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Home My WebLink AboutCLE201500221 Application 2015-11-20Application for Zoning Clearance CLE # rag I S- - aa. 1 , OFFICE USE ONLY PLEASE REVIEW ALL 3 SHEETS Check # 1110 Date; Receipt #`R it Staff: PARCEL INFORMATION Tax Map and Parcel: ! r Existing Zoning Parcel Owner;�C it r `'�-r'✓`+' �— Parcel Address:—l6v b ++ . lr�+!P' - City ( v� ✓ tate Zip ?zq-0( (include suite or floor) PRIMARY CONTACT / Who should we call/write concerning this project? Y Address: 510 Ltl�? ��y .�� State Zip ZL rt Office Phone: ( Z� Sa 11�e11 # 03 `�"� rail # E-mail %Lr4S!( APPLICANT INFORMATION Check any that apply: Change of ownershi Change of use Change of name New business Business Namefryrpe: LT. et- -r taaz 2 e. c�-@ Previous Business an this siteEj!:� H---r- j9A.1QJ/} /` r ! /¢i: 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: *This Cleamnce will only be valid on the parcel for which it is approved. If you change, intensify or wove the use to a new location, a new Zoning Clearance will be inquired. 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, rand I understand them, and that I wi If abide by them. Signature PrintedY r om'+:. APPROVAL INWRMATION �Q Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed far 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 pian. [ ] This site complies with the site plan as of this date. Notes: Building Official Date _ to 3t, _ Zoning Official Date 4 6 i� 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/l/20I l Page 2 of 3 Intake to complete the following: Reoewer to complete the following: Y / N Square footage of Use: _ ! SD() ,^ Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. I N / lermitted as: Will there be food preparation? Under Section: __ d/14� 5, i4g- If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Yit:alth Supplementary regulations section: Dept, FAX DATE Circle the one that applies Is parcel on private well or c r7 If private well, provide Health eparpnent farm. Zoning review can not begin until we receive approval from Health Dept, FAX DATE Circle the one that applies Is parcel on septic or lit: s Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Penult # Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Znnina to cornnlete the following: Parking formula: Required spaces: Y/N items to be verified in the field: Inspector : Date• Nates: Vialu ns: Yll If so, List: Pro rs: Y/ If so, ist: Variance: Q9/N If so, .List: sP`= Ya If so, List: Clearances, SDP's Revised 711 /2011 Page 3 of 3 CERTIFICATION THAT NOTICE OF THE APPLICATION HAS SEEN PROVIDED TO THE LANDOWNER This form must accompany sanixg applications (Home Occupation, Zoning Clearance, Zoning Administrator Determinations or Appeals, Sign Permits, Building Permits) tithe application is not the owner. I certify that notice of the application, fv' [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 13 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 Halling a copy of the application to f1'c CF _T [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 Sf to the following address: Date bowZA s2 - [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]. Signatu licant Print Appfic t Name ,A1--2-6//� Date 9 f— JIM N Lease Agreement " - * * 4 Table 1: Summary of Material Terms lneumnr:e PAKpd d Oats: 1117613015 Simple Mall insurance C Mkmb Holder CHARLOTTSMALLE FASHION SOLME, LLC, a I]elGVMFe WhOd Iiabklty WMPelly SEM RaLISTO Gents rlenu Uwr aaasvn ! Dimen. Char[adaevae Fs lrlon rwr C A of tie I maw— fl 10m 40* r!r Page 1 of 11 Lea= Paresmard for J.B. EnWwpdm, lite. teats umber: 4861-1U95-SBV-028�4 Lenses Name (DRAJ : J.B. EnWpdaw, lea Start lisle: 1 1181'2015 End Data: 12WMB Terient Name (Legal): J.B. Ergetptlawk Inc. Laadloed. ChuluftWoe Fashion Square. a Oafa+natrs Limked Llabtity ptryos Addraw 1510 Clamxrdwl Blvd, Apt $02 ArtingbN Wginie 22209 shnppliviiiii Conter Tres Ne" and Addm w CFwrlotteevlYe Farhion Sq— 1604 East Rim. Mail Mg" Oliioe, CtWW8eavft, VA 22901 Remit parawntuc $800 East Rio. Men MgmtOfll e. Chadetteevills. VA22M Tan ea Telephone Number. (M) 725$011 Contest Name: We purpose vrhielr apses can be used by Terre see Beim 1 Mmwpamard mutt approve all displays. It thin Aenuffnard contains a Meft Reed Table, ltie display Posting period for wW WwMsing medium or component shat be Amked to lies respedlim dates heartier sell {orgy ar such #Ilwk Rant Table. Total Contract Amoant: $8,00D.00 secaribIDemapa Deposit Amway SocaurtgdDrmrvMOr beposltDus l7ata Total Taxes: $0.00 Grand Total: $6,000.00 lneumnr:e PAKpd d Oats: 1117613015 Simple Mall insurance C Mkmb Holder CHARLOTTSMALLE FASHION SOLME, LLC, a I]elGVMFe WhOd Iiabklty WMPelly SEM RaLISTO Gents rlenu Uwr aaasvn ! Dimen. Char[adaevae Fs lrlon rwr C A of tie I maw— fl 10m 40* r!r Page 1 of 11 Lea= Paresmard for J.B. EnWwpdm, lite.