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HomeMy WebLinkAboutCLE201300215 Legacy Document 2013-10-250-1 Application for Zoning Clearance 0 OFFICE USE iO Y Check # 21 Z Date: C1 -12 -13 PLEASE REVIEW ALL 3 SHEETS Receipt # 7 Staff: (W, . PARCEL INFORMATION, \ Tax Map and Parcel: A►�G2[ �� 0 5 (o IkZ�D -d D —p ($ DD Existing Zoning h8 �' I. 0 &0 1d 64y� Parcel Owner: Coun / v r- �[bevria ✓�� Parcel Address:-2—v9--o >'CVe-,, City C VDT -eat State VN Zip 'M (include suite or floor) PRIMARY CONTACT KI G� te-,- Who should we call /write concerning this project? Address • - l �2- b►�Pib V V-✓1 5'I City C KD-ee f— State VA, Zip ZZ�13 Office Phone: ( 3q) 923' 2-0 0 Cell # �3Lf " 40 %, 25Fax # E -mail V-u k1 CXV, --ej a q MAi • Ca wl APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business �+ Business Name /Type: Cr0zz u I 1 LLB 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: D -C Ga I:N ru. KR i �1 YV,-Fa* ( S-I 'D t'P/, �J—• �'l CJ �ynpl ►�r.P P s . tJ It ✓5 o f r7D�►�ai'i ovt -- M —F'. l D —le Sa_f q —r *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 I vll C't-Ae/ - Y�v�o� ��5 e ✓� 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 Ian as of this date. Notes: G Building Official Date 3 I 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 7/1/2011 Page 2 of 3 Intake to complete the following: Y/@) Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y /Ne 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 Circle the one that applies Is parcel on private well o public water. If private well, provide Heat 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 o public sewer? Reviewer to complete the following: Square footage of Use: f O YJ/ N Permitted as: Under Section: p(l) Supplementary regulations section: Parking formula: 11,600 Required spaces: Y/N ems to be verified in the field: V1 L'^ Will you be putting up a new sign of any kind? If so, obtain proper -4�1 P % a Sign permit Permit # es, gLA Inspector Date: I >' / N lVMit-1 Will there be any new construction or renovations? If so, obtai the proper ermit. Permit 3a313- as ,6G - A- Co lqt* 511(a O R Zoning to complete the following: Notes: Viol Y/ If so, ist: Prof s: Y/N If so, ist: Vari ce: Y/� If so, ist: SP's: Y/ If so, ist: Clearances: SDP's �n � n ©�T Revised 7/1/2011 Page 3 of 3 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 ro u wI:� o � N e- wv a ✓Ic-') the owner of record of Tax Map [name(s) &the record owners of the parcel] and Parcel Number () �j (o 2 —0 I �0 0 , bl go 0 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 [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]. ignature of Applicant Nli6t4el ([C/ �rnjee1-serA Print Applicant Name Dat DESCRIPTION OF LEASED PREMISES All that certain space (the "Space ") situated in the County of Albemarle, Virginia, located on the Ground Floor of 2020 Library Avenue, Crozet, Virginia, containing 1697 square feet, more or less, shown as "Leasable Area" on a floor plan dated August 1, 2013 titled "Crozet Library: Ground Floor Lease Space," a copy of which is attached hereto and incorporated herein. Reference is made to the floor plan for a more particular description of the location of the described space. This Space is a portion of Albemarle County Parcel ID 056A2- 01 -00- 01800, containing 1.41 acres, more or less. 8 -- - -:� -- I I I I I , I I L-------------- J r--- ------ - - - - -� I I I i i I I I 1 I I ---- - - - --! ------- - - - - - J CROZET LIBRARY: GROUND FLOOR LEASE SPACE SCALE: 1/16" = l'- 0" t t t t t t r t t � t J AUGUST 1, 2013