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Home My WebLink AboutCLE201200084 Legacy Document 2012-04-301 I E Applicati ®n f ®r Zoning Clearance CLE Check I M PLEASE REVIEW ALL 3 SHEETS # Date: Receipt # Staff: PARCEL INFORMATION Tag Map and Parcel: O f61 WO -nj - (An -_ 00 %Q(_) Existing Zoning o mm rGLa& 0;1'rte e Parcel Owner:_ .Cc,,3 neC, ►ne, 3c�uan W C-ys Parcel Address: x.305 city 1o*sQ(P_ State VA- Zip 0agol (include suite or floor) !�.t Ve �•,1[� PRIMARY CONTACT 'I 11 Who should we call/write concerning this project ?V�m Address : i3�,D� 04 City 1 WA3K CI n State U Zipa3I I LI Office Phone: i Intake to complete the following: YIN Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. YIN 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 is ter? If private well, provide Heal apartment 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 p is se YIN Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YIN 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: ? O C) YIN r Permitted as: _i, k:�; � '1 6e- Under Section: 2� .'Z • I Supplementary regulations section: Parking formula: 5 � Required spaces: YIN Items to be verified in the field: Inspector • Date: Notes: Viol tions: Y /I If so, List: Pro rs: Y/ If so, List: V ce: Y If so, List: SP's: YIN If so, List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 CERTIFICATION THAT NOTICE OF THE APPI_,ICATION 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, AY XU On 1'k 0 on nnAu- [County Wplication n and number] was provided to e. CO r lS1'� the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number _C61 W () - QI -CS - OQ) InQQ by delivering a copy of the application in the manner identified below: Alt r Hand delivering a copy of the application to -�-� [N e 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 q 1161 Date Mailing a copy of the application to`�-�Q [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 q -(L- 1,= 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]. (Na wx,3�0n-."� . nature of Applicant Lao CO— Af)A0 r-� Print Applicant Name `- {-Ih -('a- Date r DEPARTMENT OF „IPROFESSIONAL AND OCCUPATIONAL REGULATION COMMONWEALTH OF VIRGINIA EXPIRES ON 9960 Mayland Dr., Suite 400, Richmond, VA 23233 NUMBER 04 -30 -2014 Telephone: (804) 367 -8500 2705145469 BOARD FOR CONTRACTORS CLASS C CONTRACTOR INVALID ON JOBS $10,000 OR MORE *CLASSIFICATIONS* CIC HIC TIPPLE POINT VENTURES LLC 13208 TIPPLE POINT RD I MIDLOTHIAN, VA 23114 r .TERATION OFTHIS DOCUMENT, USEAFTER EXPIRATION, OR USE BY PERSON90R FIRMS OTHER Oordon N. Dixon, Director 1ANTHOSE NAMED MAY RESULT IN CRIMINALPROSECUTION UNDER THE CODE OF VIRGINIA. (SEE REVERSE SIDE FOR NAMEAND /ORADDRESS CHANGE) ........ _. ............ cKETanaD> COMMONWEALTH OF VIRGINIA t.DETACHHERE) BOARD FOR CONTRACTORS I DEPARTMENT OF PROFESSIONAL AND OCCUPATIONALREGULATION 9900 Mayland Dr., Suite 400, Richmond, VA 29293 CLASS C CONTRACTOR I *CLASSIFICATIONS* CIC HIC NUMBER::,2705145469 EXPIRES. 04 -30 -2014' . TIPPLE POINT VENTURES LL 13208 TIPPLE POINT RD MIDLOTHIAN;. VA 23114 L I ' JM29R'C�” ALTERATION OF THIS DOCUMENT, USE AFTER EXPIRATION, OR USE BY PERSONSOR FIRMS OTHER THAN THOSE NAMED MAY RESULT IN CRIMINAL PROSECUTION UNDER THE CODE OF VIRGINIA: C.CRTIFICATE OF ASUMED OR FICTITIOUS NAME Commonwealth of Virginia This is to certify that the below named person, partnership, limited liability company or corporation intends to conduct or transact business under an assumed or fictitious name in the [ ] City [x] County Of ...... ......................�lbemarle 1. The ASSUMED OR FICTITIOUS NAME of business Window Depot USA of Charlottesville, VA ......................................................... ............................... . ............................................................................... ............................... 