HomeMy WebLinkAboutCLE201800040 Application 2018-02-22Application for Zoning Clearance
CLE # O� O qe
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OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # y Date:
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 032000000005BO Existing Zoning Light industrial
Parcel Owner: Seminole North, LLC
Parcel Address: 4257 Seminole Trail Citv Charlottesville State VA Zip 22911
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? Tim Slagle
Address: 1180 Seminole Trail, Ste. 105 City Charlottesville State VA ZiP 22901
Office Phone: 4( 34) 973-5571 Cell # (434) 953-6735 Fax # (434) 973-5580 E-mail trslagle@embarqmail.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name X New business
Business Name/Type: Builders FirstSource
Previous Business on this site Badger Fire Protection
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:
Warehousing and distribution of sheetrock and related products
*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 to e b t of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
0
Signature Printed
APPROVAL INFORMATION
[ ] A proved as proposed [ ] Approved with conditions [ ] Denied
[ ackflow prevention device and/or current test data needed for this site. Contact ACSA, 077-4511, 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 /
Zoning Official V1 Date
i
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:
Yl N
use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will t 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 or u lic ter
If private well, provide Healt epartment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel once or public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. s'Ee A-7 A C t-f p
Permit # Pilo 1$ - zs J
Y /I
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:
Y/N
Permitted as: w W C S 11 /mAmitiq
Under Section: 16
Supplementary regulations section:
Parking formula:
'let-rolovet, + '/Soo 4L corn fo Doi
Required spaces:
Y(N)
Ite o be verified in the field:
Inspector : Date:
Notes:
Vi at, s:
Y N
If so, List:
Pr s:
Y/N
I o,
Variance:
Y/N
If so, List:
(Y/5N
o, List:
16
Clearances:
SDP's
ILO 16`19S
7,001 - 96
IC -
Revised 11/1/2015 Page 3 of 3
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