HomeMy WebLinkAboutCLE201400106 Legacy Document 2014-06-13Application f r Zoning Clearance
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CLE, # _ L019 - 10
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OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Checic # Sy 3 1 Date: 1
Receipt # !3'q'9/DJ— Staff:
PARCEL INFORMATION u/,, Zoning 1 & M nMA i -,
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Tax Map and Parcel; ( Existing
Parcel Owner: OLD IVY PROPERTIES LLC
Parcel Address: 2250 Old Iw Road City Charlottesville state VA zip 22903
(include suite or floor)
PRIMARY.' CONTACT
Who should we call /write concerning this project ?��ts
Address: 2250 Old Ivy Road Ste 1 city Charlottesville State VA zip 22903
Office Phone: (434 326 -1322 Cell # Fax # F,-mail lymuller(_vsq us. corn
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business NamelTypeI Visiontech Sales, Inc dba VSG Inc' wholesale Plartronir sales
Previous Business on this site
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: gcsi�� '�A A jeK'� -�
*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 hereb own or leave n ission to use the space indicated on this application. I also certify that the hiformation provided
is ti a and accurate to be my know e I e read the conditions of approval,_and II uunderstand them�, a/n�d that /I will abide by them.
Printed
Signatu
AP ROYAL I ORMATION
Approved proposed [ ] Approved with conditions [ ] Denied
[ ] ow 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. • I
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date (1 :2 Tc 4
Zoning Official Date
Other Official Date
County ol'Albemarle impartment or t,ommumry tUeve,vilu,GiiL
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 7/1/2011 Page 2 of 3
0
Y
n
Intske to complete the following:
Y/N
Is use in LI, iII or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
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 public }
If private well, provide Hea ar ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic pub�ie ?
Y/ N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Reviewer to complete the following:
Square footage of Use; 2000 sq ft.
V/ N.
Permitted as:
Under Section: 2 -- •,
Supplementary regulations section:
Parking formula: //
Required spaces:
Y/
Item o be verified in the field:
Inspector
Notes:
Date:
Ll Vlllll VV VVlla
Violations:
Y/
If so, st:
Proffers:
Y/
If so, ist:
Variance:
If soist:
SP's::
If so; Zist:
Clearances:
SDP's
Revised 7/]/2011 Page 3 of 3
o-
o
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, ZONING CLEARANCE
[County application name and number]
was provided to 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
[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
[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].
Sianaire of
Print Knolicant Name
Date
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