HomeMy WebLinkAboutCLE200700243 Legacy Document 2014-04-28Application for
Zoning Clearance
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
511106 Page 2 of 3
OFFICE S 4LY
CLE # 71 24 -
Zoning Clearance = $35
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Check Date: 151 (
PLEASE REVIEW ALL 3 SHEETS
Receipt # 1h Staff.
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PARCEL INFORMATION
Tax Map and Parcel: TM 60 Parcel 48A Existing Zoning C-1
Parcel Owner: Jefferson Quarry LLC
Parcel Address: 2410 Old Ivy Road Citv Charlottesville State Vir2inia Zip 22903
(include suite or floor)
PRIMARY CONTACT .
Who should we call/write concerning this project? Sp2ce'an d 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.e4u'
APPLICANT INFORMATION
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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, parldng 5 spaces 1000 squ are 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 approval and them, and that I will abide by them.
,WIynderstapd.
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APPROVAL INFORMATION
.]�pproved as proposed Approved with conditions [ ] Denied
Backflow prevention device and/or current test data needed for this site. ContactACS'A, 977-4511, x11 9.
No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliaric.e with the existing
site plan.
�,]'fiis sitdcomplies 'th the site plan as of this date.
Notes:
Building Official Date
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
511106 Page 2 of 3
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Intake to complete the following: Reviewer to complete the following:
❑YES FN -lo Square footage of Use:
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet. ❑1.,FOp El
Peimitted as�
❑YES ❑NO
Will there be food preparation? Under Section:
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health Supplementary regulatio s'section: j
Dept. FAX DATE to d
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❑YES NO Parking formula:I
Is parcel on private well or public water? L O'O`Ua
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health Required spaces: ] n,
Dept. FAX DATE
❑YES ❑NO 1 CJ
❑YES 0 O Items to be verified in the field:
Is parcel on septic or public sewer?
Y
❑Y E S oO a�--
Will you-be putting up a. new sign of any kind? If so, obtain proper V
Sign permit.
Permit #
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21/y
Will there be any new construction or renovations?
If so, obtain the proper Permit. j
Permit #
Zoning Tech to complete the following:
Violations: Proffers:
❑YES [3 O ❑YES.[3O j
If so, List: If so, List:
Variance: SP's: '
❑YES[1�O ❑YES [P O
If so, List: If so, List:
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