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CLE201900272 Application 2019-11-26
A(Tpj#ation for Zoning Clearance°FALL CLE # 1;0a a. 7RGIN�P PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY / Check# Date: « 2Z Receipt # S Staff: PARCEL INFORMATION &4- I l W ©� 0 3-- l q A-U � Tax Map Parcel: -- '" and R „Existing Zoning Parcel Owner: ©(_ j ti✓�,� �, f�r ��t f . ` L L Parcel Address:_:?z,-7S' 51E ►SQ City �Ih�:rig 5r 1��. State V; Zip 2ZJQd (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? Allmkr Address : 73Y 6-9lfJ43T Aj l,�--Nx Ci Q+��� V p ty C%i4���J /��' State Zi Office Phone: Cell # 4'`%s`�Sl� Fax # E-mail fart✓tC�'�� +n APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name/Type: C Ina M R; ao, 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: e mp -pi's 7- 4 i-�� '.s rwy•��:i yi J .SlnLf1h11.•c c.,['y�i�cr *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 to>tes knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. t Signature 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. [ ] 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 & 2 Other Official Date county of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 t3 2 0 Z 5 - p 2-15"(— 5 Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Y U'� IsuLI, HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y// 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 lic Lw�ate If private well, provide Heal t form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic or is se N ill you be putting up a new sign of any kind? If so, obtain proper Sign permit Permit # 7_0 ( - 0 2-gcL (— S 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: �j 3 3' C� Permitted as: Under Section: 'UM O C O s O/ Supplementary regulations section: Parking formula: S G � 6Gp — c Required spaces: Zp 5r0 5 Y/N viol ns: Y ' �/ If s , ijjj ist: c ers: Y N -Ifso, List: —07 Var' . Y/ If so, ist: S is: N so, List: Clearances: 2-524 - 2- �, - 2-3 �� - 2 Z 0 SDP's - 20 �35 G zd -aZ 197,- (�-3 .-1? 03 2otib5;-32,� Gc ; ,e 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, 0*yonf [County application name and number] was provided to C�C% ��%��iE� G ' t1ES �I �' the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number by delivering a copy of the application in the manner identified below: �y "1Z Hand delivering a copy of the application to a7 Ft4 -o , X0P5C7- ,/ *A). (e [Name of the record own r 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 0 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 Applicant Print Applicant Name Date 4BbbiY '••4�Ofl Iomy�iN»V >"140AA W 44M--owwoO PN4a 'l �48 041 ylea�ooy uold �oLi w++o�o I AL r waftu 'o'd 'e;ookyo�y •eayaposay douoo� u4or M W� I IMP JYI :I Ic'_ii�!�I ♦ ♦ 1 1 I� � I� a. UI!'��ii Q®' ♦ � 111 1 1 It It I ' I'1 . ♦ ♦ � 111 � it I� III P .. ------------ i_ I� V I�I� U�■A�'www4 ELI ■w 0 V 1 6 1 IS NU t: I Ht INFUKMA I IUN JHUWN UN I HIS UUI;UMtNI SHUULU Ct I;UNSIUtKtU AF'F'KUAIMA It ANU SHALL NU I bt UStU FUN UUNSI KUC I IUN UK LLUAL NUf<F'UStS. 1T 2 3 4 5 36'-2D cT � \C G 6'-7D O I I I O \I G W i W cl co_ 675 SF ± PATIO o o O I i ! 0 O I • O 1' D g co ------------ 0 16' 1/16" = 1' NOTE: ALL DIMENSIONS ARE APPROXIMATE AND WILL BE VERIFIED UPON FINAL DESIGN. -� E-D1EN STM UNIT 328 SHOPS AT STONEFIELD Suroaaoo67200WFa0onslnAvenue 0Beffmcla,NO020814Phone: 301.552.74000Fox, 301.852.3588 05-03-13 IDMWNBY I Buis AS SHOWN mnconahuceonv l0pW0osuauc AMel5tonen&Id%cWW0D1323 LOU IQ.0" rioma Dy: I oae Pmns on 3mayl4 m ue:ve:G rimw ;a-meyis, W:W:.