HomeMy WebLinkAboutCLE201300278 Legacy Document 2013-12-03Application for Zoning Clearance
CLE#.'2L1 4q8
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OFFICE US
H-22-0
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff: y77EU
PARCEL INFORMATION
Tax Map and Parcel: 07800- 00- 00 -055DO Existing Zoning PDMC
Parcel Owner: Luxor Office Park LLC
Parcel Address: 1430 Rolkin Ct, Ste 202 City Charlottesvill9tate VA Zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Denise E. LaCour
Address: 1430 Rolkin Ct. , Ste 301 CityC'ville State VA Zip 22911
Office Phone: (434) 971 -8996 Cell # 434 - 981- 4709ax # 434 - 971 - 9344E -mail denise@denico.net
APPLICANT INFORMATION
Clieck any that apply: Change of ownership Change of use Change of name X New business
Business Name /Type: Denstock Management LLC
Previous Business on this site N/A
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: Property mngt corporate office —
S AM — 5 PM, employees
_3
*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 th 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 accura the best of my knowle ge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Denise E. LaCour, Manager
APPROV ORMATION
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 c_ Date (TC
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 /�N
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /UN
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 ublic w)
If private well, provide 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 septic o ublic sewer.
Y /ON
Will you be putting up a new sign of any kind?
Sign permit.
Permit #
If so, obtain proper
0/(@
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 2 a 13 — 2'I 1� A Cl
7.nininty to rmmnlPtP the fnllnavintr^
Reviewer to complete the following:
Square footage of Use: 1175
lD / N
Permitted as: G
�
Under Section: 2�" x • 2
Supplementary regulations section:
Panting formula:
Required spaces: S
Y/15
Items to be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y/(
If so, ist:
Proffers:
/N
f so, List:
Z�� 2day —IZ
Variance:
If o,Zist:
SP's:
Y/
If so, List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
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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 _LUXOR OFFICE PARK LLC
[name(s) of the record owners of the parcel]
and Parcel Ntunber _07800- 00- 00 -055DO
manner identified below:
the owner of record of Tax Map
by delivering a copy of the application in the
X_ Hand delivering a copy of the application to Denise E. LaCour, Manager of Luxor Office Park, LLC
[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 November 10, 2013
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].
Si ature of Applicant
Dens Management LLC
Denise E. LaCour, Manager
Print Applicant Name
November 10, 2013
Date