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CLE202000044 Application 2020-02-24
APPROVED by the Albemarle County Community Develop"nt Department Date _ 'Z ,-f --Z, Application for Zoning Cleara���� CLE #2Q2�o !2 ue PLEASE REVIEW ALL 3 SHEETS OFFICE USE ONLY Check#t! d'c Date: Receipt # PARCEL INFORMATION Tax Map and Parcel: 061O0 —40 — DO -- d 2-700 Existing Zoning G!' Parcel Owner: c.-, zg LJa &aUGT GG G � /%%,�4/V�� /LjE� JZI:r /jCE1 ParcelAddress:2-3.3 ffl/�jl,Q(iL/G Z03 City mill//LGE State %l,4 Zip2Zj(� (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? �E�✓1 �(�%) p� a 33 ) �J p��I Address : ��f(%1/11�, �)d��C: ��� City ���1�I��'(� ���� State � I Zi Office Phone:( C6) - 0(z Cell # Fax # E-mail r Ij' APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name t,"'New business Business Name/Type: �i9/Y!/oA/G�/ DGGrGE Previous Business on this site ,rlyi9177G72)J CG/i✓lG Describe the proposed business including use, number of employees, number of shifts, available parking spa)es, number of spa) vehicles, and any additional information that you can provide: 1�� G o"gp-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 / G Printed Ijm W 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. [ ] 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 Revised 11/1/2015 Page 2 of 3 Intake to complete the following: Y Lin)Ll, Is HI or PDIP zoning? Engineer's Report (CER) packet. If so, give applicant a Certified Y /%N� 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 or ublic Ovate 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 applie Is parcel on septic public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y Wi ere be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to complete the following: Reviewer to complete the V wing: Square footage of Use: 900 N DGl� (cu ltij�� pitted as: Under Section: Supplementary regulations section: — -- Parking formula: 'l zOe ,, & Required spaces: ' 5.VV,-e,5 Y / N t Items to be verified in the field: 014 Inspector Notes: Date: ViolQns: Y, J If so, ist: . Proffers: Y/N If so, List: Va rie: Y / Ifs 1st: s: Y N o, List: 2- ©© S— Z �L&Lf s b0 Clearances: SDP's 7-P17 Z-7 17 1i 2c?15-17D. -1Lo, -136� 7o15I2, Zaa-jb -170,-/w 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 tf ZUZ(-) — [County application name and number] was provided to � �ulnw L (c the owner of record of Tax Map [name(s) of the record owners of the parcel] and Parcel Number 06 (Oe w —60 -- p Z.? D O by delivering a copy of the application in the manner identified below: Hand 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]. Signature of Applicant Print Applicant Name zz Date