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HomeMy WebLinkAboutCLE202000009 Application 2020-01-30APPROVED by U* Albemarle County Community Development Department r,_ Application for Zoning leer-a.c_:� �_►'�� CLE # �,4 L a An; OFFICE USE ONLY FPLEASE REVIEW ALL 3 SHEETS Check # CGZ/: 1 Date: .� Zc3Z-v Receipt# I2yZK� Staff: AA-c— NFORMA I ,axapand Parcel: �( iU �� \ '�`1 ' �-i-�io Existing Zoning Parcel Owner: q Parcel Address: 0o �A, �� City � 4a), iktate Zi _ (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? P/ -,J 9V Address: �OC S City C� i�L(}3 SVI �1(-State �%� —Zip94 Office P one:(___) Cell #g3qM5Z&Wax # E-mail 5,7bo)-' Rq Q �r-r APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name ✓ 'New business Business Name/Type: Eiz)a:)r L.-�-- oc( ��- (ex_ C=d ? ✓f CACA A r fir« LA 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. - *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. 1 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 d/understand them, and that I will abide by them. Signature �� �eL I 1 � P �rinted )G�GP(S3-G/� ( _ p© 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 Zoning Official Date //'`Z;O Date I - 3o ,?- C Other Official V U n u �l'(�l u G( kt; - e-tM eri) k l - Z -- C, Date �' Z Z - 2 C County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 e'o n 11 0 Z d 20 a 00(2-0— Revised HA/2015 Page 2 of Intake to complete the following: Y / �N Is use in LI, 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 ublie water? If private well, provide Heal'tri-Depa ment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applie Iss� parcel on septic or Kublic sewer? Y)/ N Will you be putting u i a % new sign of any kind? If so, obtain proper Sign permit. - nn Permit # 2e4a— l 2 S Y Wil ere be any new construction or renovations? If so, obtain the pro er Pe it. Permit # `�. , 20 [T",5 53 - A C Zoning to complete the followin : Reviewer to complete the following: Square footage of Use: P16rmitted as: �Z a U(/44 Under Section: 2 l t( C. 5 t) C L Supplementary regulations section: Parking formula: ( I/Goo .i Required spaces: / N ' ns to be verified in the field: f 9 C ✓ l-(er (Cff f Inspector : Date: Notes: L�� t `6Vyuele PL ( 2CCCrS CCE 20(1 —54 Violions: Y//N If ist: Proff y/ If so, List: ------ riance: Y N so, List: SP's: y /� If so, ist: w (b 0� ci% -W d Clearances: _ z OL r 2 w(b_ z _��6 SDP's 20� - u ZOa7- l CrOZCA e (� P 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, C L % ? &11 LLB _ 0 [County application name and number] was provided to ! � Usir?t Cc the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number jb _ �>2A by delivering a copy of the application in the manner identified below: ZHand 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]. „n. Signatur of Applicant 11 - n;n� I _ EE» i r-I i —1 I I I_�- ! I - kit T=j �— i f -FTT-- I ! 17FF { 1 owni j to, FTI � I �', k � -1 � -7 �z �� Z � z�- a� Z 3 s C i- Itie .\1:111 �\Silid 11 1 Ull�t't - 1,llll ltk �A �iil ' � • i s: x S696 <r �. ver Lavjn Salon �r I -,x.:�T{�,R',�s. j��,�„r-'�5 •:r�sr�„ - �3ik Apr, �. x v