HomeMy WebLinkAboutCLE201700023 Application 2017-02-15Application fo ZM-ingClearance
CLE # !
OFFICE Y
PLEASE REVIEW ALL 3 SHEETS
Check # Date: `
Receipt # Staff:
PARCEL INFORMATION 78-31 F
Tax Map and Parcel: Existing Zoning PDMC
Parcel Owner: PJP Bldg. Two LC
Parcel Address: 630 Peter Jefferson Suitel 90 City Ch'ville State Virginia Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Emily Covey, DPR Construction
Address: 5500 Cox Road, Suite M city Richmond state VA Zip 23060
Office Phone: 8( 04) 433-4160 Cell 4 804 405-3795 Fax # 804-433-4165 E-mail emilyc(a)_dpr.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
new tenant
Business Name/Type: Bank of America
Previous Business on this site Vacant
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: US Trust bankinq services. All work one shift (9-5)
with apnroArnat�.ly 20 staff and 20 vehicles There is sufficient parking by the landlord for all employees
*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 ow.,p or have the owner's mission to use the space indicated on this application. I also certify that the information provided
is true and accurate toy — best of my knowl ge. f have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed Emily Covey
APPROVAL INFO N
[ Approved as proposed [ J Approved with conditions [ ] Denied
[ J Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-451 I, x 1 IT
[ ] 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 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 11/1/2015 Page 2 of
Intake to complete the following:
Y AO
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y [N)
Wire 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 u lic water
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 ublic sewer:
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
N
ill there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 2016-00545-AC
Coning to comQtete the tottowm
Violations:
Y/N
If so, List:
Variance:
Y/N
If so, List:
Clearances:
Reviewer to complete the following:
Square footage of Use: 3 1 1
Permitted as:
Under Section:
Supplementary regulations sectio
Parking formula:
Required spaces: t
Y(N
ms to be verified in the field:
Inspector:
Notes:
Date:
Revised I I/1/2015 Page 3 of 3