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HomeMy WebLinkAboutCLE201800046 Application 2018-02-27Application for Zoning Clearance =�`°F�` CLE # J4J� ©[)O"t � J ��AC:iNIP OFFICE USE O Y PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # _W,�Ll Staff: '7l fy PARCEL INFORMATION Tax Map and Parcel: 07800-00-00-055DO Existing Zoning PDMC Parcel Owner: Luxor Office Park, LLC Parcel Address: 1430 Rolkin Court, Suite 201 City Charlottesville State VA Zip 22911 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? David Granville Address : 1430 Rolkin Court, Suite 301 City Charlottesville State VA Zip 22911 Office Phone: (434) 971-8996 Cell # 703-943-7230 Fax # 434-971-9344 E-mail dave@denico.net APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: Denstock Management LLC Previous Business on this site N/A 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: PrOPOPty MaAa9@P4@At rnrPQrate 9ff16e 8 am 5 pm, 3 employees *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 t t I wn or have the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accu ate the best of myj wle e. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature CLi Printed Denise E. LaCour, Manager AP7ROVA INIOORMATION [ Approved a posed [ ] Approved with conditions [ ] Denied [ ] PffCkflow 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 Zoning OfficialC�KDate 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: � IsYLI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y Wi 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 1 ublic 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 applie Is parcel on septic or ublic sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # 4 C u1 d l ep%14, ct9m c, Ve i rn + Y/N Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # BID i 9- D0 A C� Zoning to complete the following: Reviewer to complete the following: Square footage of Use: f U 0 Y / tted as: ( ti('M 6V+ q 0{FI (6 Under Section: 15A • Z , 1 Supplementary regulations section: 12.2,1 tl) Parking formula: 1/20o npt Required spaces: O Yf N Ite o be verified in the field: Inspector : Date: Notes: fel0(a ". V00 SuVh,C OV11cl In C 11eW I Viol4ons: Y(r1J If s, 1st: Proffers: Y / N If so, List: 'LIMA 1CA05— 1 ] ink- CIS . 8 Var�ce: Y(N) If s , ist: SP's: Y/N If so, List: 2Dd7—I Y.UO5,— 2- Clearances: SDP's -x7? fcg Riff C e- MjOvc k) ? oiZ-1 0, I, 13 � i 'Loll SS 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, [County application name and number] was provided to Luxor Office Park, LLC [name(s) of the record owners of the parcel] and Parcel Number 07800-00-00-055DO 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 Denise E. LaCour, Manager, Luxor Office Park, LLC [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 2/21/18 Date 0 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]. 44 C — �� of Applicant D6nst6ck Management LLC, Denise E. LaCour Print Applicant Name 2/21/18 Date J(� w�[_�n. .(`hi A. I: �/[V, �� o'z 3 ,ns Nnom Ul io oee,v .»�s..,. k+uawra ara�x rii ❑I odo SINIVeU 1N3W3'J--n J13OlM _ -o A Ci 3 a J 2 65 E