HomeMy WebLinkAboutCLE201400179 Legacy Document 2014-12-02Application for Zoning Clearance`
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CLE # 22 y �-1 �
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v/ItGIN�I"
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # 2 Date: 9 l o J
Receipt # c770 19'3 Staff:
PARCEL INFORMATION 055' D - a0- 0 0 -/ ®HB s
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0(9j0()-00-00-173F0
Tax Map and Parcel: Existing Zoning
Parcel Owner: CASTLE 61- AbfprS SHoppIN6 CEN7C-A , L-L,(_
Parcel Address: 1005 6A-P_mris OL'o City GOAA L-t7ESvt1-Lf -State VA- Zip �Z9d
(include suite or floor)
PRIMARY CONTACT G� Gy0 �S
Who should we call /write concerning this project?
Address : y55 SEC410 ST SE ;�-�O% CityClfAl-t -MNW-L State VA Zip 2 Z %d
Office Phone: (/' 7) 97-/ - 9?7y Cell # 7 6f -Sod S Fax # / 7�- I P I 9' E -mail G9E61- e 14 C ,+G - ce-m
APPLICANT INFORMATION
Check any that apply: of ownership Change of use Change of name New business
�r-Change
Business Name /Type: y UM / — TAIL M Po L ► tj E PAR-le-
Previous Business on this site C4Am I 1,-E C iN E Pte} (—/,-1 6 V/ £ _S)
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: 7i2 /1110r.IA/,E fA-RK . APPA- Kfm4ik1-y 30 EMPIAV
319 pt1-klclw& SQAat
*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 o or�� owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate t e b t of - y knowledge. I have read the conditions of approval,a/a,,��n'�.ddII understand thee/m, and that I will abide by them.
Signature C ��-�
Printed
AP INFORMATION
,VROVAL
[ 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 �a" a--
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
I v
3
.S,
Intake to complete the following:
Y /�
Is use m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Wil re 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 or p lie water?
If private well, provide Health epa 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 or ublic sewer
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. _ y pwils Permit �
1
Y/N
ill there be any new construction or renovations?
If so, obtain t e per Permit.
Permit # ro — Ms H.
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: RC
J/ N N --
�ermitted as: ( � hlekrl
AU
//��
Under Section: . , ; Ol i) J
Supplementary regulations section:
Parking formula: acou km.
Required spaces: !
,1D.
Y/N
Items to be verified in the field:
Inspector : • Date:
Vi rpi" ns:
Y
I f t:
Pro
If ist:
If s
Variance:
Y/9
If so, ist:
SP's:
Y/N
If so, List:
Clearances:
SDP's C _
Revised 7/1/2011 Page 3 of 3
FORMER PROJECTOR AREA
2,155 SF
OFFICE 11 FORMER STORAGE
210 SF 320 SF
MEZZANINE
1. EMPLOYEE ACCESS ONLY THIS LEVEL
2. NO PLANNED USE FOR FORMER STORAGE
OR PROJECTOR AREAS
0
Imm
0 0
TRA POLIN AREA 1
7,760 SF
0 0
c
TRAMPOLINE AREA 2
1,880 SF
IL CORRIDORS
2,405 SF
a
0
'
77195 '
RESTROOM
LEU °o0 8 BIRTHDAY PARTY
TILITY STORAGE ° ROOM 1
LOSET CLOSET 710 SF
SF 80 SF
OPEN SPACE FOR STORAGE
PLAY STRUCTURES 1,025 SF
2,320 SF
LOBBY
2,155 SF BIRTHDAY PARTY
ROOM 2
710 SF
FIRST FLOOR AREAS:
FIRST FLOOR: 20,400 SF
MEZZANINE: 2,765 SF (ACCESS RESTRICTED TO EMPLOYEES)
PROJECT: JUMP INDOOR TRAMPOLINE PARK TOTAL: 23,165 SF
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 gl L L / /S' MA /✓ the owner of record of Tax Map
[name(s) of the record owners of the parcel]
,&Dc)qM—ot -do-,6gbh
and Parcel Number 66 I To -crn — 12-3 Eo 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
`G / 5'EM,+A1 C ,4S F_ GA N ENS S' Win/
_ Mailing a copy of the application to // f' � 7L
[Name of the record owner if the record owner is a person; GEN1 iFJI t tte
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 J/ to the following address:
Date
/yob je , SIC 1.4n/£ M /Gw4-0kl✓E, wZ S 3a / 7
[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].
Signature o ant
if "— i ZY°,%11
Print Applicant Name
9 y
Date