HomeMy WebLinkAboutCLE201300259 Legacy Document 2013-11-08Application finr ZO i g Clearance
CLE #
caunty or Atoemarte Department or Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -SUZ Fax: (434) 972.4126
Revised 7 12011 Page 2 of 3
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OFFICE
PLEASE RE17E�i' ALL 3 SHEETS
rht( Hate:
Receipt # Staff:
PARCEL INFOWNIATION j
Tax Map and Parcel:, - -A(o �''t`s� " �1� EYfsting Zoning,
ParcelOviner: NeMq "4t Vk,,CC P bLC
PorcelAddress: Z-Q7,0 &-,� 5 * 16U City k- lo4}eSU lke State_ VA Zip 27-501
(include suite or flo
PRI MARY CONTACT
Who should i %t call /svrlte concerning this project? CL. 64ri;� Qs�urk
Address-_��D tJ,Sto+S:e �d2r.�¢ �'`l�City �x�RSc�« State �� Zip ZoViL
Office Phone: (1.Qu -ILn - 3414 Cell # q(O 3S3. 6M Fax 0 C W iS r-1 r 2d2n5• Cory
APPLICANT IN]FORNIATION
Check any that aliplyx Change ofotvaers_ Change of use — Change of outne New business,
e
__. _ _._
BudnessNamerrypc: ouk- r ty �cA S(Otis (-
�it9pi
Previous Business on this site
Describe the pro"sed business including use, number of employees, number orshiit% u%uiiable ?arl�ing�apaces,aumberdr
hlelcsand any a dltionnl iatorroatianYbnt you can provide: EAPC& S TR fi ,JCL,; yin' _SVS,
4 L v
"ThXs Cleamcc ill* be tialid en tha eel far %%hi it is appro%cd ir)ou'ct range, inten3if) or motcthe use to o acu location. a ncu Zoning
Clcnrancu kill be rcquircd
I hereb) certir) that I o%%n or ha +e thr amxaes permission to use the space 64cated on this application, t also cen[5 that the intarmation prof ided
i we and aceurat to the best of )° a e. t mr read the conditions of approsal, and i underrmind therm, and that i %%;11 abide by them.
Signnture � Prinwd— 1,_.a V��.4k— --•-1 h
P AL Ild FORAIATION
[ pproved as proposed j ]Approved k0h conditions [ J Denied
[ ) Backflon prevention deti ice and orcurtvnt test data needed for this site. Contact ACSA. 977-4311. xl 17.
[ ]No physicat site inspection has been done for this clearance, Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This site romplics pith the site plan as of this date.
totes•
Building Official
Zoning Official Date «
Other Official Date
caunty or Atoemarte Department or Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -SUZ Fax: (434) 972.4126
Revised 7 12011 Page 2 of 3
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Intake to complete the following:
Y /0
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /QWill 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 or blic w�Mnent
If private well, provide Hea .
Zon ing review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that app
Is parcel on septic or ublic sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # (II�� is
Y/N
Will there be any new construction or renovations?
If so, obtain t e proper Permit.
Permit # `� a
Zoning to comDlete the following:
Reviewer to complete the following:
Square footage of Use: 30 I)
Y// N
ermitted as
Under Section: I , & l - A (l 6e
Supplementary regulations section: " G�
Parking formula: Lr
Required spaces:
Y/N
Items to be verified in the field:
Inspector : Date:
Notes:
Violations:
Y/N
If so, List:
ffers:
Y/N
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
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Adminlstrntor Determinations or Appeals, Sign Permits, Building Permits) Mlle application is not the
owner.
1 certify that notice of the application,
[County application name and number]
was provided to _Aibe t eAf, Place EA A P . the owner of record of Tax Map
(name(s) of the record o«•ners of the parcelj
and Parcel Number w.., .. T ,by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to C.lWj ae Star Ler_ I} Ss�UZu4e , E 605 ,( �
[Name of the record owner if the record owner is a Ar y enf ,r
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) t, Al ru-Ip
on Ooze
Date Inc,
Mailing a copy of the application to �_.. v. _._ ..
[Name of the record owner if rite 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
`.z._. 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 na u renvfApppli
clant
=Print Applicant Name
I0VTa )
Date
-EDENS.
October 29, 2013
County of Albemarle Department of Community Development
Attn. Rebecca Ragsdale
401 McIntire Rd
Charlottesville, VA 22902
RE: Rock Paper Scissors Zoning Clearance Application
Dear Rebecca:
The attached Zoning Clearance application has been provided to EDENS, the property
owner, and the use has been approved as defined in this application.
Please contact me if you have any questions.
Sincerely,
/ ► I;
Charlie Stewart
LEASING ASSOCIATE
EDENS
7200 Wisconsin Avenue, Suite 400
Bethesda, MD 20814
www.EDENS.com
P (301) 347 -3978 1 C (410) 353 -6826 1 F (301) 652-3588
7200 Wisconsin Avenue, Suite 400, Bethesda, MD 20814 / 80M80.9095 1 www.EDENS.com