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Home My WebLink AboutCLE201800229 Application 2018-11-20�-.fl 11113 Application for Zoning Clearance CLE # c2C) I ny a c3-0 s` PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # 10 l a--1i17 Date: Q - 31 ' g Receipt # 1 Staff- 2.1 PARCEL INFORMATION Tax Map and Parcel: _ p 1— ('n ,.-2c —n --- i'3 `W Existing Zoning Parcel OwnerChadoffsevi ll e Fashion Square Washinck n primr- Parcel Address: l �a 0- R l o Q oad Gh(A r l 0+e sy i l ie State � r-t' Zip r V (include suite or floor) PRIMARY CONTACT Dec Who y a should we call/write concerning this project? V Address : 0 IRAVW A V t City TNek State u Zip /_n( r,� xg35 ffi Oce Phone: 8( is)• I LP)- Q)7 e11 # Fax # E-mailt Aar &i i �(ajn', ckzn APPLICANT INFORMATION�� Check any that apply: Change of ownership Change of use Change of name New business � t Business Name/Type: Previous Business on this site Describe the proposed business including use, number of emplo�1,er of sh fts, available parking s aces, number of v icleA.s and any additional information that you can provide: *This Clear4hce will only be valid dn 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 o 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 st of knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. my Signature Printed SW W M umal , Vice- Wnidwg— 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 le Zoning Official Date 1�(1 11, boo Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 l,('(i w nn Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Y / Is u LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y 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 Im c wate iry If private well, provide HealtS4erartffient form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic or p lc sel � Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y/N 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: f Square footage of Use: Y/N Permitted as: r Under Section: . Supplementary regulations section: Parking formula: OM Required spaces: Y Ite to be verified in the field: Inspector: Notes: Date: Vio do s: Y/N If o, ist: Y/ Profes If sot: Var' e: Y ( If so, ist: SP's: / N f so, List: I 19 9-5C) Clearances: — I C;�]L SDP's - �f 7 Y 1G441 '1 i (� Revised 11/l/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, I'I bC'i� a i I COI kfli �/ - 0,00I1 GL -t on Nf bovll £ [County application n me a d number] G ear CC was provided to C h of 101+sf, V 11( P EA S h l o h u V (, thl; (wn"er of record Tax Map [name(s) of the record owners of the parcel] and Parcel Number by delivering a copy of the application in the manner identified below: Hand delivering 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 Mailing a copy of the application tobh Q 0 0itf [y t, t 1-e Fa S h i oh S4 L,I u ile. +ttr - i - an [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 �p �t7 office for that entity] on W j a� I to the following address: Date � (pay E_ ei ed- Charlo -Qfv�llr.. Vp �aad I [address; written notice mailed to the owner at the last known adclress of the owner as shown on the current real estate tax assessment books or current real estate tax assessment records satisfies this requirement]. Signature of Applicant Sat, M M afflo-� , Vice IpreS'l&ad— Print Applicant Name c Date ci gobi d Vol 4vd.) apd w < s,vaOI3, CL o V1, WADVbc4cps W 0 Fili I Kiosk Layout Diagram Locate and designate the kiosk perimeter (10' x 20') and its orientation. Mark this on the mall floor with masking tape. Consult a Hickory Farms representative. Starting roughly 36" from the 10' line (as shown in the top of the diagram) start laying out the stairstep bases. Place (3) bases side by side so that the outsides are 26" from the line (see diagram). Place 3 more bases 32 1/4" away to form the other side of the kiosk as indicated by the diagram. With this done correctly, the rest of the kiosk should fit as indicated by the diagram. 120" 16" Corner Tower , ....., ............... �, 17 7/8" _ Stairstep Work Desk v� W 32 1/4" 26" 2 a) on Swing cis W Gates Kiosk Height: 11'-0" (Top of Silo) 8'-0" (Top of Light Poles) Cooler shelf sits here a a� coo a) Cn C3 coo ti a� 03 03 Cn P1 p.. (2) Large plastic remgvable bases :Corner Tower Cash Wrap B asl Baskets Beefstick Table 8 (Job 35 7/8" Plastic remov- able bases 240"