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Home My WebLink AboutCLE201900120 Action Letter 2019-11-20Application for Zoning Clearance T CLE #� IC1 - I �0 PLEASE REVIEW ALL 3 SHEETS OFFICE US ONLY Check # Date: (D ` 4 ' 19 Receipt # Staff: PARCEL INFORMATION f Tax Map and Parcel: �� (� IC is Existing Zoning P��'iYltt�r Dt�/P'/3�'' Ac-i-l'Mit. Parcel Owner:.`��c=' c1i— C.I(SVI-$t��yy�yy `•�iW� tr�jc�� 1-.I--� Parcel Address:31.5 ,la� r��tStte %% ipcemcx:L (include suite or floor) PRIMARY CONTACT f� Who should we call/write concerning this project? Address :_� ),755 TcA) 6yn Pr;yi City(:h4r loy k!;v)llie State V` q Zip Office Phone: !� Fax # E-mail APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name ✓New business Business Name/Type: �� ` y) —2con°-) Previous Business on this site T\C. r; jYISrCAe- lc- t 11 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: j kk i1'f Ae T tXAkri' b"e I'zi ✓lc.•l'►1!1%Zi *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or rnove the new location, a new Zoning Clearance will be required. I hereby certify that 1 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 he best of y knowledge. I hav ead the conditions of approval, and I understand them, and that I will abide by them. Signature Printed��,�+ 0.3� APPROVAL INFORMATION Approved as proposed [ ]Approved with conditions [ ]Denied ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-45 11, xl 17. ><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 << Other Official �eal Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 Revised I I/1/2015 Page 2 of 3 Intake to complete the following: Y Is U31 LI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified N W' I there be food preparation? f 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 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 appli s Is parcel on septic or 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 Permit. Permit # Zoning to complete the following: Reviewer to complete the following: Square footage of Use: 1 v3 J/ N Permitted as: Eaffnq eSjfa61(S1,rken tV Under Section: 15A Z �% 2 - Z • (S �� Supplementary regulations section` t1 f A - Parking formula: eeV, �m fez ii1 {P J Required spaces: 9 Y/N Items o be verified in the field: Inspector: Notes: Date: Viol Y/ If so, ist: (lme Auk of p-4I I¢ Proff s: Y If so, is /t: Vari ce: Y / N) If so, ist: N o�Ie SP's- Y /i If so, ist: None Clearances: GLF -2.OIz-(OZ txOL �ar)s4e SDP's zoo -7ZZ Cja&r(wi Vtft4 ft Ile 200? OWer l..&4,) V 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, 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 cant ��-4 �j Print Applicant Name 1z-ee Date _fit jo �n Wxi&W-9m ci 1-7 I i ' n l' f- rn+' COMMONWEAL TH OF VIR GINIA VIRGINIA DEPARTMENT OF HEALTH In accordance with the regulations of the Board of Health of the Commonwealth of Virginia this certifies that Pap N Zan's LLC is hereby granted a permit/license by the Albemarle County Health Department to operate a full service restaurantt Trading as: Pap N Zan's Located at: 375 Four leaf Lane #101 Charlottesville, VA, 22936 Mailing Address: 3155 Malbon Drive, Charlottesville, VA, 22911 Conditions of Permit (if applicable); Date of Expiration vember-30, 2020 Environmental Health Specialist, Sr: THIS PERMIT IS NOT TRANSFERABLE FROM ONE INDIVIDUAL OR LOCATION TO ANOTHER New owners are required to make written application for a permit Please Direct Questions or Concerns to the Albemarle County Health Department Environmental Health Services 1138 Rose Hill Drive Charlottesville VA 22903 (434) 972.6219