HomeMy WebLinkAboutCLE201900296 Application 2020-01-024�/
APPROWD
by the Albemarle County
Comm
unity D"OPment Department
Application for Zoning Cl0W_ane
__
CLE# % 67a ,/
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Check # '1 Date: (� /
Receipt # 0,0 _ Staff:
PARCEL INFORMATION �y
Tax Map Parcel: +5 / A"
and Existing Zoning
Parcel Owner:
Parcel Address: 1950 RIO HILL CENTER City CHARLOTTESVILLE State VA Zip 22901
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? HIEU PHAN
Address: 1950 RIO HILL CENTER City CHARLOTTESVILLE State VA Zip 22901
Office Phone: () Cell # 7039457958 Fax # E-mail TOPDESIGN919@GMAIL.COM
APPLICANT INFORMATION
Check any that apply: Change of ownership X Change of use Change of name New business
Business Name/Type: T AND C NAILS 2
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:
NAILS S.A.I 0N, (a) €MPLOY€€S
*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 the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature wz¢Z4 Q.yL Printed HIEU PHAN
AP,VROVAL 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
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
�Z-oth - D3Z9 5-A C
Revised 11 /02/2015 Page 2 of 3
Intake to complete the following:
Y/N
Is use 'n LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
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 o ublic �water.If private well, provide Health eform.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that app '
Is parcel on septic or u�sewe,?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
W/ N
11 there be any new construction or renovations?
If so, obtain the proper Permit.
Permit# 0'2—D(� d 32- 9-Ac
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use:
Y rmitted as:
Under Section:
Supplementary regulations section:
Parking formula:
I � god y�s1 t ��P'�PtvJ t�
Required spaces: ( S S ct�Z. S
Y /
Items to be verified in the field:
I�6Pc �a�e S I cf4 (-c- S
Inspector:
Notes:
Date:
iolations:
/N
so, List:
l�c.ab�e
offers:
Y/N
so, List:
2 3 �
-Z
Variance:
Y/N
If so, List:
V� cq�j3 4 S q�,
's:
Y/N
soList:
, 5( Zook 31
Clearances:
Gie ,
SDP's
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rg .e�GI c ifs
Revised 11/1/2015 Page 3 of 3