HomeMy WebLinkAboutCLE201700064 Application 2017-04-12Application for Zoning Clearance�oY�
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PLEASE REVIEW ALL 3 SHEETS
OFFICE US NLY 2
Check # Date: J
Receipt # Staff:
PARCEL INFO ION
Tax Map and Pare 1: 061 WO-03-00-019AO, 61 WO-H--tt--025M Existing Zoning NMD / PD & Overlay District
Parcel Owner: OCT Stonefield Property Owner LLC
Parcel Address: 2025 Bond Street . City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Yvonne Jones
Address : 240 Royal Palm Way, Suite 201 City Palm Beach State FL Zip 33480
Office Phone: 2( 12) 546-0865 Cell # 312-286-6905 Fax # E-mail yjones@oconnorcp.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use X Change of name New business
Business Name/Type: OCT Stonefield Property Owner LLC
Previous Business on this site vacant land, not in use
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:
*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 1 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 Printed Yvonne Jones
APPPPVAL INFORMATION
[ pproved 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
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 11/02/2015 Page 2 of 3
Intake to complete the following:
Is
Is u I, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
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 or ublic water9
If private well, provide He It in
form.
Zoning review can not begin ntil we receive approval from Health
Dept. FAX DATE
Circle the one that Crblic
Is parcel on septic sewer
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:
Q
/ Nmitted as:
Under Section:
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field.
Inspector Date:
Notes:
Violations:
Y/N
If so, List:
Proffers:
Y/N
If so, List:
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearances:
SDP's
Revised 11/1/2015 Page 3 of 3
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