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Home My WebLink AboutCLE201500069 Application 2015-05-04FQ Application for Zoning Clearance �i�: CLE # 2b 15 - (O— �,.. e ,.,; �r �'arra*�rr PLEASE REVIEW ALL 3 SHEETS OFFICE USE OtiLY 14-'7 15 Checic # Wou Date: — � Staff: 1 r y�-e.l� Receipt # PARCEL INFORMATI�g� �no Existing ZoninParcel Tax Map and Parcel: 0�)h� Lo� Owner• AF—j5��! l,'A LS. Parcel Address: City State Zip z - include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Address J oo I ?k 1J 1VC. t -y, Cit y State Zip 6 � Office Phone: ��Oell'it G Fax # E-mail APPLICANT INFORMATION Cheek any that apply: Change of ownership Change of use Change of name `C _New business Business Name/Type: Previous Business on this site Describe the proposed business including use, number o loyees, number, of shifts, available parkin s aces, number of vehicles, and any additional information that you can provider *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to�new Mon, �new oning 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 of approval, and I understand them, and that I will abide by them. is true and accurate to best of my wledge. I ha e read the conditions Signature Printed APPROVAL INFORMATION [ ]Denied Approved as proposed [ ] Approved with conditions [ 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 Department of Community Development i 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 Revised 7/l/2011 Page 2 of 3 Intake to complete the following: Reviewer to complete the following: ` / NSquare footage of Use: I use in LI, HI or PDIP zoning? If so, give applicant a Certified ✓ Engineer's Report (CER) packet. P / N Permitted as: 0 lam- I C2 Y/ Will t ere 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 r-pu`b� a er? If private well, provide H Ith De ment 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 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 # Under Section: 2 Supplementary regulations section: Parking formula: Required spaces: 2 Y/ Items to be verified in the field: Inspector: Notes: Date: Zoning to complete the following: Viol tions: Y/ If so, ist: Proffers: /N If so, List: Varia' ce: Y/ If so, List: SP's: N If so, List: Clearances: SDP's Revised 1/1/2011 Page 3 of 3 CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER T/tis form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the o)vner. I certify that notice of the application, [ .f Xj OAK XW 4 [County application name and number] r.L,"4jZ}1�U�� was provided to ® v SCJ 1? r%weer of record of Tax Map [name(s) of the recor owners of the parcel] and Parcel Number manner identified below: by delivering a copy of the application in the 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 Mailing a copy of the application to V V4— [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 snown Qrn the current real estate tax assessment books.or current real estate tax assessment records satisfies this requirement]. L Print Appli ant Name Date 4 STORY CLASS A OFFICE BUILDING SIZE 78,200 SF AVAILABLE 8 OFFICES + 5 WORKSTATIONS 7 Full Service Lease includes professional property management services, janitorial services and parking 1 Fully furnished, professional office space 71 Shared conference room and kitchen Deborah van Eersel 434.924.0696 dv5q(avirginia.edu uvaresearchpark.com Where innovation takes flight There's a space here for you. WorkSpaces at the UVA Research Park provide vibrant, move -in ready offices for independent professionals and small businesses on highly flexible terms. You'll share a building with well-regarded companies such as Booz Allen Hamilton, and Battelle, and have access to a variety of amenities including conference space, a full-service restaurant, and walking trails. Located on North US Route 29, the Park is conveniently located less than one mile from major shopping/retail/housing, the Charlottesville -Albemarle Airport, and Rivanna Station. ME UNIVERS=,f`TIRGIN7 �. FomnuioN No. 41 Noshing Space SPACE TO. N Grab a bite to eat and chat INNOVATE the shared kitchen. There' Plenty of room for big ideas No. 11 Huddle Space N Use the white board and intimate setting for informal brainstorming sessions and collaborative discussions. No. 2 1 Meeting Space N Suitemates have access to any of the Park's meeting rooms. The WorkSpaces 2 conference room is outfitted with seating for eight, a table with integrated power, projector and drop-down screen. No. 3 1 Creation, Space N Here you'll find a printer, scanner, and fax machine, as well as work space for putting it all together. -, J7iIC_c with coworkers in s space for coffee mugs in the cabinets and snacks in the full size fridge. ® The research park's Innovation Cafe is just next door in Town Center Three, and serves breakfast and lunch, and can cater any event. No. 5 1 Chatting Space ® A private space to make a phone call away . from the hustle and bustle of the office. )MrVTT)TTAT. DTTSJMSS CERTIFICATE REQUIRED TO BE FILED BY A PERSON CONDUCTING BUSINESS IN THE COMMONWEALTH OF VIRGIMIA. UNDER AS ASSUMED I hereby certify in accordance with provisions of 59.1-69 of the 1950 code of Virginia that I am conducting the business of �t� �•-,� •� , _ �/� - At kv d. j crhe .-z"41-14-1= I � IL a f-1- o - 1�_ {. 1 t+; ti j (Type of business Ex. Resta w'nat; Salon, ext.) � n A _ (Cftr) ell of vi rgtnia Assumed or Fictitious uame) And that no other person has any interest of any kind in said business ;and that I am the sole owner and Proprietor thereof. Owners Address: P.O. Box (If you have one) G") Given Wader my hand thisJj day of 20 i Commonwealth of Virginia to-wit;�� of Own I understand Deputy Clerk or Notary public in and for the Commonwealth and City aforesaid, do hereby certify that vV l , Whose name is signed to the foregoing and hereunto annexed cer t4.ncaday ted. dated the I --��—! --_ Of ly has this day personally appeared before me and acknowledged the same before me in the office. Given under my hand this day of t �L. 5 . zo � P d Clerk IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII .. Doc ID: 033086430001. 'TVPe,:,..CHA RECORDED IN CLERK'S OFFICE OF Recorded: 03%31/2015.,at 10:21':42 AM C ALBEMARLE ON Fee Amt: $10.00 Pape 1 of i MARCH 31, 2015 at 10:21:42 AM Albemarle County, VA AS REQUIRED BY VA CODE §58.1-80, Debra M. Shipp Ciruit Clerk SATAi�E: $0.00 CAL: $0.00BK 2 6 PG4 6O CO DE t S CIRUIT CLERK F