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HomeMy WebLinkAboutCLE201500212 Application 2015-11-04B kdq . pel� , +-t� (52 -015 -61535 -RC Application for ZoningClearance' CLE #_ 30t3_ — t �� "� �� PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check #Date: Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: Z a Cr if- 0 _ Existing Zoning P-_t� P Parcel Owner:— uy ll� C-6 uL1 d(&0. k;n __,_• Parcel Address: 1017 © Ses 8"CWae k- •3 vd , City C_ hatr(tl-fsrr, (1e✓ State V 0 Zip 224?( I (include suite or tloor)3iL rif• �, o i PRIMARY CONTACT �`. N91rc���� 1ASt L5 Who should we call/write concerning this project? ti m a r% Address: 1? O PSB* Ld0O 21 $ City 0 r L4-kSiJ1t '/ state VA- Zip22,,io -1 Office Phone: �) �S�-' 8 , Cell # Fax # 12)L —qW1 E-mail c- v, r9,( rnia . dd v - APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: u V P 1 1 1 C 60— Previous Business on this site Y C,7y 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: CLn P o V� (ma --i e.W kto t% *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 permi 'on to use the space indicated on this application. I also certify that the information provided is true and accurate to th best of my knowledg ve read the conditions of approval, and I understand them, and that I will abide by them. Signature ��1 ��XFPrinted � % ✓'/' � ��� APPROVA 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 OfficialLaid Date 1 36 / t / Zoning Official Date �� S 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 )/ N use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet, Y 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 well o public water? . If private well, provide H epa ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies--------., Is parcel on septic ublie sewer? Y/ Wil u be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Yl/ N V111 there be any new construction or renovations? If so, obtain the proper Permit. Permit # (3 2-015P-- 01-3,5 —1qL Zoning to complete the following: Reviewer to complete the following: Square footage of Use: Y N Permitted as: Under Section: e7 /, Supplementary regulations section: Parking formula:____gg �.i) r -JJ Required spaces: -7:� Y I Items to be verified in the field: Inspector • Date: Notes: Violations: YAist: If rollers: i/N If so, List: Y=A *A 0 C?5 Van ce: Y/0 If so, List: SP's: Y/N If so, List: Clearances: SDP's rs 1vA0- Revised 7/112011 Page 3 of 3 sA Hl ,l 1777 Sl'S i ENI Office of Facilities Planning and Capital Development October 22, 2015 Community Development Department Division of Zoning and Current Development 401 McIntire Road Charlottesville, VA 22902 To the County Engineer: The University of Virginia Medical Center is planning to locate administrative functions with approximately 90 employees to Town Center One Research Parte Blvd. It is my understanding that in order to occupy this space, we will need to submit this Letter of Performance Standards along with our Zoning Clearance Application. We have addressed the performance standards of Zoning Ordinance Section 18-14.14 Noise Our operation will not create sound or impart noise levels in excess of the values specified in Section 4.14.1. Our major sources of noise are - Vibration Our operation will not produce any detectable earthborn vibrations. Glare Our operation is completely contained within the building. The interior lighting associated with this operation does not produce glare that is visible beyond the lot line. Air Pollutian There will be no emission of smoke, odor, or gaseous pollutants produced by this use. Water Pollution No liquid wastes will be generated by this operation. Our operation does not represent a hazard to water quality 1003 west Main Street? Box 800799 Chadottesville, Va 22908 434-924-8400 / 434-9824818 HEATH SYSIUM Office of Facilities Planning and Capital Development Radioactivity This operation does not require handing of radioactive materials. There will be no radioactive emissions. Electrical interference This operation does not require any equipment that would generate electrical disturbances that would adversely affect the operation of equipment on any other lot or premises. Please feel free to contact our office with any further questions you may have. Sincerely, 16 Kevin E. Fox, Administrato WA Medical Center Facilities Planning & Capital Development 1003 west Main Street, Box 900799 Charlottesville, V422908 434-924-8400 / 434-9924918 EXHIBIT A 1116" = V -O" W, W w Q1 I PMGCI: UVA Med Center at TC1 - 2nd Floor - EPIC W. UVA Foundation job rwmber 15017 d-MrtW !EXHIBIT A �=by. checked by: Checker copydGhi:&2015brwarch1fsc1L P.0 ff I %V - A C 9 1 7 L C f S r I qv-vd sed 13JLA Is A8.2 _ 1 =y t .am A A 00 w's- } J, ,p l Ae4 obw 7 r F �# ���{�i 5 •-�y 'fir. ���� Ark ip *+`�` i -=. �� ��} ��. �~ ��� �. -�� `• � fir � � rr'*�'�'� .� #t. ,.• ..•,, � +S+ ,. 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