HomeMy WebLinkAboutCLE201600068 Application 2016-03-23Application for Zoning Clearance
CLE # _ A0/& -GW! -
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FL-heck
FICS USE ONLY
PLEASE REVIEW ALL 3 SHEETS # =1 ODate. 3 o�-L i1peipt # 1 ti 7 staff:
PARCEL INMMUTION
Tax Map and Parcel: 04500-02-00-00100 Existing Zoning H/C .
Parted Owner: R. Belie Beats LLC.
Parcel Address; 1885 Seminole Trail city Charlottesville State V' inia Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Jon Voilentine
Address: 8410 W Bryn Mawr aty Chicago State IL Zip 606031
Office Phone: (Z73) 339-4182 Cell # 708-826-3410 pax # R -Trail lon.yollenfine@uscellular.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business NnmeJType: U.S. Cellular, wireless telecommunications and sales
Previous Business on this site Calico Corner Showroom
Describe the proposed business including use, number of employees, number of shills, available parldng spaces, number of
vehicles, and any additional information that you can provide:
Unoted Stater COW IMF COMWAIGA, d.b a. U.S, Cellular, is a mglonal GaMew which c-Auns and operatee the fgh-IsFossA
sariroloer Fnlnr nm„�,rgi�.nfinnc m&b&mj* In Fhn I Inifne4 Rkhoe _eonrin A A millinn riiefnm ar In d7A rn�rkm+a_ r __•73_U C
*This Clearance will only be valid on the parcel for which it is approved. Ifyou chv►ge, intensify or move the use to anew location, a newZoning
Clearance will be required.
I hereby certify that I own or have the owner's pewrission to use the space indicated on this application. I also certify chat the infbrnnation provided
is true and accurate to the best of my knowled . I have road the conditions ofappr+oval, and I understand Orem, and that I will abide by them.
Signature printed Jon Vollentine, US Cellular, RE Services
APP OVAL INFORMATION
[ pproved as proposed [ ] Approved with conditions [ ] Denied
[ Backflow prevention device "or current test data needed for this site. Contact ACSA, 977-4511, xl17.
[ ] 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 1 G
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 11/02/2015 Page 2 of 3
Intake to complete the following:
l N
use in LI, HE or PDIP zoning? If so, give applicant a Certified
Engi"neees Report (CBR) packet.
Y
Wike 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 weR or public wa;r—D
If private well, provide Health Department form.
Zoning review can not begin until we receive appraval from Health
Dept. FAX DATE
Circle the one that app
Is parcel on septic, orublic sew
YJ/ N
dill you be putting up a newsignof any kind? If so, obtain proper
Sipp�
Per
Permit #
!N
ill there be any neve construction or renovations?
If so, obtain the Per'..+
Permit #��.
Zonine to complete the followinne:
- MY Ok Ao (+-h 6 A 15 ILI
Reviewer td complete the following:
Square footage of Use: �do i
%ermitted as: L
Under Section: of D[ _ 1 1 as iJJ[fCi
T—'
Supplementary regulations section:
Parking formula: I ft j , F�f V* V(NL
Required spaces: 13
Y/
Ite be verified in the field:
Yio�'�Qno:
Y�(N)
Ifs , zst:
Pro
Yl
Ifs , zs,
Variance:
Y/N
If so, hist:
/N
so, List:
Clearances:
SDP's 22
Revised 1 11112 0 15 Page 3 of 3
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