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HomeMy WebLinkAboutCLE201900261 Action Letter 2019-11-15Application for Zoning Clearance®"�� CLE # PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # $37 Date: Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 0 Y_' O Q — QD •- QQ - Q Existing Zoning_ r Parcel Owner: Parcel Address: 960 H//-y,-J P )-t°t4-,�S JU City( {A&---JU lJs/k State 11A . Zipdd (include suite or fl r) PRIMARY CONTACT J� �- Who should we call/write concerning this project? /C "',sc J j / o 1 Address:- 9(a � it " Ppi f ,Q,(�_ city t%NA/`LO• e,,Su tate Y4 Zip APO J Office Phone: (� Jbd_PP&� Cell # 70/'9ol%-8YIM Fax # 9,?q- M-I/-mail APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name business _New Business Name/Type: U MAt)Sky St ( 613/►i/L && 'SAIrs A � P -�P(���� Previous Business on this site &&IIJA2 �,A1 j,Ql to 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: _� A4,0r Or- A)WOYJon *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew Zoning Clearance will be required. I hereby certify that 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 best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signaturelk� 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, x117. >1 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 ri U15 1 2-0(? Other Official Date -.uauty of Amemarie uepartment of Uommunity 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 LIs LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y Wil ere 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 ublic wate . 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 appI' Is parcel on septic or ublic sewer /N ill 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 # Zoning to complete the followinL-: Reviewer to complete the following: Square footage of Use: e_-5 h t,,4e � ; �� ¢ /N -miffed as: Moto( Vetiicie SL���si 5efvi�t',rE Under Section: 24 . Z . I Supplementary regulations section: e���ce S"11 Parking formula: �' S �'1a�1 — Er,PIG"fees 5 pa7 q �"cct Required spaces: Y/N Item o be verified in the field: 2q3 raCCs '? S e a(cc 4 i 54 e- Ian Inspector: Notes: Date: Viol ns: Y / Ifs st: None ie - dfliq Prof Y / If so, ist: Now Vari rice: Y /N/' If sol..1%ist: I V 0n 's: N so, List: 5 P -zoo pq[a Clearances: SDP's 2,yb3 l07 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, [County application name and number] was provided to �/1i�9�(.ZSh'4'�SGC LLB the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number nqDU - O0_ Q (- 66%Vby delivering a copy of the application in the manner identified below: © 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]. Signature o Applicant PU'S &.--- I l (,) j/ Print Applicant Name L y-J Date s i 7 } ®x•E LTUS HAKINS DESIGN ML' S } UANSKY SBARU , e e 960 Hilron Heights Rd E : }33 I i charloaes�ne vA