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Home My WebLink AboutCLE201500237 Application 2015-11-19Application for ZoningClearance CLE # aO l �- �7 X 'tA(Rid1A OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # t 0 LA g Date: 0-61) Receipt # I u a, Staff: PARCEL INFORMATION Tax Map and Parcel: Parcel No. 031000000007BO Existing Zoning Special permit use (RA) Parcel Owner: EAC Real Estate, LLC Parcel Address: 505 St. Francis Avenue City Earlysville State VA Zip 22936 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Wendy Koelsch, Corp. Counsel, VetCor of Earlysville LLC Address :350 Lincoln Place, Suite 111 City Hingham State MA Zip 02043 Office Phone: (Z§1 ) 749-8151 Cell # Fax # 781-740-2109 E-mail wkoelsch@vetcor.com APPLICANT INFORMATION Check any that apply: X Change of ownership Change of use Change of name New business Business Name/Type; Earlysville Animal Hospital 1 veterinary hospital Previous Business on this site veterinary hospital 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: *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 the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. /to Signature l/v-` c -x' ex-/, , Printed Wendy Koelsch, Corp. Counsel, VetCor 1, L APPROVAL INFORMA ION/9tJ—C _o? q9 [ ] Approved as proposed] Approved with conditions •ST [ ] 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 Date I 6 -Ib Zoning Official F2 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 11/02/2015 Page 2 of 3 Intake to complete the following: Y / Irl Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Yl 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 o Is parcel onMe�Health r public water? If private wDepartment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel r public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # YIN Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to comDIete the followinin Reviewer to complete the following: Square footage of Use: �T, IN ermitted as: �N�LL1 asp%/'d/ Under Section: �•�' �� Supplementary regulations section: Parking formula: g/ -Pk "i Reqllfired spaces: YI Items to be verified in the field: Inspector : Date: Notes: Viola 'ons; Y / �iV If fist: Proffers: Y / i� so, If so, List: mance: /N If so, List: s• N f so, List: q Ir Clearances: SDP's l Revised 11/I/2015 Page 3 of 3 ?�r�`C4rv,_ CERTIFICATION � T NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER Thin form nutst =company zonft gp&atl w (Howe [occupation, Zoning Clearance, Zoning AdmLristrator Detenxinadions or Appeals, Sign Permits, Building Permits) ifthe application Is not Me owner. I certify that notice ofthe application, [County application name and number] was provided to the owner of record of Tax Map [narne(s) of the record owners of the parcel] and Parcel Number 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 mord 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 of the application to [Name of the record owner if the record owner is a person, if the owner of mord is an entity, identify the recipient of the record and the recipient's title or of Bee for that entity] on IM to the following address: [address; written notice mailed to the owner at the last known address of the owner as drown on the current real estate tax assessment books or current real estate tax assessment records satisfies this requirement]. Snatum Applicant ac U en g Print plicant Nam �� • Date r e c 4 5[ l d Q W IN C3 La La n. 0 GI :: yi .a Q s Ot a° O E u V] LL li II I� l d Q IN l d Q " : r VetCor VetCor Professional Practices LLC 350 Lincoln Place, Suite 111 Hingham, MA 02043 P: 781.749.8151 F: 781.740.2109 W: vetcor.00m November 16, 2015 County of Albemarle Attn: Mr. Stewart Wright Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Re: Application for Zoning Clearance: Earlysville Animal Hospital 505 St. Francis Avenue, Earlysville, VA 22936 Dear Mr. Wright: Following up on our conversation today, effective on Wed., 11117115, VetCor of Earlysville LLC will be the new business owner / Tenant at Earlysville Animal Hospital, located at the address as listed above, based on an Asset Purchase taking place that day. Accordingly, enclosed for filing, please find the completed Application for Zoning Clearance. (As we discussed, the Veterinary Hospital's business activity, name, veterinarians -in -charge / Chiefs of Staff, etc. will remain the same.) Also enclosed is our check (# 91048) in the amount of $54.00 in payment of applicable fee. Thank you for your assistance. (And thank you in advance for sending the follow-up email to the Albemarle County Assessments Division to let them know that they can proceed to issue a Business License.) Very truly yours, eI" �C.-/;-- Wendy SZ&oelsch Corporate Counsel WSK/krk Encls. cc: Peter R. DeFeo, Chief Development Officer and General Counsel Quality Medicine. Compassionate Care.