•R' F- ❑ ❑ m W a 0 L LU W Z ~ W S Q U � Z❑ iii vi W O Z 7 z U F y Zd ¢ w U >' O Q U U q a COD tn a o g 0 --� Y O W Z Z a S m U O Z y YO = E Z r O U W y ❑ O LL d a a w a o z a V1 U) z O W Z = z O Z, co 0 Z ❑ to j 7Z`p� Q W LOU I Z m U w m W z N a U LMLI O U O O 2 N < � Lil o O Z W ss O LL 7 ❑ O m m J ❑ s _ < C7 o >. 72 °o W WW O o m U OF U - u m t m U Z LSS Z O W W In W W J w H U � y COL w 2 F ❑ w U W m 0 Z LL O W W X W 0 Z J z z Z O U Ca cn o 2 H N J w m U �2 W w r W Z O O Q O N Z � y W (n oa w w Fn 0� a 00 o W O O m m O Q Z ❑ ❑ W J 0 m X U W m a W O Q � W W X m y Y U z 1--- w ui = J U m Q N =) W Q N � O °D v rni CO VIN LL z O O Y W U m Z uj a m LU ui w U O (G 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 by delivering a copy of the application in the manner identified below: Hand delivering 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 Mailing a copy of the application to F a le— �T , [Name of the record owner if the repo 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]. , i ture o pplicant C)-4T /ej, 4, 1 �/) Print Applicant Name x g11a/vi / 3 at