HomeMy WebLinkAboutCLE201500038 Legacy Document 2015-03-26Application for Zoning Clearance
CLE # 2015-3$
OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # 167-9 Date: 3/,3 /5
Receipt # q $ q 5 5 Staff:
PARCEL INFORMATION
Tax Map and Parcel: 56 Parcel 110 Existing Zoning HC
Parcel Owner: Blue Ridge Investors LLC
Parcel Address: 540 Radford Lane, Suite 300 City Charlottesville State VA Zip 22903
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? MUY Pizza Southeast, LLC
Address : 17890 Blanco Rd, Ste 401 City San Antonio State TX Zip 78232
Office Phone: 210 408-2400 Cell # Fax # 210-858-0829 E-mail wendy.melendez@rhuycompanies.com
APPLICANT INFORMATION
Check any that apply: X Change of ownership Change of use Change of name New business
Business Name/Type: MUY Pizza Southeast, LLC dba Pizza Hut #31208
Previous Business on this site Pizza Hut
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:
Restaurant, 10 employees, 2 parking spaces, 6 delivery vehicles, average of 7 shifts/day
*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 ow r have the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accu to to the b st of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by thein.
Signature Printed .lames H. Bodenstedt
APPROVAL/ INFORMATION
>J' 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 r Date f I
Zoning Official Date�22fl/S
Other Official t'I 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
Intake to complete the following:
Y/h
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
D 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 or p -ic wat r?
If private well, provide Health rtment 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 pu is sewer?
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 #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: A) 4
Y/N
Permitted as: w
Under Section: A.2
Supplementary regulations section:
Parking formula: j 1
Required spaces:
Y/
Items to be verified in the field:
Inspector:
Notes:
Date:
Viol tions:
Y/
If so,``�tist:
Profkers:
Y/
If so, ist:
Vari vce:
Y/(N)
If so"List:
SP's:
Y/N
If so, List:
6S�SS
Clearances:
SDP's
4e2)
ej
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,
[County application name and number]
was provided to Blue Ridge Investors, LLC the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 56 Parcel 110 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 Kristin P. Peura of Blue Ridge Investors, LLC
[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:
c/o Great Eastern Management, P.O. Box 5526, Charlottesville, VA 22905-5526
[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' at e of Applicant
James H. Bodenstedt
Print Applicant Name
2/26/2015
Date
Exhibit A- I
The Premises