HomeMy WebLinkAboutCLE201600176 Application 2016-09-02Application for Zoning Clearance
CLE #,9016 - 1% 0Elf,
OFFICE U E LY p
PLEASE REVIEW ALL 3 SHEETS Check # Date: t]
Receipt # Staff: /2*
PARCEL INFORMATJ()
Tax Map and Parcel: 1 / Existing Zonin 1
Parcel Owner: e.,( P 6 7 L
Parcel Address: t� - r 0/ 12d I `
City t'tate v% Zip z D
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? &0 W WL-Q-4 l
Address :_j / 2 Ash h ir",/rr �r __ city 1 tare VA ZiP 2iU
Office Phone: (_ } Cell # '67-q1- 0 Fax # E-mail
WX
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type:
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parkin spaces, number of
vehicles, and any additional information that you can provide: --A lry jo ¢, 10W%v�,C A, .► AA PM rx l
*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, -anew 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 acc o e t of my knowledge. I have read the conditions of approval, and I understaandf them, and that I will abide by them.
Signature Printed A IJ0a AA S U a. y„.z, t
APPROVAL INFORMATION
[ WApproved as proposed [ ] Approved with conditions [ ] 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 con)plies with the site plan as of this }ate,
Notes: VAIJ Y< :n/M.f.kf Ill �Niil:r s„ a CAle ei C .r- r -
Building Official Date
Zoning Official I-#4� r 11 Date N/
fff
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 11/1/2015 Page 2 of
'wl
Intake to complete the following:
Y /(D
Is use m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
YIQ
Wille 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 well or p c wa ?
If private well, provide Health a ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli s
Is parcel on septic or p lic se r?
YIN
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
se�
Y / N Ye"I'IQ�Will there be anw co struction or renovations?
If so, obtain the per Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: 02
vicn-
as:
Under
rSSectioi
Suppleme(tat
Parking formula:
Required spaces: —
Y
Item o be verified in the field:
Inspector • Date: _
Notes:
Viol s:
Y/
If s ist:
Proff s:
YI
If so, ist:
Variance:
Y 1(N
If so, st:
SP's:
If //k� isIs
If st:
Clearances: I � �
SDP's
Revised 11/1/2015 Page 3 of 3
Zoning Clearance Checklist
Applicant MUST HAVE the following information to apply for a Zoning Clearance:
1) Tax Map and Parcel or Address, Building Name, Suite/Unit/Floor numbers, if applicable.
2) A Floor Plan - either a sketch or an architectural drawing
a) If using less than the entire structure, note the location within the structure;
b) Note the total square footage of the use;
c) Note the square footage of each room or area of use;
d) Note the use of each room or area of use.
FEES
Zoning Clearance = $54
Temporary Fundraising Activity = No fee
Conditions of Approval
FIREWORKS:
1. No person shall sell, offer for sale, store, display or discharge any fireworks in any filling station or on any premises where gasoline
or other inflammable liquids are stored or dispensed. (Code 1967 10-13.) County Code Section 6-200 and 6-300 and must be a
minimum of 100 ft from any gas pumps/propane distribution tank.
2. The site shall be cleaned and restored to its original condition on or before July 1 lth. This shall include removal of all structures,
,signs, debris, and the like.
3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications subject
to Zoning Administrator's approval.
4. Building permits shall be obtained for all proposed structures and/or lighting.
5. Sign permits shall be obtained for all proposed signage.
6. The sale of fireworks requires a special permit from Fire/Rescue department.
CHRISTMAS TREES:
I. The outside storage of combustible material or flammable materials shall be located so as not to constitute a hazard and shall not be
less than 15 feet from any building on the site. Any open burning must comply with the Virginia Statewide Fire Prevention Code and
the Albemarle County Code.
2. The site shall be cleaned and restored to its original condition on or before January 2. This shall include the removal of all structures,
signs, debris, and the like.
3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications subject
to Zoning Administrator's approval.
4. Building permits shall be obtained for all proposed structures and/or lighting.
5. Sign permits shall be obtained for all proposed signage.
OTHER REVIEWS:
1. Is the property on public or private water/sewer?
Private requires Health Department, Public requires ACSA review (2 to 5 days)
2. Will you be operating a bakery?
USDA review is required (approx. 2 weeks but as long as 6 weeks)
3. If you are serving prepackaged baked goods but not making them on the Premises, only Health Department will review. (2 to 5 days)
4. If you will be operating any business that is in an industrially zoned district or of an industrial nature you will need to provide a
Letter of Performance Standards or Certified Engineer's Report (a staff member will provide an information packet addressing this
requirement) (5 to 10 days as soon as the Letter or Report is received by this Department)
5. If there has been no site inspection within the last three (3) months for the parcel/site, then one will be conducted to verify that the
project is in compliance with an approved site plan (if applicable).
