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HomeMy WebLinkAboutCLE201900290 Action Letter 2019-12-26�N� APPROVED by %eAlbemarle County �ornmunity Development Department Applicat*-oon rX_o_J, arance ��t A` � Ei CLE # - �1 R l O � `t r- PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check # oL D Date: I Z-Gt Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: 7$-� (0,)- Existing Zoning C Parcel Owner: G7(� Parcel Address:l65fl sfak 'f i? fm> AI✓41e City arlo t/1 a//te �_ Zip floor) �)C)r (include suite or �if'•t. � "� 5CeOA4,A( PRIMARY CONTACT J� Who should we call/write concerning this project? A) kla f � �'� /� Address: �5 k'Ljif-Cblof� � t rtf e CityWo*'-/c !/� State L104 Zip Office Phone: U Cell # ! / ! <�iax # E-mail ' ' , ✓Z°L',t/ �j't1L�c�� APPLICANT INFORMATION Check any that apply: Change of ownership of useChange of name New business %Change Business Name/Type:Ol Previous Business on this site Ae—r Q_ {Q e Lf I 1 G"_ Slac' 9t� Describe the proposed business including use, number of employees, number of shifts, vailable par •ng numb of 1 �s��l��ces, vehicles, an a y additional informati n that you can provide Tyf.• t~ 13 t? L 7 Gt *I1is C I epkiFce wifl only be va kd on fh e 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 accurat to the best of my knowledge. I have read the conditions of approval, a d I understand them, and that I will abide by them". Signature Printed APPROVAL INFORMATI Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl 17. [� o 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 12_ Zli / 5 Zoning Official Date t Z � ZC>1 9 Other Official Date l,ounty of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126 Revised 11/02/2015 Page 2 of 3 co< Intake to complete the following: Y /a Is use m Ll, HI or PD1P zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y NY W i Ohere 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 Depa in form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that ap 1' Is parcel on septic of public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y /© Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to comDlete the following: Reviewer to complete the following: Square footage of Use: l!/ � F ..Bdrmrtted as: Under Section: Supplementary regulations section: ev Parking formula: U 0 �v 5 C Required spaces: 4 Y / N Items —to be verified in the field: s i ir- �a rrL`'2 Inspector : Date: Notes: Viol ns: Y / If so, st: (xJ 0n�e offers: �/ N If so, List: nN%A Varrice: Y/ If so, st: � f C) � SP's Y/� Ifs , tst: NO Clearances: Ue 109 1 OO ZS SDP's No 4jc (g) a-' (CAA+ "'G-f �,u+ Revised l l/l/2015 Page 3 of 3 ON 0 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, 'q [County application name and nu ber] was provided to 6 %J f � .! & Lam, k-C the owner of record of Tax Map [n e(s) of the record owners of the parcel] and Parcel Number manner identified below: 7�r - 602 by delivering a copy of the application in the Hand delivering a copy of the application to 5y544 p A&I'l S. I►"IG30 of Q6f [Name of the record owner if the rec d 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] KU1 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 Iva Print Applicant Name /,�.7,//?/9 Date