HomeMy WebLinkAboutCLE201900164 Application 2019-08-12-PPROVE" '
r6e Albemarle Couijiy
Daip
Vile C'
pp cation for Zo !-T�nkClearanc
CLE #
CLE # c �--
LL �TL 11
PLEASE AS; CF E'
'REVIEW A 3SHE SHEETS ,VIEW ALL 3 SHEETS
PLEASE RE 0 �Fl c—'1
0 ---FCheek # Date.
PARCEL INI�Y}tMA7'IO 1 Receipt Staff: Ak
��I 4) �A 1�'I O�
Tax Map and Parcel.
—0(?-
'07 0 — t OZOD
r C - — — y �6 ��. Existing Zonhjg—�� --r' �fA-R/-k V— V1- 11
Parcel Owne : 5
Parcel Addrm:-39.g MEP6QT5 VA(ly �—AQ
i iitN .
(include suite or floor} State VA
r) zip 2210
Sj$A� V,00 - �-4 460
PRIMARY CONTACT
I Who should we cull write concerning this project"
A16 kr'
I Address Citv ft),46,;-kc state zip
Office Phone:
4-q-) —U7 073; cell # 414.804 - 11( 46 Fax tfE-mail
APPLICANT INFORMATION
Check any that apply: Change of ownership _Changcofuse _Change
—_ofnanle _New business
Business Name/'J'ypc- En4;rA)0-At A —
Previous Business on this site 01L ocr-4'e-b Eet)Fo,2
Describe the proposed business Including use, number of employees, number of shifts, avail e parking spacT nymber of
vehicles, and any additional infornwtion that Nou can provide: 6,tN(-tf / V�AAft tZ�Wf 2AP U16ji It -
*This Clearance Will only be valid on the parcel for which it is approved. It you change. intensity or move the use to a new 1()C,.,(
Clearance will be required, ion, a new Zoning
I hereby certify that I "n Or have the omier's permission to use the Space indicated on this al)Pcalloll I also %:c'tjf)'tha[ the inforination Provided
is true and accururn to (lie best of it kn6*-1cd8c..l have read the conditions of approval, and I understand them, and that I will abide by them.
Signature/
Printed
APP�R 1, INF 9MA ION
] Approved as proposed Approved With conditions Denied
I Back -flow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511 , xl 17.
I No physical site inspection has been done for this clearance. Therefore, it is not a determination ot,compliance Will, the existing
site plan.
I I '['his Site CORIPlics With the site plan as of this date,
Notes:
Building Official Date
Zoning Official Date 5 t 9
Other Official (,.z A �v, jC,
County of Alberunrle Department of Community Development
401 McIntire Road CharlottLNville, VA 22902 Voice: (434) 296.5832 Fax: (434) 972-4126
Revised 11102/2()15 Page 2 of 3
Intake to complete the following:
Y /
Is u m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
,! N
ill 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 c wat
If private well, provide HalikrDepartment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic u
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 137-CIM - 0(6 SYrAC,
Zonine to com lete the followi :
Reviewer to complete the following:
Square footage of Use: `'Q6
tted as: rr-54( lIv 1
Under Section: 2-Y( 7-, ( --'> Z5 r 21( , S 16c
Supplementary regulations section: �—
Parking formula:'��0
a e la,k
Required spaces: VI�O
Y l 5 7`ls S CO �
Ite to be verified in the field:
Inspector:
Notes:
Viol ns:
ist:
z I/(B_ 2m 11- 2 Sb
� Fothd �
Proffers:Ifs
Ifs st:
Z A 2004 0'6'6 - c
P 7FR 2 2 A
Vari cc:
Y o
If so, st:
ZD Z C W i
Vtit✓Vt ,
SP's.
Y /
If so, Pist:
p
7-016 Z007 - 0
- 2.
----------------------------
Clearances:
� 7 � 17 2 ($
(p s 7
SDP's
2LIP 2 ? - 7- 5.4 2 O <7 ' 2
20(4-15
zm l S - 2-CO, - PTC, - I tf��
e . _ .1.11
{
2-60- B
2® -
20( - 2013- Z
�� P 76 Rt- 24evised i I/1/2015 Page 3 of 3
N
Suey
twt trvo scab
Magnetic
Not th