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HomeMy WebLinkAboutCLE201900145 Application 2019-07-19Application for Zonin Clearance`:"��x } CLE # dOl o 1 tI5 5Leo 16(313L�;g2 I13.y OFFICE SFF,�.ONLY ` PLEASE REVIEW ALL 3 SHEETS Check cc Date: rp 2-q ( t.q Recei # Staff: PARCEL INFORMATION Tax Map and Parcel: C- y— qC.j Q Existing Zoning n,?C� Parcel Owners x�7 V_Z0 O-LLL LL_( Parcel Address: Rio +1`'`y l G tty ` C� �� State',JA Zip (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Address: SO&A Ccu.9-1 City_ Nt'w70�7 AJI%mS State Zip 7%pc2 Office Phone: Cell j# r (r��i`HEj Fax # E-mail 1eeSP..,C&�)e a) Apr Syewp 1 lJl� — � � C14CfC. APPLICANT INFORMATION Check any that apply: _Change of ownership Change of use Change of name _JNew business Business Name/Type: Previous Business on this site Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide: I-AS'7 ChSut,�L- Sb r'cx7,�> / ZS 6>4? / fosfrtF75 Sltc'�G Ctt- tzL ?b41i-0L *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 �tst o�ow have read the conditions of approval, and I understand them, and that I will abide by them. t e Signature Printed r� E-t5 C AGc,6- AP7ROVAL 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 Zoning Official Date -7 — Other Official V / U 'L., if ('I ( Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 62v(j-/7?d Revised 11/1/2015 Page 2 of 3 Intake to complete the following: Is Is u LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. VN 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 o ublic water? If private well, provide Health epar ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that appli Is parcel on septic or Cublic sewer 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 # 6 2bt`!- 01770 4'ek,ck4 i p- L 4 Reviewer to complete the following: Square footage of Use: r• Q,pS��v�u�ts m tted as: plC. Under Section: 25, , 2 1 -2 2 • Z , Supplementary regulations section: Parking formula: I ppb 9Fg `Z 6 S�D4C,es Required spaces: Y / N Items to be verified in the field: Inspector : Dater` Notes: Zoning to complete the following: V'olations: '_ L 10,f 1 Proffers: / N GZii �Xvs-ok�J,Y� N Ifso, List: so, List: Zvlo2O16 00-IK 773 2015--8 ( �µAzeo3—cog it (SR - Z3 7-Vic 2-ot 5 ­29, Zat 5 -79 Zc�r�31, -vit - 3 0 (l 14'9-7 ' D7 `Z-'v(0Z0/O_1Z3v, 2_o1v-16?,, 20o7-t6 ariance: SP's-/? Y / N Y /,N so, List: If s� List: Clearances: SDP's Z©li_ 10, 20 q-Sv, Z012-_03 Z©I2_L L'l X`Z, 2et7- g Zor7-l3u 7SgcjC5�6-!o s,, �`P��r-ice( Revised 11/l/2015 Page 3 of 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. 1 certify that notice of the application, was provided to [County application name and number] [name(s) of the record owners of the parcel] and Parcel Number manner identified below: Hand delivering a copy of the application to the owner of record of Tax Map by delivering a copy of the application in the [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 [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 to the following address: [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]. Signature of Appli ant Print Applicant Name Date B.'33 M - ) q7:�o,4c- COMMONWEALTH of VIRGINIA In Cooperllion will) the State Department of Health Phone (434) 972-6219 Fax (434) 972-4310 Reese Cagle Skrimp Shack 5460 Brickshire Dr. Providence Forge, VA 23140 77truiues Jcffersr»> Health District 1138 Rose Hill Drive P. 0. Sox 7546 Charlottesville, Virginia 22906 .tune 1311' 2019 At BEMANLE - CHARLOTTESVILLE FLUVANNA COUNTY (PALMYRA) GREENE COUNTY (STANARDSVILLE) LOUISA COUNTY (LOUISA) NELSON COUNTY (LOVINGTOII) RE: Plan review Approval for Skrimp Shack located at 1970 Rio Hill Center Charlottesville, VA 22901 Mr, Cagle: The plans for your proposed restaurant have been reviewed and approved by the Charlottesville/ Albemarle Health Department based the plans and answers to the plan review packet that you submitted May 29"', 2019. Below you will find additional information to have in place before a food permit can be issued. 1. Ensure all electrical conduits, pipes, soda lines, electrical cords/conduits, and drain lines are sealed, Ventilation and exhaust intakes are to be protected, and electrical cords are located at least 6" off the floor and behind and / or below equipment whenever possible. 2. Light bulbs / lamps shall be shielded, coated, or otherwise shatter -resistant in areas where exposed food, clean equipment, utensils, and linens; or unwrapped single -service and single -use articles are located. 3. All floors, floor coverings, walls, wall coverings and ceilings shall be designed, constructed and installed so they are smooth and easily cleanable, except that antislip floors or applications may be used for safety reasons. Where floor drains are planned, floors are to slope to the drains. A copy of the Virginia Food Regulations which govern food service facilities in the Commonwealth can be found at the following website' http://wvnv.vdh.virginia.qov/EnvironlT)entalHealth/Food/Requlatior�s . Please call me to schedule an inspection once all the equipment is in place and fully operational prior to opening, at which point your annual permit to operate will be issued. if you have any questions pertaining to this matter or wish to schedule an inspection, please call me at (434) 972-4304. Sincerely, Reed Cranford, REHS, CPF Environmental Health Specialist, Sr,