HomeMy WebLinkAboutCLE201800008 Application 2018-01-12S
Application for Zoni'C earance_�
CLE#30 I Il�V
An
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PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # 7Date:
Receipt # Staff
PARCEL INFORMATION
Tax Map and Parcel: 061 WO-01-OA-000800 Existing Zoning Neighborhood Model District
Parcel Owner: Anvince Land Trust
Parcel Address: 340 Greenbrier Dr., Suite A-1 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: Rock Steady Boxing Charlottesville
Previous Business on this site The Elements Hot Yoga
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:
Fitnccc St vain 2 employees, 1 shift, ne Gompapy 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 her6certifyhat wn or h t o er's permissi to use the space indicated on this application. I also certify that the information provided
is trt e. I hav read theconditions of approval, and I understand them, and that I will abide by them.
/11
SignPrinted Sue A. Albrecht
AP)ROVAL INFORMATION
[ oved as proposed [ ] Approved with conditions [ ] Denied
flowprevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
Ac
hysical 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 / /W//
Zoning Official Date (� 2
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 /SN
Is use in LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /lih Wil 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 public Ovate
If private well, provide Healt Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap .
Is parcel on septic public sewer?
/ N
ill you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /
Will 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
ermitted as: Ih ti ac't �ith�C�l � (!C,
Under Section: L0. (fir: i - C6 de of (wo r )
Supplementary regulations section:
Parking formula: V as -
Required spaces: 2-7
Y/N
Ite o be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y/N
If so List:
nba��°c
Proffers:
Y/N
If so List:
ZtA iI- n5 coc e Of DCL;eloptr, r,
Var' e:
Y / N
Ifs ist:
9:
N
Z'o',
List: US C-
Clearances: `
2o16— Lil ElemeyJ5 30
SDP's
D`f—q t
2olz- jyz� MANIA
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 W-01-OA-00800
manner identified below:
the owner of record of Tax Map
by delivering a copy of the application in the
QHand 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 1 /8/2018
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].
Sue A. Albrecht
Print Applicant Name
1 /8/2018
Date
Rock Steady Boxing Charlottesville
techline,
Women's
Locker Room
Office
/ � C
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Fitness
Studio
SUITE A-1
3400SF
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ryl
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q 4
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Men's
Locker Room
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Kitchen
Meeting
° Room
\ -- ---------- --------
SUITE A-1 LAYOUT
SCALE:NTS
PROJECT NAME: Greenbrier Commons
DESIGN ENVIRONS
CORPORATION
REVISIONS:
340 GREENBRIER DRIVE
DESIGNED BUILT • FURNISHED • INSTALLED
DATE: BY:
CHARLOTTESVILLE, VA 22901
;I
SINCE 1978
DRAWN BY: IRENE VOLENICK
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(eoo)e�ani2 edprerm,ms,cwn wc p�Al3araz
SUITE A-1
Rock Steady Boxing Charlottesville
DATE: 1 /8/1 8 SCALE: NTS
0
340 GREENBRIER DRIVE CHARLOTTESVILLE, VIRGINIA 22901
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