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HomeMy WebLinkAboutCLE201500268 Application 2016-02-225av �Sa3s3A C' Application for ZoningClearance ; CLE # O 1 �— � �la7fA OFFICE USE ONLY FPLEASE REVIEW ALL 3 SHEETS Check: # 3Date: 1 1 Receipt # 1 qa.4 S Staff; PARCEL INFORMATION Tax Map and Parcel: 0076M1-00-00-00260 Existing Zoning PD -SC Parcel Owner: 5th Street station Ventures,,LLC Parcel Address. 425 Merchant Walk Square, Bldg. 2000City dharlotfesville State Virginia Zip 22902 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Dan Tucker Address: 5 SW Broad Street, Suite B Ci Fairburn t3� State Georgia Zip 30213 Office Phone: (Z70) 692-8300 Cell # 434 245-4909 Fax # 770 692-8302 E-mail _ dan@sicollinsent.com APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name x New business Business NametType; PetSmart / Mercantile Previous Business on this site mostly undeveloped 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: This 14,109 square foot mercantile business has 22 full and part time employees, and the store iso en from B am to 9 pm. There are two to three employees working infrequently after hours. The estimated occupancy load for egress purposes is 329 persons. *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 rquired. I hereby certify that I own or have the o%vner s percussion to use the space indicated on this application. I also certify that the information provided is true and accurate to the best ofmy knowledge, I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed APPROVAL INFORMATION ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ) Backtloiv 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, itis not a determination of compliance with the existing site plan. [ I This site complies with the site plan as of this date. Notes: Building Official Date / .,)-1J 1 J 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/I/2011 Page 2 of 3 4 L Intake to complete the following: Y�Is LI, HI or !'DIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y Wi there be food preparation? 1f 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 public seater? Ifprivate well, provide H form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that appli Is parcel on septic or ©blit sewer ,Y// N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # ZO/ N 1Viil there be any new construction or renovations? If so, obtain the proper Permit. Permit # � 0D Zonintr to eotnDlete the fnllasvinat Reviewer to complete the following: Square footage of Use: &IN Permitted as: /" e-1 Under Section: 2,5-,Z ./ Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector • Date: Notes: Viol ons: Y/V If so, List; Proffers: YIN If so, List- 69-/ Vari e: YIN If so, ist: SP's: Y/N If so, List: Clearances: SDP's Revised 71112011 Page I of 3 CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER This form must accompany zoning applications (Houle Occupation, Zoning Clearance, Zoning Administrator Determinations or Appeals, Sigh Permits, Building Permits) Y"the application is not the owner. I certify that notice of the application, Apprication for Zoning Clearance - PetSmart [County application name and number] was provided to 5th Street Station Ventures, LLC - Dan Tucker the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number manner identified below: 0076M1 -00-00-002B0 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 5th Street Station Ventures, LLC - Dan Tucker [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 12-10-15 Date to the following address: 5 SW Broad Street Suite B Fairburn GA 30213 [address; written notice inailed 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]. Signato f Applicant Stacy Kelley Print Applicant Name 12-10-15 Date