HomeMy WebLinkAboutCLE201300261 Legacy Document 2013-11-08Or, I a H-P j
:application for Zon °ng Clearance
CLE #
PLEASE REVIEW ALL 3 SHEETS
OFFICE C` ILY . -1
Check # Date: 1
Receipt # Staff:
PARCEL INFORNIAT P p�p 1� y/}
Tax Nlap and Parcel! Jn d 0 h ° n yoo - �1`' m Existing Zoning % A410
Parcel Owner: A `�e k"� .tt V�'Ce Ew ULC
Parcel Address: 102-0 &,,,1 `fit'+ A160 City C],o(.Ano.k State \1A Zip ZLlot
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? C� enr;;e �2tJar}
Address: 17,0O 4Jen.e 4400City &'-H-ee4u State �1a Zip 7,0'11L
Office Phone: i( ol) 3`-11- 31111 Cell # t{la 3S "- 6M Fax # 10i -f,5Z' 3T'9E_ mail G* Wurl (cJ 2d¢n5, CoM
APPLICANT INFORMATION
Check any that apply: of ownership Change of use Change of name New business
�yChange
m C A la {(y 1. IyJ
SusinesIsNatne/Type: (/ d t% 5r
Previous Business on this site N �`
Describe the proposed business including use, number of employees, number oishlfts, available parking spaces, number `of
vehiel , and any additional Information that you can provide:
an o �cc..Jr rye ` ht" �•1 tu' �aG c
r.�
*This Clearance N01 only be valid on the parcel for %A hid it is approved. If you chaAgff intensify dr move the ak to a nee% location, a neiv Zoning
Clearance will be required.
1 hereby certif that I o%An or have the ovwe?s permission to use the space indicated on this application. 1 also certify that the infarmation provided
is true and accurate to the best of my kno%%Icdge. I have read the canditions of appro%al. and I understand them, and that I u ill abide by them.
Signature 1'�� / —"- 'Printed
APP AL INFOR151ATION
KJX'pproved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -3511, xi 17.
[ ] 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 11 --c ((
Zoning Official Date -7/11, /V 1-4
Other Official Date
county of Aloemarie iiepartment of Community Development
401 Nlclntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 9724126
Revised 7t Ii2011 Page 2 of 3
Intake to complete the following:
Y On Is LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
W l re be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval fi•om Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well or public water
If private well, provide He epartment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic or ublic sewer
Y/N
ill you be putting up a new sign of any kind?
Sign permi . 0a "3 _d
Permit # p�
If so, obtain proper
Y/N
Will there be any new construction or renovations?
If so, obtain th proper Pe it.
Permit # 4q
Zonina to com lete the followin :
Reviewer to complete the following:
Square footage of Use:11L v
N
fitted as:
Under Section:
Supplementary regulations section:
Parking formula: q �; �I I M
Required spaces:
Y/N
Items to be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y/N
If so, List:
//"�ffers:
JYIN
C so, List:
T1
2f:
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearances:
SDP's
Y a ro
A
�
Revised 7/1/2011 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
27iis form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application 1s not (lie
owner.
I certify that notice of the application,
[County application name and number]
was provided to AlLe t-vvle Pace EA A P UC 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 CkW to S+eun Le VI;,;� SSC�Grul2 t;DEN$ � l
[Name of the record owner if the record`owner is a qr 430n4
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] i -I1 erq_le
on i j "11 13 place C-aPrP
Date Tn�
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 to the following address:
Date
[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
Casl'ah� ^�t l�Gt ��;s
Print Applicant Name
Date
EDENS.
October 29, 2013
County of Albemarle Department of Community Development
Attn. Rebecca Ragsdale
401 McIntire Rd
Charlottesville, VA 22902
RE: Alakazam 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,
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
7 200 Wisconsin Avenue, Sude 400, Bethesda, MD 20814 / 800.680,9095 / www,EDENS.com