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Home My WebLink AboutCLE201200117 Legacy Document 2012-05-31-J`(3_ Application for Zonln Clearance MPy CLE # PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # IrD 1,9 Date: Receipt #.� Staff: YnIKC PARCEL INFORMATION Tax Map and Parcel: 6 '- 12 — zO 1 Ca Existing Zoning PIS C Parcel Owner: S 'A OQ' PER S \ 0 O (z t—i �_u C Parcel Address: ,3L0 ci� NL�% (z k.,, > City G \4rArzte,`r`r State \ieL Zip (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? V3 f i - ey S M VAN 243' Z2'Zoq Address: \t2 \ ftiR U N G'To N '6-U'3) City RR LX!N G- L•oNState V A Zip Office Phone: ( u) Z 5 -�� If Cell # -4a3 R'L1�--'S -ilFax # E -mail Y- stew- ftm ewpW S-k-\ @y APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: lzr(z P�Z_K__5 1 (2'k Cd o (Z-21 t__ S SIPI C. S 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: 7t M e �c t -- - P f-� • �N t- R o N T 0 F P-M t; P, wzb- S *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 V- S C: f APPROVAL IN OR.MATION 'Approved as proposed [ ] Approved with conditions [ ] Denied [ J Bacicflow 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 determinafion of compliance with the existing site plan. [ ] This site complies with the site plan as of this date. Notes; Building Official... Date ( , Zoning Official Slate Other Official Date County of Albemarle Department of Uommumry _uevelopmenL 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 7/1/2011 Page 2 of 3 A l-tCQ- Co 0, j�e. - Intake to complete the following: Reviewer to complete -the following: - Y / N Square footage of Use: Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. (:Y?/ N ) % Permitted as: Sl?fF4An -A/ ell Y /. N Will there be food preparation? /7 Under Section: ��1�Nt_p- & , If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Supplementary regulations section: Dept. FAX DATE Circle the one that applies Parking formula: Is parcel on private well or public water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE Y/ Circle the one that applies Items to be verified in the field: Is parcel on septic or public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Inspector : Date: Y / 1\1 Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # R__ uvuun Violations: Y/N If so, List: n Prof s: Y T If so, List: Variance: cY3 /N If so, List: SP's: /.N If so, List: Clearances: SDP's Revised 7/1/2011 Page 3 of 3 'en < CERTIFICATION THAT NOTICE OF THE APPLICATI ®N 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 certit, that notice of the application, [County application name and number] was provided to R G i9N pAo &:.P /y!� the owner of record of Tax Map [name(s) of the record owners of the parcel] - and Parcel Number 6/- / M CC) 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 V — =y Mziling z copy of the application to [Name of the record o er 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 c! b Z 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]. Sign ,pdre f Applicant 1 /vsGp# - I7' Print Applicant Name Date Federal Realty ° INVESTMENT TRUST FOUNDATIONS OF OPPORTUNITY 1117 Emmet Sheet Charlottesville, VA 22903 PTT: 434.977.0100 T1: 434.296.3563 May 2212012 Yoseph Asmellash JB Enterprise 1121 Arlington Boulevard #N243 Arlington, VA 22209 Re: Shopper's World Dear Mr. Asmellash: This letter is to confirm that Federal Realty Investment Trust has negotiated terms with you at Shopper's World for the term of. June 17, 2012 through July 5, 2012 for the retail sale of fireworks. The sole purpose of this letter is to allow you to obtain the necessary permits for the space, as the License Agreement is still in the process of being fully executed. Please let me know if you have any questions or need anything further. Sincerely, 4n U, � " `02a v�- Tina D. Morgan Specialty Leasing Administrator cc: File xvwxv.federal realq %corn NYSE: FRL V,, 3AIW0 UVVYNE138 IZ c m LD �B 0 Z -6 (D • a -5; :Go wo t—I 2t Cd cc cj tu —j 0 2 cq co Igmo Hs J X0'9 LW OLUS 3AI80 NOINIYVO(j r---N