HomeMy WebLinkAboutCLE201700196 Application 2017-08-27Application for Zgnin� Clearance
CLE # �L Z C Q�
PLEASE REVIEW ALL 3 SHEETS
OFFICE US O t j f
Check # & Date: �-1 �
Receipt #/ l 0 t S Staff: e
PARCEL INFORMATION
Tax Map and Parcel: 061 WO-01-OA-00800 Existing Zoning Neighborhood Model District
Parcel Owner: Anvince Land Trust
Parcel Address: 340 Greenbrier Drive Suite C & C1 City Charlottesville State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Sue A. Albrecht
Address : 340 Greenbrier Drive City Charlottesville State VA Zip 22901
Office Phone: (434) 973-6161 Cell # 434-531-2435 Fax # 434-973-0732 E-mail sue@designenvirons.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Service Pros Installation Group Inc.
Previous Business on this site Priority Transportation
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:
Storage 1 shift, 1 emPploT e@ 86 available spots, Po sempanyvehicles-
parking
*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 wn or ha the ner's permissio to use the space indicated on this application. I also certify that the information provided
is true an the bes w edge. I have ead the conditions of approval, and I understand them, and that I will abide by them.
Signatur Printed Sue A. Albrecht
APPROVAL INFORMATION
t] 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:
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A2Building
Official Date
Zoning Official Date ���s/� i 7
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 LNN�
Is LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /
Will Ure 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 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 appl'
Is parcel on septic public sew
Y /K)
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /
Wil ere 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:
Y/N
Permitted 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
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
[County application name and number]
was provided to Anvince Land Trust
[name(s) of the record owners of the parcel]
and Parcel Number 061 WO-0 1 -OA-00800
manner identified below:
the owner of record of Tax Map
by delivering a copy of the application in the
Hand delivering a copy of the application to Anvince Land Trust
[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 08/19/2017
Date
Mailing 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
to the following address:
[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].
/igg2n4at�ureof Applicant
Sue A. Albrecht
Print Applicant Name
08/19/2017
Date
EXHIBIT A
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PROJECT NAME: Greenbrier Commons
340 GREENBRIER DRIVE
CHARLOTTESVILLE, VA 22901
DRAWN BY: IRENE VOLENICK
Suite C & C-1
DATE: 7/20/17 SCALE: ntS
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DESIGN ENVIRONS CORPORAT
DESIGNED - BUILT • FURNISHED • INSTALLED
SINCE 197E
leool aro-n+z nx c.e.rer3.or�x
340 GREENBRIER DRIVE CHARLOTTESVILLE, VIRGINIA 22901
REVISIONS:
DATE: BY:
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