HomeMy WebLinkAboutCLE201700060 Application 2017-03-06Application for Zoning Clearance
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # Date: 3
Receipt # Staff: `)<j
PARCEL INFORMATION
Tax Map and Parcel: 061 W0-04-11 -;k0100 Existing Zoning C1- Commercial
Parcel Owner: Sugaray, LLC
Parcel Address: 3510 Remson Court, Suite 201 City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? KATIE BERLETH
Address: 25 ENTERPRISE CENTER City MIDDLETOWN State RI Zip 02842
Office Phone: (401) 846-3100 Cell # 4015231073 Fax # E-mail-KBERtET+f@Efb4B-Rf4C-EH1F
Email: kberleth@embracehomeloans.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: EMBRACE HOME LOANS, (MORTGAGE LENDER)
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:
Private mortgage lender. 5 on -situ employees. Standard lousiness hours
*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 accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature lC-/� Printed Katie Berleth
APPROVAL INFORMATION
tool Approved as proposed [ J 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
Zoning Official A 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:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / i1r
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 public 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 or public sewer?
-if, N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # ',-O 11 —
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:
2560
()/N
Permitted as: 0
Under Section:
Supplementary regulations section:
Parking formula:
a(
Required spaces: / J
Y /
Item be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y/1
If so, IDS
Proffers:
Y/
If so, Est:
Variance:
Y / IQ
If so, st:
SP's:
Y /
If so, ist:
Clearances:
SDP's
Revised 11/1/2015 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form 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, Zoning Clearance cuL ,&I I — Llo
[County application name and number]
was provided to George Ray of Sugaray LLC the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 061 WO-04-00-30100
manner identified below:
by delivering a copy of the application in the
Hand delivering 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
Mailing a copy of the application to George Ray of Sugaray LLC, building owner
[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 02/27/17
Date
to the following address:
Sugaray, LLC Attn: George W. Ray Jr, 690 Berkmar Cir., Charlottesville, VA 22901
[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].
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Signature of Applicant
Katie Berleth
Print Applicant Name
02/27/17
Date