HomeMy WebLinkAboutCLE201700199 Application 2017-09-20Application for Zoning Clearance
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CLE #),0 i -00 !Ti
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY a) i
Check # I OW05 Date:
Receipt # +'E� Staff:
PARCEL INFORMATION C p
Tax Map and Parcel: -��p - ` a � —"� �� T- O Existing Zoning " ke(ld enl '
Parcel Owner: P\t ion kAQmQ�
Parcel Address: Telb �f r (LU ID 17 City State r Zip aa��
(include suite or floo )
PRIMARY CONTACT
I
Who should we call/write concerning this project?KQr, I
�^�Clyl
Address : �1�J� 5c;t�n � Si.�C 0t✓1 City 0�-C 10i+Q,5iyi l l d State Vµ zip D )C_la
Office Phone: (y34)&:oZ O 104 Cell # Fax # E-mail fCc
APPLICANT INFO` 4 M_ATION
Check any that apply: _ Changeof ownership Change of use Change of name M r rosiness
[�
Business Name/Type: _ T ku�PYD�L`A
Previous Business on th;
vehicles, and any additio; aa, information that yob can provide:
*This Clearance will only b. valid on the parcel for which it is approved. If you change, intensify or move the use to a new location, ;3cw Z,on�ng
Clearance will be required.
I hereby certify that I own (.r ha-e the owner's permission to use the space indicated on this apl)lication. I also certify, that the inform �,ioi provided
is true and accurate Vhe best of my knawledge. I have read the conditions of approval, and 1 understand them, and that I will abide by them.
Signature Printed
APP,.,OVAL INFORMATION
[V44pproved 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 existir-g
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official _ Date f
_
o/�
Zoning Official ,f��/ Date ell `.�
Other Official Date
County of Albemarle Department of Community Development
401 1Vlciucire Road Chariottesville, :'A 22562 Voicc: (134) 296-5832 Fax: (434) 972-4126
al
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 lQeWilll ere 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 o public water?
If private well, provide Heat epartment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one 1.1--.at ap
Is parcel can septic r public sewer?
Y / 1`:;
Will you be putting up a new sign of any kind? If so, obtain proper
Sign p};rmit.
Permil #
r v ,
v
�Il tl<:re be any new construction or renovations?
If so, a':,:ain the groper Permit.
Zonine to complete the followinz:
Reviewer to complete the following:
Square footage of Use: 1 S' j
YJN /
ermitted as: I�� c��rrneS(�ISti,
Under Section: 1".1 In t G. C 1 a'
Supplementary regulations section:
Parking formula: 2—
Required spaces:
Y/
Items to be verified in the field:
Inspector:_
Notes:
Date.:
Vi on:;:
Y
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
yld — 000S
l(',0114E �'S1f e�'Pyll
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, -ZOrli nP r l a-arurncz -
[County application name and number]
was provided to -war-) PCQr�(I-s the owner of record of Tax Map
[name s) of the record owners of the parcel]
and Parcel Number by delivering a copy of the application in the
manner identified below:
EZTHand delivering a copy of the application to Dad K.c �s�( /� c,c�r� Nara rS
[Name of the recordownei 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 'i11-4/(--4 _
Date
J Mc;iing a . vpy of tiic 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].
ignatiire of Applicant
Print Applicant Name
�7l(4liq
Date
SF 18 Sales Office
BUILDING PERMIT FORM
Tax Map/Parcel #: 76-52-lot 18 Electric Provider: Dominion
Community/Subdivision: Sunset Overlook Zoning:
Current Owner/Developer: Forge Farm, LLC
Address: 195 Riverbend Drive, Charlottesville, VA. 22911
Builder: NVR Inc - Ryan Homes
Address: 1885 Seminole Trail, Suite 201 Charlottesville va 22901
Lien Agent: Benjamin C. Winn, Esq (703) 803-7529
Address: 3926 Pender Drive, #200, Fairfax, VA 22030
Address: TBD Sun Valley Drive
Lot #: 18 Section Phase
House Type: Milan Elevation: E
House Dimensions: 38x43 Poured Concrete Foundation
Bldg Ext. Part Stone Decks: (sq. ft) Porches: 102 (sq. ft)
# bedrm: _ 3 # Bathrm: 2 Full / 1 Half
Fireplace: Family Room Wood Gas/Propane X
Sewer Service Public:—X— Private Septic:
Water Service Public: X Private Well:
Heat Service Gas: Elect:_ HVAC: Propane:
Finished Square Footage
First Floor
1095 Second Floor 1444 Basement 531
Morning Rm
Bonus Room Rec Room
Bonus Rm
Other: Add. Area
Elevation E
26 Bath
Total First
1121 Total second 1444 Total Basement 531
Unfinished Square Feet
Garage Att_X_ Det 451 Sq. Feet Unfinished Basement area: 590 Sq. Feet
Total Finished Square Feet: 3096 Total Unfinished Sq. Feet 1041
Estimated Cost of: Electrical - $7200.00 Plumbing - $6900.00 Heating/Air: $8300.00 Gas: $900.00
Estimated Building Cost of Structure: $12S,000
$13,854.00 Water &Sewer Fees (Vendor #28572 Service Authority, Acct 121-012A)
2154.95 Building Permit Fee (Vendor 27802 Albemarle County, Acct 121-010B)
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SETBACK
EXISTING CONTOUR
X 505.37 SPOT ELEVATION
SETBACKS:
FRONT SETBACK: 5'
SIDE SETBACK: S'
REAR SETBACK: 2o'
LOT COVERAGE (SF):
BUILDING. 3,834 SF
DRIVEWAYISWK: 392 SF
YARD: 3,256 SF
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