HomeMy WebLinkAboutCLE201500165 Application 2015-08-05Application for Zonin Clearance's
CLE# C)1S'—I
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # j Date: `7
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 61 W -3-19A Existing Zoning Neighborhood Model District
Parcel Owner:Albemarle Place EAAP, LLC
Parcel Address: 2015 Bond Street Suite 170 City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Stephen Glasgow
Address : "1015-A Collier RD City Atlanta State GA Zip 30318
Office Phone: (855) 773-7791 Cell # 404-227-4147 Fax # E-maii.steve@countryclubprep.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Country Club Prep of VA LLC
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:
Retail men and womens clothin and accessories. aprox 8 employees , 2 shills
*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.
1 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 1 will abide by them.
Signature _ Printed
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, xl 17.
[ ] 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 c� _!— _ _ Date
Zoning Official _ Date
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 3
Intake to complete the following:
Y/0
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /V
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 wellrr public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or ublic sewe
D/ N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #%/
Y /
Will sere 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: 13/
ennilted as: !'
Under Section: d IL2,ma /)e- �14C_0— ,-- • () I
Supplementary regulations section
Parking formula:
Proffers:
&)/ N
If so, List:
Required spaces:
Li
Y/;K)
Items to be verified in the field:
Inspector:
Notes:
Date:
SP's:
Y
If s, ist:
Viol tions:
Y (j I
If so, List:
Proffers:
&)/ N
If so, List:
Li
Variance:
6)/ N
If so, List:
SP's:
Y
If s, ist:
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, Country Club Prep of VA LLC
[County application name and number]
was provided to Allbemarle Place EAAP, LLC the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 61 W -3-19A
manner identified below:
Hand delivering a copy of the application to
by delivering a copy of the application in the
[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
x Mailing a copy of the application to Albemarle Place EAAP, 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 07/17/2015
Date
to the following address:
c/o Edens Limited Partnership 1221 Main Street Suite 1000 Columbia ,SC 29201
[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].
Signature of Applicant
Print Ap licant Name
_7 Date
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