HomeMy WebLinkAboutCLE201500162 Application 2015-08-05C
Application for Zoning Clearance
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CLI;# �S "-'
OFFICE USE ONLY �_1S
PLEASE REVIEW ALL 3 SHEETS
Check # 3 �1 Date:
`d Staff:
Receipt # 100-19 _
PARCEL INFORMATION.f
—' 13 A Existing Zoning �V��o 2✓ M C
Tax Map and Parcel: 71<�
Parcel Owner: Alan Taylor
1926 Abby Rd, Suite 102 City Charlottesville VA 22911
State Zi
Parcel Address: p
(include suite or floor)
PRIMARY CONTACT Daniel Mur hree- The Dimension Group
p p
Who should we call/write concerning this project?
Address : 10755 Sandhill Rd City Dallas State TX Zip 75238
Office Phone: (343.9400 Cell # Fax # E-mail dmurphree@dimensiongrp.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name x New business
Business Name/Type. SuperCuts
Previous Business on this site n/a
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: Tenant finish out in the Rivanna Ridge Shopping Center
*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 liav owner's p rmission to use the space indicated on this application. I also certify that the information provided
is true and ace to tot bes o my dg I have read the conditions of approval, and I understand them, and that I will abide by them.
V Arinted Daniel Murphree
Signature T
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 C�— Date
Zoning Official Date, "v/5/A J%S
Other Official Date
County of Aluemarle llepa1'TmenC U1 %.uuuuunu.y UUVY JVV1A1G AL
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Revised 7/1/2011 Page 2 of
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e i c
Intake to complete the following:
Y/6
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/l
Wil[''tjjiere 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 wel _pu.b' ter?
If private well, provide epartment form.
Zoning review can not begin until we receive approval from Health
Dept, FAX DATE
Circle the one that appl'
Is parcel on septic ora rc se
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 #
th -P-11
Reviewer to complete the following:
Square footage of Use:
ON. 1
Permitted as:�i.�rl���°1
Under Section: z-
Supplementary regulations section:
Parking formula:
Required spaces: � U
Y/N
Items to be verified in the field:
Inspector : Date:
Notes:
LV VVIR IUM e om
ZiUillll w
viol ns:
Y/�
If so, List:
P offers:
Y6/N
If so, List:
Variance:
Y/a
If so, List:
SP's:
U/N
If so, List:
Clearances:
SDP's
Revised 7/1/2011 Page 3 of 3
0
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.
County of Albemarle
I certify that notice of the application,
[County application name and number]
was provided to Alan Taylor the owner of record of Tax Map
[name(s) of the record 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]
Mo
Date .
X Mailing a copy of the application to
Alan Taylor
[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]
7/27/15
on
Date
to the following address:
clan@riverbenddev.com, 321 East Main St., Charlottesville, VA 22902
[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],
wigpplicant
Daniel'Muprhree
Print Applicant Name
Date
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