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HomeMy WebLinkAboutCLE201400189 Legacy Document 2014-09-22Application for Zoning Clearance 0 PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # )70q Date: °I 1 CA Staff: Receipt # Q I / PARCEL INFORMATION / Tax Map and Parcel: (7 Existing Zoning C Parcel Owner: C-bE Y� L.o ('rf �S Z-IcC1iJ i Parcel Address: —k GQ- e \P, q> City State Zip zy-)Q1 (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? Address: 1 S� o C L(+CSFs'22N Z city 13,1 Lxw t,,� a W State VIA-- Zip fl Office Phone: (2 � Cell # Fax # E -mail R Sb1 6 L(�a F� Cr 0 tc.;Q APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business ,p Business Name /Type: S C3 �`� �` (��Z.S �' S / 1 U t �' Z>,j P '`l C 69 Previous Business on this site kf Zo U (A-(?-'E IL 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: ^C 6-IT F, P =z kc=r--to -S F (wtv S \b P( k *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 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 Printed y° SL`' j-ga -1 ELP/1K3 '� 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 of this date. Notes: Building Official Date Zoning Official Date Other Official Date County of Albemarle vepartment of Community lieveiopmenL 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 7/1/2011 Page 2 of 3 6. Intake to complete the following: Is Is u LI, HI or PDIP zoning? Engineer's Report (CER) packet. Y /N If so, give applicant a Certified 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 �wa Is parce l on private well o publi? If private well, provide Hea t form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that app Is parcel on septic or Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 61N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Y �/ 7.nnina to rmmnlPtP the fnllnwina: Reviewer to complete the following: Square footage of Use: S' /N / Permitted as: ��Q�� ir►l �i l �S Under Section: A I AA. 12L-AL. ! �� Supplementary regulations section: Parking formula: Required spaces: Y/6 Items to be verified in the field: Inspector: Notes: Date: Violations: Y /(I3) If so, List: Prof,�rs: Y/9 If so, List: Varia Y /�I If so, List: 's: /N If so, List: 2-� Sa Clearances: SDP's Revised 7/1/2011 Page 3 of 3 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, was provided to CF- S [County application name and number] [name(s) of the record owners of the parcel] the owner of record of Tax Map and Parcel Number �— S _31 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 � � \j r`'�~`"` ` �S [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 to the following address: Date [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]. S ignatu pdqoppli cant Print Applicant Name 15-7, . I 115- % Date Lease Agreement Table 1: Summary of Material Terms ;Lease Name (DBA)c Lease Number 4661 0914 SBV 343 J.B. Enterprises, Inc. . ....:... 'Lease Date: 09110/2014 :.....................__ I Subtotal ................... ............................._.... . ...... _............ .......... ... ..... ............. ........ ................._..... ;Start Date: !End Date: i :10/01/2014 111./ 01 /2014 . :..: -. - :.:::...:; .... :.. Tenant Name (Legal): : - _ .. _.. ......:: .. ....... .. .... ...:........ ...: . Landlord Agent 1J.B. Enterprises, Inc. Charlottesville Fashion Square, a Delaware Limited Liability i ;Corporation ................._ _......... ;Office Address. . . . ;Shopping Center Trade Name and Address: ;811,1 Cobden Court, #101 'Charlottesville Fashion Square :Manassas, VA 20109 .1600 East Rio Road _ ......................................................................._.............._ Tenant's Telephone Number: _.._.__..._.................... ...........':Charlottesville, VA 22901 ;703 725 5011 ........ ....... ....... ::..... ....... !Contact Name: Yoseph Asmellash :....................... ................... _.... SIC /MIX Code: Total Contract Amount: $2,500.00 Other Retail. (2641). Total Taxes: $0.00 Grand.Total: $2,500.00 Space Rent Table (Remit Payment to: !Charlottesville Fashion Square 11600 East Rio Road Charlottesville, VA 22901 .. . ....... . Sole purpose for which space can be used by Tenant. ;See Exhibit 1 iManagement must approve all displays. If this Agreement ,contains a Media Rent Table, the display posting period for any advertising medium or component shall be limited to the respective dates therefor set forth. in such Media Rent. 'Table. .. ..... .......... .... .......... , ... ............................_.. Securely /Damage Security /Damage Deposit Due . Deposit Amount: ' Date: :$0.00 I Shopping Center Name I. City /State I Sub Use Type I Location I Sq. Ft. / Dlmen. Charlottesville Fashion Square lCharlottesville, VA Outdoor /Parking Lot IRte. 29 Overflow Lot 110000 Shopping Center Name I City /State Space Start Date I Space End Date I Subtotal I Sales Tax Total Charlottesville Fashion Square Charlottesville, VA 10/01/201 11/01/2014 $2,500.00 $0.00 $2,500.00 Payment Schedule Payment Due Date Amount Due 10/01/2014 $2,500.00 Total Due $2,500.00 Insurance Required Date: 10/01/2014 Single Mall Insurance Certificate Holder: CHARLOTTESVILLE FASHION SQUARE, LLC, a Delaware limited liability company Landlord owns and operates certain real estate, together with certain buildings and improvements located thereon, commonly known as the Shopping Center. In consideration of the premises, covenants and agreements as stated Lease Agreement for J. B. Enterprises, Inc. OEM • •JR i� j :i o — iO ? eta„.,,'=; {.... I� NN}NL�II � �.✓ r' ---INN1 n u U I I ! Aeuugdor I `, - 'ri g �� • � •` :,x,1"1 .' yyyy