2. The above business is owned by the following entity type: [ ] SOLE PROPRIETORSHIP (Complete A below) [ ] PARTNERSHIP (Complete B below) [x] LIMITED LIABILITY COMPANY (Complete C below) [ 7 CORPORATION (Complete C below). A. NAME OF OWNER ............................................................................................................................... ............................... RESIDENCEADDRESS ....................................................................................................................... ............................... POSTOFFICE ADDRESS .................................................................................................................... ............................... B. NAME OF PARTNERSHIP .................................................................................................................. ............................... OFFICEADDRESS ............................................................................................................................... ............................... POSTOFFICE ADDRESS .................................................................................................................... ............................... (1) is this a general partnership? [ ] NO [ ] YES. If YES, complete the Statement of Partners on .Page Two of Two. (2) Is this a. domestic limited partnership? [ ] NO [ ] YES. If YES, a certified copy of this certificate must be filed Cr G with the State Corporation Commission. Va. Code § 59.1 -70. rt 2 (3) Is this a foreign limited partnership? [ ] NO [ ] YES. If YES, indicate the date of the certif sate of registration to transact business in the Commonwealth of Virginia issued by the State Corporation �y o rte, Comnlissron : .................. ............................... �n A certified copy of this certificate must be fled with the State Coiporati.on Commission. Va. Code § 59.1 -70. CD rn !jC. NAME OF [ ] CORPORATION [x] LIMITED LIABILITY COMPANY R7 Tipple Point Ventures LLC t" .. .......................................................................................................... .........7..................... 2.305. Diive Suite F Charlottesville VA 22901 OFFICE ADDRESS ' ' POSTOFFICE ADDRESS ....... : ............................. ............................................................................................................ l) A corporation or limited liability company must file a certified copy of this certificate with the State Corporation Commission.. Va. Code § 59.1 -70. (2) Is this a foreign corporation or a foreign limited liability company? [x] NO [ ] YES. If YES, indicate the date of the certificate of authority /registration. to transact business in the Commonwealth. of Virginia issued by the State Corporation Couunission :........... ............................... ACKNOWLEDGMENT I. certify that the .foregoing is true and correct to the best of my knowledge and belief. Sole Proprietorship .................................................. ............................... NAME OF OWNER SIGNATURE OF OWNER Partnershh) ...................................................... ............................... NAME OF GENERAL PARTNER SIGNATURE OF GENERAL PARTNER Corporation.......... ............................... .......... A . ............................... NAME OF PRESIDENT SIGNATURE OF PRESIDENT Limited Liability Company Laura Amor ............................:...:................... ............................... y i NAML OF MEMBER/MANAGER 'IGNAI'L�RI� JF MBER/MANAGER [ ]City k-' County of ....4r) ?�s: cr-�, �1�r- .f .......................... State /Commonwealth of .. 1.rjJ.: C................. ............................... 1-4 Subscribed and �> pknowledged before me this ... !........ day Of . by ............./ l: �r. l! 7....... 1'/.:.....". tr'' y;'..... ............................... ..,......,.. - �;........ "KEITH N wit". ;�: /� 1 fLE . _, NAME My commission eYDires IIIIIIIIIIIlIIIII VIIIVIIIVIIIVIIIVIII I I�IIVIIIVIIIVIIIVIIIVIIIIIIIIIII Doc ID: 006664000001 Type. CHA Recorded: 04/05/2012 at 11:18:31 AM Fee Amt: $10.00 Pape i of i Albemarle County, VA Debra M. Shipp r F BK24 PG453 NOTARY.PU6UC % ! COMMONWEALTH OFSjR iD •PfU CL R < ¢'� NOI ARY PUBLIC �^ i NOTARY REGISTRATION NU s ?r3*Rffl lo......`;7.3. /..:7..: 3 .... MY COMMISSION EXPIRES JULY 31, 2014 ` CORDED IN CLERKS OFFICE OF .............. I.............. , Clerk by A .. Circuit Court on rN ALBEMARLE COUNTY ON April.05,2012 AT 11:18:31 AM $0.00 GRANTOR TAX PD AS REQUIRED BY VA CODE 958.1 -802 STATE: $0.00 LOCAL: $0.00 ALBEMARLE COUNTY, VA DEBRA M, SHIPP CLERK