HomeMy WebLinkAboutCLE201600178 Application 2016-09-02ra
Application for Zonin Clearance a ,
CLE # A_r
OFFICE USE O LY
PLEASE REVIEW ALL 3 SHEETS Check # /T.v Date: ��` f LO
Receipt# 70,T6-, Staff: 5•
PARCEL INFORMATION
Tax Map and Parcel: 061 WO-01-OA-009AO Existing Zoning C-1
Parcel Owner: Sue A. Albrecht
Parcel Address: 2300 Commonwealth Drive City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we calllwrite concerning this project? Sue A. Albrecht
Address: 255 Ipswich Place City Charlottesville State VA Zip 22901
or
Office Phone: (434) 531-243§fjL I Cell # 434-531-24391,"Fax # 434-973-0732 E-mail sue@designenvirons.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Hands of Favor LLC
Previous Business on this site Rimm Kaufman
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:
.1 Stylist=ig Consultant, 1 Shaft, 1 Employes, 48 Available Parking Spares, & Ng Company VahiGia
,This Clearance will only be valid on the parcel for which it is approved. Ifyou 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 owucrs permission to use the space indicated on this application. I also certify that the information provided
is true and accurst o the best of w die. I have r ad th approval, and I understand them, and that I will abide by them.
Si Printed
AP OVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xi 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 complies with the site plan as of this date.
Notes:
Building Official Date �ti — e,)- —` L
Zoning Official -OaDate
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
IntalKto complete the following:
YIN
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y
Will there 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 lic wa
If private well, provide 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 septic or lic sew
Y/N
Will u be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
YI
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the folIowinL:
Reviewer to complete the following:
Square footage of Use: MO
jtr it iti n
mitted as: '
Under Section: - L
Supplementary regulations section:
Violations:
YIN
If so, List:
Proffers:
YIN
If so, List:
Variance:
Y/N
If so, List:
SP's:
YIN
If so, List:
Clearances:
SDP's
Revised 11/1/2015 Page 3 of
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
Thisform must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner,
I certify that notice of the application, Sue A. Albrecht
[County application name and number]
was provided to Sue A. Albrecht the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 061 WO-0 1 -OA-009AO by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to Commonwealth Business Center
[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
Mailing 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
to the following address:
[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].
Sue A. Albrecht
Print Applicant Name
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PROJECT NAME:
COMMONWEALTH BUSINESS CENTER
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OF FAVOR C
DESIGN ENVIRONS CORPORATION
DESIGNED BUILT • FURNISHED • INSTALLED
SINCE 1978
REVISIONS:
CATS' BY:
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340 GREENBRIER DRIVE CHARLOTTESVILLE, VIRGINlA 22901