HomeMy WebLinkAboutCLE201800168 Approval - County 2018-07-13Application for Zoning Clearance'°�A`
CLE #. Y)& a
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OFFICE USE ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL INFORMATION
Tax Map and Parcel: 061 WO-01-OA-0009130 Existing ZoningC-1 Commercial
Parcel Owner•PMJB Land Trust
Parcel Address:2340 Commonwealth Dr., Suite 200 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: 4( 34) 973-6161 Cell # 434-531-2435 Fax # 424-973-0732 E-mail sue@designenvirons.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: Loan Depot, LLC
Previous Business on this site PC, -k"— , L
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
ve 'cles, a d any additional information that you can provide: i�rt�V1 Se � Vi 2-ef 1zv
*This Clearance will o ly 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 herpbY1tvsQfy that own or a er's permission to use the space indicated on this application. I also certify that the information provided
is a and ac to the b o y o ledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Si gna a Printed Sue A. Albrecht
APPROVAL 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
Zoning Official 3 Z f
Date
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
Revised 11/02/2015 Page 2 of 3
Intake to complete the following:
Y /
Is us n LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
Y /(N�
Will 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 p b •c water
ater?
If private well, provide Healthwrriiient 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 u lic sewer?r
Y / N Phjo�
Will you be putting- a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /
rN
Wil 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: L /�
Y/ N -d fit, . l i S 4yk -Z) a�
Permitted as.
Under Section:
Supplementary regulations section:
Parking formula:
I t a k t-c � e0 jr � + or" �C% �! l o✓S
o-" 2 i �`atcd
Required spaces:
Y/N
Items to be verified in the field:
Inspector Date:
Notes:
Violations:
Y/(N)
If so, ist:
Proffers:
Y/
If so, ist:
Variance:
if
If so, ist:
SPA
If
If so -, List:
Clearances: Zo/QOv''n^
SDP's
000gS
is
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 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-009130 by delivering a copy of the application in the
manner identified below:
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 7/3/18
Date
Q 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
7/3/18
Date
PAI
A
PR,
RECEIVED
AMOUNT:
Comments
Legal Ad
County of Albemarle
Department of Community Development
PH: (434) 296-5832
307 324
For:
510
.-�l 4630
c7c cz-) AS
cash
cr it and
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SUB APPLICATION(s)
Sub Applicatic, Comrn5nt
!APPLICANT / CONTACT INFORMATION
icontacjypf� -1- tqame Address Citystate. zi Phone
phonecell
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- ... ...... 1.11 1.,.. . I - - .., ...... . . . .......
CZ-,tS=,, SUE A. ALBRECHT � 80 ROSLYN FOREST LANE CH4.RLOTTES\,ILL 22901 4349736161 434531243
I
Signature of Contractor orAuthorized Agent Date