HomeMy WebLinkAboutCLE202000026 Action Letter 2020-02-19e
APPROVED
by .1'1.lbemarle County
omr-miniZy Development Departmnt
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Application -for-Zoning---pranceF
CLE #
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY Z�� Z �2�
Check# Date:
Receipt # ' Ztj�(o Staff: G
PARCEL INFORMATION
Tax Map and ParcelGj w_� 3 ' �� Existing Zoning
s� ����
Parcel Owner: �_X..- L' iV,loIC ���ic t ✓J( ii L&)
Parcel Address: L Yn i VA t �CGt� City (�6�%L0 1,(JWtittate // ZipQ
(include suite or floor) , Yy
PRIMARY CONTACT
Who
should we call/write concerning this project?
Address: C-7Y6L�&4 vt tnuC\CY,eS �,) City f-Ria M State Zip 2J Z.33
Office Phone: (_) Cell #434 `%_1"6zy2i;ax # E-mail _LO64m AOVARs� 719,
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name �% New business
Business Name/Type: L L L
Previous Business on this site im C sm d
Describe the proposed business including use, number of employees, number of shifts, Mailable arking spaces, nu her o
v hieles, and any information �
additional that you can pr vide: a.v4 6� i h. kivt tz ct�,�ci Y��cz
3ew,
e f -1 CGv��51.� o� v �� � Ip� u,
*This Clearance will on y 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 certif 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 accurat the best of my oiwledge. I have read the conditions of approval and I understand them, and that I will abide by them.
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, 977-451 1, x117.
b,o�tNo 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 ?11i1�
Zoning Official Date M I I l ZO ZU
Other Official Date 4.,e
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Revised l 1 /] 12015 Page 2 of 3
Intake to complete the following:
,Y// N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y'fN
W i 1 t re 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 obli ater?
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 applies
Is parcel on septic or 15ubhv) sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /'N�
Wil�tfiere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Reviewer to complete the following:
Square footage of Use: 4115
L�xbctaEo>ri�S ReSettrLh r
Y N
ermitted as:
.T
Under Section:
Supplementary regulations section:
Parking formula:
ll�f—ac&ye�,CQ
�e�ad c�PP1 b �pvol;C
Required spaces:
Y /(N
Item be verified in the field
Inspector:
Notes:
Date:
Zoning to complete the following:
Viol tions:
Y/
If soist:
7(9YV
n�>7
ZA,% A Zoo 3 oov0 6
6 ariance:
I
SP's:
If so, List:
A t Jgj 000 Z-Z
M/N
so, List:
S P 2-004 C000-3 l
Clearances:
C,1� z�iY oo I71
SDP's
5 0P
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,
[County application name and number]
was provided to the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number
manner identified below:
Hand delivering a copy of the application to
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 Applicant
w � t -D / A
Print Applicant Name
Date
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