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CLE202200152 Application 2022-11-29 (2)Zoning Clearance Application FOR OFFICE USE ONLY Fee Amount: $ 61,36 Application fee: $59 + Technology Surcharge: $2.36 Receipt #: Clearance Number: Date Paid: By: Check #: By: Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Albemarle County Community Development 401 Mclnere Rd, North Wing t 4x. Ceadotlesvile, VA 22902 �rlk(4{qjl Pmne 434296.5832 Name: Doyoung Moon E-Mail Address: bulpankoreanbbq@gmail.com Mailing Address: 2075 Bond St. #180, Charlottesville, VA 22901 Tax Map and Parcel 61W-03--19A3 number and/or Address 2075 Bond St. #180, Charlottesville, VA 22901 of the Business: Phone #: Zoning: staff will fill our if unknown 703 336 3918 O'Connor Property Management 240 Parcel Owner: OCT STONEFIELD PROPERTY OWNER LLC Owner's Address: Palm ay, Suite m eac , o 33480 212-546-0899 Check any that apply: X❑ New Business ❑ Change of Use ❑ Change of Ownership Change of Name Business Name: MOONGANE, INC Description of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info. Korean Restaurant, # of employees : full time 5, Server 15, # of shift : 2, Shopping center parking Previous Business on Site: None Floor Plan: Please attach either an architectural drawing or a sketch of the proposed business indicating the location of uses, the uses of rooms, the total square footage of the use, and any additional information. ASIS Total Square Footage Used for the Business: 4,336 Is the Parcel Zoned LI, HI, or PDIP? Yes ® No If yes, fill out a Certified Engineer's Report (CERI Will there be food preparation? ® Yes ❑ No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? © Public ❑ Private If on private well, provide Virginia Department of Health approval Is the Parcel on public sewer or septic? © Public ❑ septic If on septic, provide Virginia Department of Health approval Will you be putting up any new signage? ❑ Yes ® No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes © No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit #s: .e-..._., Type something... Zoning Clearance is required first before a building permit for interior u fit by new tenant Zoning Clearance review cannot begin until the application above is complete and all applicable forms and fees are submitted. 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 the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature 14, Printed Doyoung Moon Date V l / /7 o y7 2 oyal da Albemarle County Zoning Clearance Application 401 Wnb Rd f4d"hW Ch McIntire Rd, Noah wing Ghadottesvile. VA 22902 Phone 434.296.5832 Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either informed or are going to inform the owner of your zoning clearance application. CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER I certify that I will provide (or have provided) notice of this clearance application, Moongane Inc clearance number provided by Staff or business name to OCT STONEFIELD PROPERTY OWNER LLC the owner Name of landowner on record of Tax Map and Parcel Number 61W-03--19A3 by either delivering a TMP number of property copy of the application to them in person or by sending them a copy of the application by mail. (Please check one of the following below) ❑X Hand delivering a copy of the application to the owner identified above on Date ❑ Mailing a copy of the application to the owner identified above on to the following address: (Written notice to the owner and last known address on our record books will satisfy this requirement. Please see staff for help determining this information if needed) Signature of Applicant Applicant Name Printed Doyodng Moon Date // / 7 q �, z Z 3 COAIMONIVEALTH OF VIRGINIA VIRGINIA DEPARTMENT OF HEALTH Blue Ridge Heald: District In accordance with the regulations of the Board of Health of the Commonwealth of Virginia this certifies that MOONGANE, INC is hereby granted a permf icense by the Albemarle County Health Department to operate a Full Service Restaurant Trading as: BULPAN KOREAN BBQ Located at: 2075 Bond Street, Suite 180, Charlottesville, VA, 22901 Mailing Address; 73 Court Place, Charlottesville, VA, 22901 Conditions of Permit (d applicable); Maximum Seating Capacity: 100 Date of Expiration December 31, 2023 Monica Garcia Environmental Health Specialist Sr. THIS PERMIT IS NOT TRANSFERABLE FROM ONE INDIVIDUAL OR LOCATION TO ANOTHER New owners are required to make written application for a permit. 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