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Home My WebLink AboutCLE201500116 Application 2015-06-25Application for Zonin ClearanceOP IS — � 1 CLE # o PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check #0bS Date: -S 01 Receipt # 00001 Staff; S PARCEL INFORMATION ) Tax Map and Parcel: 6 - ✓ Existing Zoning_ Tax Parcel Owner: S'IfoJ°f-_rN i 66T1vre-9 • G% �,.,,� � Parcel Address: l6gj 6 /ZTo /0> City Gf�Y9Je�7rEsx'�QState �� Zip '2n - o(include (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Address; �S�o GLF��'E-dV�oN t,UD City f¢/ZLTAX-_Z6N State _ Zip ZZZb11 Office Phone; (3!3)x'25 ' 510 I/Cell # '�D?-_4U"-5"Fax # E-mail 11,45M Falf5H@ G 9Z APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business NamelType: "s L N -r E 's;�S 1 r Lr2 Previous Business on this site S (i U Pr 2Fs ]'l- f��.l T r' ��'I✓ 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: 7 Z; �-e *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, andel that I will abide by them. Signature Printed Ve C- zf'i� APPROVAL INFORMATION 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 rt �^ Date Zoning Official 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 a. Intake to complete the following: Reviewer to complete the following: Y / Square footage of Use: Is us8� LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y /�Will e be food preparation? d / N % Permitted as: Under Section: 41 eA 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 SP's(' Y/O If so, List: Circle the one that appliesParking Is parcel on private well o � iw—aqt formula: Required spaces: If private well, provide HDe<ftirient form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Y/ Circle the one that a lies Is parcel on septic public sew ? Items to be verified in the field: Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Inspector : Date: Y / N Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # 7n"," r +n rmmnlPtP 1 -hp fnllnwinu! Violations: /�% If sList: /o, Proffers: Y / If so, ist: Variance: Y/ If suiist: SP's(' Y/O If so, List: Clearances: SDP's 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, 'o a��NG— �' -��t2f CG [County application name and number] was provided to the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number t, —, 3 3 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 co of theapplication 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 t to the following address: Date -2� I [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]. Siignat/e.g Applicant Y" S C— /f /1-,c C-/Is/3 Print Applicant Name 15 Date �j ,� &A •V i "'raft Lease Agreement Table 1: Summary of Material Terms Lease Name (DBA): Lease Number: J.B. Enterprises, Inc. Lease Date: ' Space Rent Table Lot Shopping Center Name Start Date: -End Date: Space Start Date Space End Date 06/25/2015 107/06/2015 Tenant Name (Legal): _..._... _ - - .Landlord: .---.._ J.B. Enterprises, Inc. ;Charlottesville Fashion Square, a Delaware Limited Liability 06/25/201 07!06!201 'Corporation ffice Address -Shopping Center Trade Name and Address: 8111 Cobden Court, #101 :Charlottesville Fashion Square ;Manassas, VA 20109 :1600 East Rio Road ;Tenant's Telephone Number: - - --- iCharlottesville, VA 22901 703.725.5011 Remit Payment to: ;Charlottesville Fashion Square i '1600 East Rio Road i 'Charlottesville, VA 22901 i ;Contact Name: ;Sole purpose for which space can be used by Tenant: i ;Yoseph Asmellash 'See Exhibit 1 Management must approve all displays. If this Agreement contains a Media Rent Table, the display posting period for ;any advertising medium or component shall be limited to the respective dates therefor set forth in such Media Rent i ;Table. ;SIC/MIX Code: Total Contract Amount: $3,250.00 _ ;Security%bamage - 'Security/Damage Deposit Due Other.Retail :(2641 ) Total Taxes: $0.00 Deposit Amount: i Date: . Grand -Total: $3,250.00 $0.00 Space Rent Table Lot Shopping Center Name City/State Space Start Date Space End Date Subtotal Safes Tax Total Charlottesville Fashion Square Charlottesville, VA 06/25/201 07!06!201 $3,250.0 $0.0 $3,250.00 Payment Schedule Payment Due Date Amount Due 06/25/2015 $3,250.00 Total Due $3,250.00 Insurance Required Date: 06/25/2015 Single Mall Insurance Certificate Holder. CHARLOTTESVILLE FASHION SQUARE, LLC, a Delaware limited liability company Landlord owns and operates certain real estate, together with certain buildings and improvements located thereon, commonly known as the Shopping Center. In consideration of the premises, covenants and agreements as stated above and hereinafter set forth, it is agreed by and between the parties as follows: Lease Agreement for J.B. Enterprises, Inc.