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HomeMy WebLinkAboutCLE201700217 Application 2017-10-10Application for Zoning Clearance CLE#CQ©a/ ?T m Al: y ��RGIN�P OFFICE USE Y Q �"111 PLEASE REVIEW ALL 3 SHEETS Check # 1 Date: - p` Receipt # Staff PARCEL INFORMATION Tax Map and Parcel: 061 WO-0 1 -OA-0009BO Existing Zoning C-1 Commercial Parcel Owner: PMJB Land Trust Parcel Address: 2340 Commonwealth Dr., Suite 206 City Charlottesville State VA Zip 22901 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Sue A. Albrecht Address : 80 Roslyn Forest Lane 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: Forthright Legal / Non Profit Organization Previous Business on this site Parker, McElwain & Jacobs 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: Immigration Law Office 1 employ@@, 1 shift, ne GorA any vehicles *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 t he best o IYYkn ledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature A.% P Printed Sue A. Albrecht A ROVAL INFORMATION 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: Building Official Date l/ 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 / f Is u n LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y / Will�tere 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 ublelpartment water If private well, provide Health 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 lie sewer? Y / u Wil ou be putting up a new sign of any kind? Sign permit. Permit # If so, obtain proper Y /( 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: I1.1 lrmi ted as: n (c,�fC(1U'r.t�� 4N Under Section: 21- 7- Supplementary regulations section: Parking formula: Ztic nQ4- Required spaces: Y N Ite to be verified in the field: Inspector : Notes: Date: Vio ons: Y N If so; ist: PrQ�s: Y M If so, ist: V ce: I Y If so, ist: SP, Y DN) If sst: Clearances: 2-0e7~V�� SDP's Revised I l/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 PMJB Land Trust the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 061 W-01-OA-009B0 manner identified below: by delivering a copy of the application in the Hand delivering a copy of the application to PMJB 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 9/28/2017 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 to the following address: Date [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 as es t records satisfies this requirement]. Sue A. Albrecht Print Applicant Name 9/28/2017 Date 2340 COMMONWEALTH DRIVE, SUITE SCALE: NITS PROJECT NAME: FORTHRIGHT LEGAL - ZONING CLEARANCE 2340 COMMONWEALTH DRIVE CHARLOTTESVILLE, VA 22901 DRAWN BY: IRENE VOLENICK ZONING CLEARANCE 206 DESIGN ENVIRONS CORPORATIO DESIGNED • BUILT • FURNISHED • INSTALLED SINCE 1978 REVISIONS: DATE: BY: DATE: 9/28/1 7 SCALE: NTS 340 GREENBRIER DRIVE CHARLOTTESVILLE, VIRGINIA 22901