HomeMy WebLinkAboutCLE200700148 Legacy Document 2014-01-09Application for Rsad -V�-
Zoning Clearance
�.10
Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
CLE # -Z0 0 -7—/ q F
Check # Date:
Recei t # Staff:
PARCEL INFORMATION
Tax Map and Parcel: TM 60 Parcel 48A Existing Zoning C -1
Parcel Owner: Jefferson Quarry LLC
Parcel Address: 2410 Old Iry Road City Charlottesville State Vir inia Zip 22903
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Space and Real Estate Management, University of Virginia
Address : P.O. Box 400884 City Charlottesville State Virginia Zip 22904
Office Phone: (434 ) 982 -5914 Cell # Fax # 434 982 -5914 E -mail churt @virginia.edu
APPLICANT INFORMATION
Business Name/Type: University of Virginia
Previous Business on this site new construction
Describe the proposed business, including use, number of employees, number of shifts, available parking spaces and any
additional information that you can provide: general office use, parking 5 spaces / 1000 square feet
*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 t the best of my knowledge. I have read the conditions of approv land I ndersta d them, and that I will abide by them.
Si ature-
APPROVAL INFORMATION
[ ] Approved as proposed Vf /Approved with conditions anl
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 77 -4Bhbk fi r. Device 8 (1/Oir .
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determi atL% cD j j? n
site plan. Contact ACSA 977 -4511, x 119
[ ] This site mplies the site pla as of this ate.
Notes: G� o Sfi 5 at,Q
Building Official Date
Zoning Official Date d �)-* Q
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434). 972 -4126
5/1/06 Page 2 of 3
lIntake to complete the following:
❑YES DO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
❑YES ❑NO
Will there be food preparation?
f so, give applicant a Health Department form.
toning review can not begin until we receive approval from Health
>ept. FAX DATE
❑YES NO
Is parcel on private well r public wat ?
If private well, provide He D ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
❑YES ❑NO
Is parcel on septic pu lic sewe ?
❑YES NO
Will you.be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
YES DO
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
)5P* -4-Sq
Zoning Tech to complete the following:
Violations:
❑YES [3O
If so, List:
v 10 2.00 �-- a:59
Variance:
❑ Y E S [)YO
If so, List:
�AakJ
Reviewer to complete the following: 1 r q
Square footage of Use: l��i
;MO LI ❑f�r /
ted as: (J Ac al -- d j i; M
Section: :�;� • � . L - L —I,
Supplementary r gulations section:
A1/1.
Parking formuo:
Required spaces:
EYES INJU
Items to be verified in the field:
%.A,h 00-_ Z `�
r oar`
Proffers:
❑Y E S
If so, List:
SP's:
DY E S Mf O
If so, List:
5/1/06 Page 3 of
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PRESIDENT'S OFFICE
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600886
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