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Home My WebLink AboutCLE201300234 Legacy Document 2013-10-04W ss r„ Application for Zonin Clearance,;_'` CLE # % I - 23 OFFICE U E ON Y b Date: C1 12�- 0 PLEASE REVIEW ALL 3 SHEETS Check # Receipt # 61261l`76 Staff: rJilU-, PARCEL INFORMATION G — 3 Existing Zoning C Tax Map and Parcel: Parcel Owner: Sl-k4 P01IN 6- 5c� C Parcel Address: \<l G J L _ 2zn e�� City ) State )(5:�k _ Zip 0r'l.) (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Y,3 Ste N-S to --u E1 S Address : G Io Cl_A fEN--,a tv GU-V -W3- City State Q A Zip Office Phone: -S.\) Cell Fax # E -mail V�Si✓��1 itSV"�l;i i�sla � 7`�1+1�+ APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: • 5 G. t C►`C E �� 1't'�l 5 / �% ti "'04TC � Previous Business on this site 3, P 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: C1✓ f' P 1,S1 PK N �, F�-o� X2,3, �i- ��f`�S S -,\(ZA L- q: S fvS1Pi.oYC-Z C; (r2) , el ;� &+•+Zy oC= 9A2 kiaJ 11.12%7-11t3 — 41 147.) l z *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. Signature Printed Y0 5 EP If 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 �i 1 3° C z2 Zoning Official Date -3 a Other Official Date County of Albemarle Department of Community Deveiopmeni 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 7/1/2011 Page 2 of 3 C;dll Intake to complete the following: Y // /i Is ukeKLI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y/ Will t 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 Reviewer to complete the following: Square footage of Use: O/N / Permitted as: J`PAS�)AM Under Section: �, o Supplementary regulations section: Circle the one that applies rarxmg rormuia: Is parcel on private well o" is Ovate ? If private well, provide Hea ent form. Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE Circle the one that aa�� Is parcel on septic ba ublic sewe ? Y/N Will you be putting up a new sign of any kind? Sign permit. Permit # Y/ Item o be verified in the field: If so, obtain proper Inspector : Date: I, / N Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7.. +., ^n Ja+n 4hn fn1inwina- uvauaa w .At,— Violations: Y /P If so, is Proffers: Y/ If so, ist: Variance: N I'p'so, List: SP's: Y If so, List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 Lease Agreement Table 1: Summary of Material Terms Lease Name (DBA): Lease Number: J.B. Enterprises, Inc. Lease Date: Start Date: 10/02/2013 (Tenant Name (Legal): Landlord: ,nd Date: 1/01/2013 Office Address: -,."IShopping 'Center Trade Name -and -Address: - --- -- 1510 Clarendon Blvd. , # 302 Charlottesville Fashion Square ,Arlington , VA 22209 1600 East R.19 Road, Charlottesville, VA 22901 ITenant's Telephone Number: 1703.725.5011 Remit Payment to: Charlottesville Fashion Square �1600 East Rio Road - Charlottesville, VA 22901 ;Contact Name: Sole purpose for which space can be used by Tenant: For the promotion and tale of of pumpkins & seasonal plants during the period October 2-No'vember 1,2013, including setup and takedown time and for no other use whatsoever. U. B. Enterprises is required to obtain all permits as required ibylaw for such a sale and event. B. Enterprises is responsible for all.expenses incurred for i 'the event. All. displays and set ups must meet with mall imanagemqnt approval and no pavement penetrations are ;allowed in,setting up event equipment. The primary event 'location will be the overflow parking lot facing, Hwy. 29. Management must approve all displays. If this Agreement contains a Media Rent Table, the display posting period for an y advertising medium or component shall be limited to � (the respective dates therefor set forth in such Media Rent T able. -------- --------- ',SIC/MIX Code: `!total Contract Amount: $2,500.00 (Security /Damage Security/Damage Deposit Due I (Total Taxes: $0.00 (Deposit A mount: Date: 'Other Retail'- Misc Grand Total: $2,500.00 00.00 (2651) Space Rent Table I Shopping Center Name I City/State Space Start Date I Space End Date I Subtotal -- I Sales Tax I Tota Charlottesville Fashion uare Square Charlottesville, VA 10/02/2011 11/01/2011 $2,500.01 $0.01 Payment Schedule Payment Due Date Amount Due 10/02/2013 $2,500.00 Total Due $2,500.00 Lease Agreement for J.B. Enterprises, Inc. t n o eA M ry � m �L CL 6 0 � 1� i PP04 0, 0 (r �v N •� �p N cli o :4+ U ;m 1�...� rcC U 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 C F S the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 3 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 ' ' application to c N � it z C l C' :S 1 Mailing a copy of the apple a �1� � � � �R [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]. • r Signatu • opplicant YoSC_Pj� X4--5 F? ELL Print Applicant Name 12,5-%/3 Date