Revised 11/1/2015 Page 1 of
Application for Zoning Clearance
CLE#.60 -1
OFFICE U E Y
PLEASE REVIEW ALL 3 SHEETS Check # Date:
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: Existing Zoning_�� _
Parcel Owner:_ I] "@..� la
Parcel Address: ` c? City fptote �% Zip z p
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning/this project? Al i2ig
i`",tate
a
Address :_i'/% 2 456 �rt.�a:1 �rr � � _ City #e LIA _ Zip 2 - 11
Office Phone: ( �) Cell # YZqz 0 9 Fax # E-mail
•C;�'d✓t
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name Y New business
Business Name/Type:
Previous Business on this 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: _ d%llAt% /VLpr rd, j —T,<,1,k,
`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 acc o e t of my knowledge, I have read the conditions of approval, and I understand
! them, and that I will abide by them.
Signature Printed Ua A/S6 W I�jQa y
APPtOVAL INFORMATION
[ Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl I7.
[ ] 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,�t9�4AIX, I an�lr:tdc� 1�11 Jll�� fir Notes: I.%.R IL, a CAfi'o .0 M e _
Building Official Date ee
IL
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 1l/l/2015 Page 2 of 3
Intake to complete the following:
Y16
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Yl
Will re 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 well or p c wa
If private well, provide Health a meet form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE _
Circle the one that appli s
Is parcel on septic or p lic se r?
YIN
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
YIN
Will there bean rewcWstruction or renovations?
If so, obtain the Aroper Permit.
Permit #
Zoning Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: y i `3 6b
YIN - '�rl`i'`
as:
UnderrSSectioi
Supplemehtai
Parking formula:
Required spaces:
Y
Item o be verified in the field:
Inspector Notes:
Viol ' s:
Y /
If s Ist:
Proffers*
Y / 1Q
If so, ist:
Variance:
if so
If so, st:
SP's:
Y /�
Ifs , ist:
Clearances:
clip: -I I U
SDP's
Revised 11/1/2015 Page 3 of 3
Ask.
ff
www.dmv ow.com
Virginia Department of Motor Vehicles
Post office Box 27412
Richmond, Virginia 23289-0001
ZONING COMPLIANCE
ANGELCARE LLC
450 WESTFIELD RC
CHARLOTTESVILLE, VA 22901
Purpose: Use this form to verify that your business is being operated from a properly zoned address.
instructions: Send completed form to Motor Carrier Services at the address above.
OA 139 (2/22/2016)
You are receiving this Zoning Compliance form from DMV Motor Carrier Services because you have either changed your business address previously filed with
this office, or we have received information indicating that the business is no longer located at the address previously provided.
In order to confirm compliance with the established place of business requirements set forth in Virginia Code 46.2-2011.11, it will be necessary to provide the
information requested below. Failure to provide this information by the response date listed below will lead to the suspension and subsequent revocation of
your certificate or license. If your new business address does not satisfy all applicable local zoning regulations, the certificate or license will remain suspended.
If your certificate or license is suspended, you will be required to submit to DMV a $50.00 reinstatement fee. If your certificate or license is revoked and you
still intend to provide or arrange passenger transportation, you will be required to re -apply for the certificate or license fulfilling all requirements necessary for an
original application.
���I�ID�N�V�19�VpV�dl�
(`0MMONWEA1[ TH of VIRGINIIA
Richard D. Holcomb Department of Motor Vehicles Post office Box 27412
Commissioner Richmond, VA 23269-0001
2300 West Broad Street
August 5, 2016
ANGELCARE LLC
450 WESTFIELD RD
CHARLOTTESVILLE VA 22901
NOTICE/ORDER OF SUSPENSION
Customer No: T25030213
RE: NON EM MEDICAL TRANS 417
Dear Sir or Madam:
Our records indicate a recent change in your primary business street
address. As a DMV certificate or license holder you are required to have the
enclosed Zoning Compliance Form No. OA139 completed to confirm that your new place
of business satisfies all local zoning regulations.
The Zoning Compliance form must be completed and returned to DMV Motor
Carrier Services no later than the 'Response Date' indicated. Failure to return
this form will result in the suspension of your certificate or license and any
vehicle registrations issued to motor vehicles operating under the certificate, if
applicable. The suspension will be effective at 12:01 a.m. on September 4, 2016
unless prior to that date the completed Zoning Compliance Form OA139 is received by
DMV Motor Carrier Services. You will also be required to pay a $50 reinstatement
fee, if your certificate or license is suspended.
Should you choose not to submit the required form, you may submit a request
for a DMV administrative hearing prior to the suspension date to show cause why the
Order of Suspension should not be enforced. In order for the request to be
accepted, it must be in writing, signed, dated and mailed to DMV at the address on
this letterhead, or delivered to DMV at 2300 W. Broad Street, Richmond, Virginia.
If you have any questions regarding this Order of Suspgension, you may
contact a Motor Carrier Services representative at (804)249-5130 or by email at
mcsonline@dmv.virginia.gov. Hearing impaired individuals mayy contact the
telecommunications device for the deaf (TDD) at 800-272-9268.
Richard D. Holcomb, Commissioner
By
Judy Petersen, Director
Motor Carrier Services
Virginia Code Sections 46.2-2011.11(A.1), 46.2-2011.24(3)(13), 46.2-2011.26
MCS144
Phone: (804) 497-7100 TDD: 1-800-272-9268 Website: www.dmvNOW.com