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HomeMy WebLinkAboutCLE201900187 Action Letter 2019-08-26GPPROVECj .. •ti 1. „i , ,epai is 01,5 LfLl I � r;L4 ApphCatiOfl lOr Y'Ji1,111iIi �1CQ1 Qlll, CLE # I pI _9'L' OFFICE US ONLY PLEASE REVIEW ALL 3 SHEETS Check # Date: Receipt # Staff: PARCEL INFORMATION ��L existing Tax Map and Parcel: ts, (b Zoning DC {/ Parcel Owner: ��, � �,!l �%-� s t� L cj Parcel Address: `J l l v.2 S ,,C'e— City .1—b LC State �/ � Zip _ (include suite or 91 �14L PRIMARY CONTACT Who should we call/write concerning this project? Y1 C-Ar O �� �C= City Address: ��C �x �j` ell y C f-Q"Ze—� State N) Zip 2-UA Office Phone: (X'I) ?jj ' 3 Cell # 'jC'Lm t— Fax # E-mail-&xtYYLI% tl t-ne�j APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: Previous Business on this site 1^713sc Describe the proposed business including use, number of employees, number of s 'fts, available parking spaces, numb of information , vehicles, and any additional that you can provide: '60l YI 1Pr J � ►� `c -�' atas � er- *This tlearance 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 ermission to use the space indicated on this application. I also certify that the information provided is true and accurate to the best of my w d j have read e con �tions of approval, and I understand the , and that I will abide y them. (II a ,,00 Signature �( � Printed tvet? APPROVAL INFORMATION P] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-45 11, x117. [>4:.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 13 �t y 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 11/1/2015 Page 2 of Intake to complete the following: Y /0 Is use LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / Wil Sre 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 epa ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that appI' Is parcel on septic o ublic 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 Pen -nit. Permit # Zoning to complete the following: Reviewer to complete the following: Square footage of Use: 500 YEN miffed as: t L e Under Section: ZO igo L Supplementary regulations section: Parking formula: (000 S F 206, Required spaces: I Y/N Item be verified in the field: S k�,, --cd P� ��1� Or, Inspector: Notes: Date: iolations: /N f so, List: _R U l 0 zo ( 3 31 Proffe Y//•I If so, ist: J1/v�e Vari ce: Y/ If so, ist: � / off SP's- Y/—L If so�ist: Clearances: ,, f � � A,�l � ' ( SDP's Revised 11 /1 /20l 5 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, was provided to [County application name and number] [name(s) of the record owners of the parcel] and Parcel Number manner identified below: the owner of record of Tax Map by delivering a copy of the application in the 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 [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]. -( - J�- Signature of Ap licant J Print ApplicAnt Name , - 3 -I Date V"