CLE202200157 Application 2022-12-05Zoning Clearance Information
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Phone 434 296 5832
What is a Zoning Clearance?
A Zoning Clearance is verification from Albemarle County that a proposed use, whether it is a new business or other activity
(see Zoning definition of "Use"), satisfies all requirements of the Albemarle County Zoning Ordinance and ensures public
health and safety. A Zoning Clearance Application is reviewed by the Zoning Department, Building Inspections Department,
as well as any other applicable departments or agencies.
A Zoning Clearance is Required in the Following Circumstances
• Opening a new business
• Changing or expanding an existing business
• Buying an existing business
• Moving a business to a new location or changing its name
• Before natural resource extraction
• Any uses listed in Section 5 of the Albemarle County Zoning Ordinance as requiring a Zoning Clearance
Items Required to Apply for a Zoning Clearance
Before filling out a Zoning Clearance Application ensure you have or have done the following:
Tax Map and Parcel number or Address of the property. Include suite/unit/floor number, if applicable.
R11 Description of the proposed business/use. Include any and all relevant information such as a description of the
business, the number of employees, number of shifts, availability of parking, etc.
A Floor Plan. A sketch or an architectural drawing of the total square footage of the use. If using less than the entire
structure, note the location within the structure. Note the square footage of and use of each room.
Nd/Provide notice to the owner if the applicant is not the owner. Within ten days of applying for a zoning clearance, the
applicant, if they are not the owner of the parcel and/or structure, shall inform the owner that they have applied for a
Zoning Clearance. Please fill out the form on page 3.
• Other Approvals/Documents if applicable.
• A Certified Engineer's Report is required if the parcel is zoned Industrial (LI, HI, or PDIP).
• Health Department approval is required for food preparation or if the parcel is on private well or septic.
• Bakeries require USDA approval.
• Any additional approvals the Zoning Administrator may require including Department of Social Services and Fire +
Rescue.
• If you have any questions feel free to contact Staff at (434) 296-5832
Submitting an Application
Once you have all the required information provided above:
1. Fill out an application. Please complete page 2 in its entirety.
2. Submit an application. Bring or send a completed application to Albemarle County Community Development at
401 McIntire Rd, North Wing, Charlottesville, VA 22902
3. Pay. The application fee can be paid for in person or online. If paying online please attach a copy of your payment re-
ceipt. A Zoning Clearance Application will not be processed until payment has been received.
4. Notify the Owner. If you are not the owner of the property please fill out page 3.
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
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Name:
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E-Mail Address:
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Mailing Address:
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Phone #:
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Tax Map and Parcel
number and/or Address
of the Business:
Parcel Owner:
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5ftmr^fRHoFF LLC
Zoning:
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Owners Address: 14109151
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Check any that apply:
New Business ❑ Change of Use ❑ Change of Ownership Change of Name
Business Name:
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D9SCription of Business'
Describe the business including use, number of employees, number of shies, availability of parking, and any additional info.
A'sL. jALAS Of ME..>S APPAAFL, AFMOYMYnAIELT `G Er►PLCrMIKS PA-Arn,41 LY
ONE SH7Ft 11-i, �vE fl£57GNA7�fl QAI1Vt]tV(r C�S7a�6iLS RlQLAr�DLor2t�.
Previous Business on Site: Timi-fr /hq [A1L LoA^3S
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.
Total Square Footage Used
for the Business:
3105
Is the Parcel Zoned LI, HI, or PDIP?
❑ Yes ® No If yes, fig out a Certified Engineers Report (CER)
Will there be food preparation?
Ej Yes ® No If yes, provide Virginia Department of Health approval
Is the Parcel on public water or private well?
Public Pnvate If on private well, provide Virginia Department of Health approval
is the Parcel on public sewer or septic?
Public F1 Septic If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
rA Yes ❑ No If yes, obtain appropriate sign permit and list permit At below
Will there be new construction or renovations?
ElYes ® No If yes, obtain appropriate building permit and list permit A below
Please list any applicable Building Permit #s:
WA
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 1 understand
them, and thattII pwiillllabide by them.//A
Signature ` "A � -X � Printed M£W=S ✓• I'�1L�
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Zoning Clearance Application i = 4e,MOIntlre Rd ROMChadofte$0118, VA 2
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IykLl\�. Phone 434.2%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,
BR C L C n]5 CNAR�o i 7ESv7L l
clearance number provided by Staff or business name
to LU the owner
Name of landovmer on record
of Tax Map and Parcel Number 06I410 - 00 -00 -1 a0yo 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)
J Hand delivering a copy of the application to the owner identified above on
Date
[ 4 Mailing a copy of the application to the owner identified above on
Date I a 151 as to the following address:
Was w. w►�SH�NG7oN s7. ey 5,,FrCLh OA a3y3'4
(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
Date
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