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HomeMy WebLinkAboutCLE201900017 Application 2019-04-11Ll ►(- t9 Application for Zoning Clearance CLE # OFFICE U O Y p 9 PLEASE REVIEW ALL 3 SHEETS Check # Date: - 7 Receipt # Staff: PARCEL INFOR O Tax Map and Parcel: - -( -mq% Existing Zoning 116� Parcel Owner: r k*_� 11 J Parcel Address: City e State Zip0q)5 (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? �¢� S q r\ �A Address: 3�Z_ �0 1 Q i t City CY`0.Ao11e5-It State_ `/A Zil) 0�11 Office Phone:0 ��Cell # Fax # E-mail eGG(� APPLICANT INFORMATION Check any that apply: � CChange of ownership Change of use Change of name ?( New business Business Name/Type: li f CAS•TA y 0, *� Previous Business on this site Describe the proposed business including use, number of employees, numb,r of shifts, available parking spaces, number of vehicles, and any additional information that you can provide: a.� 0-ts<. *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. � n Signature ��C ; Q n A; (I. 1) Printed 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, x]17. [ ] 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 OfficialDate Zoning Official Date Other Official 5�t �;'�l�1cc( � � c^t^r�o'G� <i Date 1J County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 Revised 1 ]/1/2015 Page 2 of Intake to complete the following: Y /,-�) Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. OY/N Will there 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 n�blic waterIf private well, provide Healthepartment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic ogpublic sewer. VIl you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit# j'2101-0OZM s -Will there be any new construction or renovations? If so, obtain the proper Permit. Permit# 1j"Ll'(�% �c"Lg•-/(L Gonmg to complete the tonowtne: Violations: Y/N If so, List: Vt021,-(7-04'0( ZaiC-z01 2y1n=6-, 2 C,'s _ 73 Variance: Y/N If so, List: VA/9�5 sy l`t8`l-5`T Clearances: 2oD -1.1? -Z65 -3,2L OD -12 IL11 -zk,n 7 4! - 1 `G2, _ r _ J f z0cct-3? -1R'5,751t) 2©�l-19,-1tb,2O►�2118 ?Olb-!181.�217. 137 139 2 01 '9 25 Reviewer to complete the following: Square footage of Use: 2 Y I Z 0 Y/N j Rt5'!ctJMvgl�f Permitted as: � cfQ lv( � Under Section: Z 5, A, Z Supplementary regulations section: Parking formula: 5 5 5110001k9 C t°�►7 r Required spaces: Y/N Items to be verified in the field: Inspector : Date: Notes: Proffers: Y/N If so, List: .LMA `93 -c` SP's: Y/N If so, List: S�' lt54�-e7 l 171% SDP's 26,013. 3.3z ee-,t-cj /2�5 If9, lq`r41, 1227 136, 1223 -70 Revised l 1/1/2015 Page 3 of 3 COMMONWEALTH OF VIRGINIA VIRGINIA DEPARTMENT OF HEALTH In accordance with the regulations of the Board of Health of the Commonwealth of Virginia this certifies that Gaitan, Adrian & Requero, Sandra is hereby granted a permitllicense by the Albemarle County Health Department to operate a Full Service Restaurant Trading as: MI CASITA SALVADORIAN RESTAURANT Located at: 312 Pantops Center Charlottesville, VA, 22911 Mailing Address: 815 Orangedale Avenue, Charlottesville, VA, 22903 Conditions of Permit (if applicable); Date of Expiration April 30, 2020 Casandra Styles u 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. Please Direct Questions or Concerns to the Albemarle County Health Department Environmental Health Services 1138 Rose Hill Drive Charlottesville VA 22903 (434) 972-6219 . W ynn. u V_.yc ♦.vn .. nu uw...y Chief Executive Officer Travis G. Hill March 28, 2019 To Whom It May Concern: �.n.0 uan Jeffrey Painter Board of Directors Maria J.K. Everett Beth Hungate-Noland Mark Rubin This is to inform you that a retail application has been received from an establishment that is located in your city/county. The following is the basic information pertaining to the application: License Number: 750444 Company Name: Mi Casita Salvadorian Restaurant Inc Trade Name: Mi Casita Salvadorian Restaurant Address, City, State & Zip Code: 312 Pantops Shopping Ctr, Charlottesville, VA 22911-8655 Type of Establishment: Restaurant Type of License Applied For: Wine and Beer On Premises, Mixed Beverage Restaurant Date of Receipt: March 27, 2019 You are receiving this email notification per Code 4.1-230-13 which states: "Except for applicants for wine shipper's, beer shipper's, wine and beer shipper's licenses, and delivery permits, the Board shall notify the local governing body of each license application through the county or city attorney or the chief law -enforcement officer of the locality. Local governing bodies shall submit objections to the granting of a license within 30 days of the filing of the application." Please feel free to contact our office at (804) 298-3767 if you have any questions, need any further information or wish to file any objections against the above listed application. Please be sure to reference the license number listed above. Thank you, Ricky Blanco License Technician License Records Management Retail License Section (804) 298-3767 - Phone (804) 213-4592 - Fax Ricky.Blanco@abc.virginia.gov 2901 Hermitage Road, Richmond, Virginia 23220 1 804.213.4400 1 www.abc.virginia.gov