HomeMy WebLinkAboutCLE201600278 Application 2016-12-27Application for Zoning Clearance
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY /
Check # Date: yl
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 061 UO-01-00-010AO Existing Zoning Commercial - C-1
Parcel Owner: 2123 Berkmar LLC
Parcel Address: 2123 Berkmar Drive City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? George Leaman
Address: 1495 Pinedale Rd. City Charlottesville State VA Zip 22901
Office Phone: (_434) 220-3300 Cell # 4349876368 Fax # 4342203301 E-mail leaman@pdcnet.org
APPLICANT INFORMATION
Check any that apply: Change of ownership X. Change of use Change of name New business
Business Name/Type: Philosophy Documentation Center / administrative office
Previous Business on this site Terry Dean's Dance Studio / Jazzercise
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:
I.A.1aare establos;hQd b, miness; With 8 employees workipg regular offir--o- ho wrs; A4=-Fri There
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r%n fhic nrnnorty two noort R fnr &!aff1 Wo ovnorrt to honin wnrlr in Into wontor / o rIv cnrinn 9017
*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 oryave the owner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to;fhe bet of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature �_ Printed George Leaman
APPROVAL INFORMATION
[ ] 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 ` — <�
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Zoning Official Date�2/�9/7iI
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:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
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 o ublic w r?
If private well, provide Health epartment 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 p lic sew ?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use:
5,040
) / N
eermitted as:
Under Section: ;� -2 •2•/
Supplementary regulations section:
Parking formula:
J� pz�
Required spaces:
Y /
Items o be verified in the field:
Inspector : Date:
Notes:
Violations:
Y / V
If so, List:
Proffers:
Y /
If so, List:
Varian e:
Y / 4�Y
If so, List:
SP's:
Y / t N)
If so, ist:
Clearances:
SDP's
Revised 11/1/2015 Page 3 of 3