HomeMy WebLinkAboutCLE201600035 Application 2016-02-24Application for Zoning Clearance
CLE # J
Y,
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # ///-3 Date:
Receipt # /U 31999 Staff.
PARCEL INFORMATION
Tax Map and Parcel: 07800-00-00-058G2 Existing Zoning Commerical
Parcel Owner: Rivers Edge I, LLC
Parcel Address: 325 Winding River Lane, Suite 102 City Charlottesville State VA Zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? James R. Clark, MD
Address: 325 Winding River Lane, Suite 102 City Charlottesville State VA Zip 22911
Office Phone: (434) 817-2442 Cell # 434-825-8107 Fax # 434-817-8492 E-mail clarkmd@cvil lemed research. con
APPLICANT INFORMATION
Check any that apply: X Change of ownership Change of use Change of name New business
Business Name/Type: Charlottesville Medical Research Center, LLC/Clinical Research Facility
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: Clinical Research,9 employees, ]..Shift, 41ai r
snares 9 vehirinc
°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 to the best of my knowledge. I ve read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed James R. Clark, MD
APPROVAL INFORMATION
tXj 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 Date
Zoning Official Date2
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