HomeMy WebLinkAboutCLE201700137 Application 2017-06-09Application for Zoning Clearance
CLE # ffl -M
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OFFICE E
PLEASE REN71EW ALL 3 SHEETS Check # Date: • �7
Receipt
PARCEL INFORMATION T
Tax Map and Parcel: 78-17D Fang Zoning PDSC
Parcel Owner: PANTOPS SHOPPING CENGER I LLC
Parcel Address; 302 PANTOPS CTR -City CHARLOTTESVILLIState VIRGINIA Zip 22911
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(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? TERRI HAMMER
Address, 6225 WILLOW GLEN ROAD City MIDLOTHIAN State VIRGINIA Zip 23112
OMee Phone: ( 04 j 275�692 Cell # 804-9 680 452 F
$ E-mail terrihammer@gmail.com
APPLICANT INFORMATION
Check iy that apply: Change of ownership Change of use Change of name rx New business
Business Name/Type: Cellular phone sales
Previous Business on this site Cellular phone sales
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: --Sale of Boost Mobile phones - 2 employees - square Footage of
space is approximately 1250 - unknow number of parking spaces since it's in a shopping center
*This Clearance will only be valid on the pa-cei for which it is approved. If you change, intensify or move the use to a new Iocation, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owners permission to use the space indicated on this application, I also certify that the information provided
is true and accurate to c best ofmy knowledge. I have read the conditions ofapproval�and I understand them, and that I will abide by them.
Signature Printed
APPROVAL INFORMATION
[X) Approved as proposed [ ) Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 9774511, xI I7.
[ 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 �- �'Z�''l Date
Zoning OfficialZr Bate t�/q Ab 7
Other Official Late
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 2%-5832 Fax- (434) 9'724126
Revised 11 /1/2015 Page 2 of 3
Intake to complete the fallowing:
Is u'scs in LI, IU 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 r publ' water?
If private well, provide . De went form.
Zoning review can not begin until we receive approval fmm Health
Dept. FAX DATE _
Circle the one that appli
Is parcel on septle or ubtic se ?
Y t NT
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 #
7.nnino to eamplete the following_
Reviewer to complete the following:
Square footage of Use:
1250
d�/N
Permitted as: r�t.►� _w. _av�,._ r.n_
Under Section:
Supplementary regulations section:
Parking formula:
/a o�
Required spares:
Y/?
Items to be verified in the field:
Inspector Date:
Notes:
Violations: --
Y /
If so, ist:
ffers.
LV /N
If so, List:
2 AAA
B
k
arlance:
V/N
If so, List:
P's=
QV /N
? If so, List:
_ —7
to
—7n 3
I
Clearances:
SDP's
o g-3
q-17 13�
Revised 11/1/2015 Page 3 of 3
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must "company aontng applications (Home Occupadox, Zoning Clearance, Zoning
Administrator iDeterminadons or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, appplication for zoning clearance
[County application name and number]
was provided to Pantops Shopping Center P LLC the owner of record of Tax Map
[na2ne(s) of the record owners of the parcel]
and Parcel Number 78-17D by delivering a copy of the application in the
manner identified below;
Hand delivering a copy of the application to
[;Marne 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 far that entity]
on
Late
XX Mailing a copy of the application to Pantops Shopping Center i LLC
[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 05/18/2017 p to the following address;
date
Delivered by email.
[address; written notice mailed to the owner at the last known address of the owner as shown can
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
I ofpplicaart
T. C. Hammer
Print Applicant Marne
05/18/2017
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