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HomeMy WebLinkAboutCLE201900076 Action Letter 2019-04-25APPROVED Ly the Albemarle County Community Development Department APp lication for Zonin Clearance �Y �L�, CLE # _, lL 1 — � A � ��RGINIP�� PLEASE REVIEW ALL 3 SHEETS OFFICE nUSE ONLY A Check #vK D D 0 Date: L4 - Q ' I Receipt # Staff: ' Z,<.�✓ PARCEL INFORMAyTION Tax Map and Parcel: Existing Zoning t6t VJ tl tP I V C Parcel Owner: ESY-cLyi t,4 tk) i V1 t', (C�30-Pe+erJe_�:Fei-sotv) Parcel Address: Su i-e. t'z 0 Ctty Ch6ty ���` I �e—State 'r ', Zip 2 G (include suite or floor) PRIMARY CONTACT r j Who should we call/write concerning this project? {� n q�,_l(,4 sr _ a t^,0 -, J State p Address :� L-� Yi ,�S lQvd � ����-� �?� City /( ��- Zi Office Phone: ) 3 _S Cell # Fax # E-mailk�a, APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: _P1 e r--e, (� Y­O c. , (2L LC_ Previous Business on this site M ecb I cei I T rO GC- C n r• AA I,4,13 c r_O u iyi P_) Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of ve icles, and any additionali4formation that you canprovide: c_,_,c >,)sweayne k_ nC sk 2E5 C _ve ,, *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 accurat e best of my knowledg have read the conditions of approval, and I understand them, and that I will abide by them. Signature 4e. Printed pOVI Q 1(4 F . M e rcL 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 117. [ ] 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 Date Z ©l Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Y /(N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / 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 public water' --� If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that ap Is parcel on septic o blic sew Y / 6) Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y /CNN Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to comDlete the following: Reviewer to complete the following: Square footage of Use: I IQ S F Permitted as: t Under Section: t� (0�`-"S,O'r-t I OWT-C c Supplementary regulations section: Parking formula: ' 17,00 Ai S-F Required spaces: Y/N Ite be verified in the field: P L (SO l V Ict Ce O V� a6t f Inspector : Date: Notes: Viol ns: Y /U If so t: V N OU offers: / N p q Oso,List: % 3 'Z-M$ - �2�Q - Vari e: Y/ If so, ist: �.'t V P's: Y N so, List: ZOOO 37 �(eswi , Clearances: P LE 7 D 1 ,5 SDP's 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, _ZQ in r' ��(f� Qa r-Oy re- C L E -i-J-- [Cdunty application name and number] was provided to � �- the owner of record of Tax Map [name(s) of he record owners of he parcel] and Parcel Number 0 ` 7 ? 00 00000 by delivering a copy of the application in the manner identified below: l 7 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 to -Em V d L. m) i v7P � R14 1 nAC'F" [Name of thelrecord owner if the re ord 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 (% �/— 0 `/ 201 % to the following address: Date 36 [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]. AA - Signature of Applicant lDovialcl � . -Py eyz,e Print Applicant Name Anal, I 3 2U 1 Date ' I-d xz� 00 ] L0 Ul O f�yWLr) wa� WO E, a W�a oU (8"IVDS Ol .LOIN) 1` V-ld FIDVdS GNIV INOIJ VDO-1 d .LIUIHX9