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HomeMy WebLinkAboutCLE201300265 Legacy Document 2013-11-136� I m 0 1 � Application for Zoning Clearance`s " " "''` OFFICE US Y PLEASE REVIEW ALL 3 SHEETS Check # Date: Staff:( Receipt # PARCEL INFORMATION Tax Map and Parcel: 4—j t.,.J `03 — 00 - (9 % Existing Zoning Parcel Owner: k (kp cna r � e P �C_ ce. 'L A kP LLC � d e ne Parcel Address: ,�C) E6 BGr, I4 ` Sur -,Z. t 4� City ('"G(' �C44e_5 U rI� State \J Q Zip aQcb I ^ (include suite or floor) PRIMARY CONTACT ^ h 11 Who should we call /write concerning this project? N l' C� r'a 'c�,J, -. KAA n,. L I 1 N► 5 Address : ' nAl1 Co g c �e I oe City Y'-) X o t State Iy Zip3Tz qaa Office Phone: G,�b aj%--770C xia3 Cell # Fax #`'i6S -, %-7707E -mail LiSc lJiII�em.SQ 1.(4ard54, APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: r- d n4e I Dj�A G 1 u3omc� fl` 5 C .14k i a ccesSC�r Ie5 Previous Business on this site X11 CN�w 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: QU cmpk4eqe, � tamer � ��� ilab 0.r i4_ ��'-�� .� �»� 1.���� � �.xl„I�'�t A �.- 1-- 4n��.,z�l `�� v�4:,��RS �.T.�,�.,�,a•� s vtzi;��_I�� n�1 *This Clea •ante 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. 1 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 � Z� c a Printed I I G M.5 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 ofthis date. Notes: Building Official �— Date Zoning Official Date 4/ /izyz�12 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 re .Ccnv� Intake to complete the following: Y /.'. Is u LI, HI orPDIP zonin4? Ifso, give applicant a Certified Engineer's Report (CER) packet. Y / W ffi nix' re be food preparation? if give applicant a HealthDepartnTent form Zoning review can not begnitnitilwe receive approval fromHealth Dept. FAX DATE Circle the one that applies Is parcel on private tirell or p nc 1vatee If private well provide Health Went form Zoning review can not begin urrtilive receive approvalfromHealth Dept. FAX DATE Circle the one that app Is parcelonseptic or r lic setiver'? Y/N Wilyoubeputtingup anew sign of any kind? Ifso, obtain proper S ign perrrit. Permit # Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7Aili"er to the fnllnu inu- Reviewer to complete the following: Square footage ofUse: 5,19 She Y)/N i Permitted as: Y Under Section: ��� c c , .) Supplerrentary regulations section: Park ingforrrarl<1: /f '7 Required spaces: Y /8I Items to be verified inthe field: Inspector: Date: Notes: = '�._.�._-�.- .mot' - - -- - - - - -- — - b iolations : /N If so, List: Proffers: (9/N Ifso, List: Vann�} ce: Yll� Ifso, List: SP's• Y/d') Ifso, List: Clearances: r4 , �/ SDP's 8U Revised 7/1 /2011 Page 3 of 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, -Zo c [County application name and number] was provided to •K C m°.c Jc, L�,NP . I 1 C the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number h, I Lj -03 - 00 - 14 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 .�be mc,c le �rtice, ic�K ?, LLc k4r\° �ennl er ��0ii,�� [Name of the record owner if the record owner is a person; `.�}�c �i 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 \ \ 1 ( 1 l --), to the following address: Date -7aoo )LSCnr In -�� `1ao , lnp [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]. le l LAAFctsGr LL, Pial C'r11.-1'ir, ; So;4c,i ©oo X01OML)- ,SC 4%0 �--)A , Signature of Applicant Print Applicant Name Date fT01LETl - _ A I i. .....E l /%l ........... 1 2/5,f FITTING' } TOILETtt 7t . LOUNGE J. i JI7t1 r;�i i ft f r i`'J II .... I ;l STOCK OFFICE -Y_. it r - I Am F--., ( i i I I CASH }� WRAP �._. i j j 2.1 _ ��1l�f�f /flfrf i y 0 ` c` .!... ... _ - - j I Y, r. I I ------- CALCULATIONS APPROXIMArEGROSS.AF,EA: _5,858sf � � I I SalesArea 5,048sf �'•-BG -% -_ i I I I Non-Sales Area 8109f 147 ' '-0 -------- I i SF Breakdown: i 1 I Sales Area 4,455 sf I SALES j j OlscountArea 180sf j i AREA FWngAneae 500 s 1 I Stock 590 sf I OfBce5 50 s Tollets(50sfea) 100sf i 0 j j j l I I I I I I I i I j j j I I ` T I'__. cc ;� i •� x1.,:1. _ .T i EXHIBIT A SHOPPING CENTER J`'VI'11111J I .�• I'I�IL D R i If. 111111;% .. I I k�rg 1- _�ht try; :GAL, — II Q FEHIYEEB DVIJ)DA} •—•— . i �y �...r��l ! •I I LEgev]ERYPb3 .�_+1'. •�i �� - FlfiLEEBLU�N5 � -,;�1 -- l.: t t NOHUI�GF6L 0 ! I I14 III ! : \ 4 f I EYFIAYEEPAMNO • ` The parties acknowledge that this Site Flan is for ldentificaffm purposes only te anycoant, and does not constitu ren representation orwananty by Landlord that any exisf M or future oonriAf ons shown exists. or that, it they do exist, will confsoe to Mist 9aonghout all or my part tof the Lease Ten. except to the wctentsuch coa rjt. representation or warranty is expresslyset forth in the Lease mDENs. LEASE�PitEYISES - A -.a uM