HomeMy WebLinkAboutCLE201700239 Application 2017-10-30Application for Zoning Clearance
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CLE # 17- 2
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OFFICE US ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL INFORMATIONtt.��
Tax Mapand Parcel:--
Existing Zoning l =L
Parcel Owner
Parcel Address: City _� C�pTiP5t111'� State \/A Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concernin this roject?
Address : City State U0` Zip qG
Office Phone: 6141 93\4 7q(e 1 Cell # (off Fax # E-mail CA 22(-, 1,CGvo- j
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APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name &----New business
Business Name/Type: <� C
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: 86,1(L , Om 0 — 6"le SLn 44 �� }
*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 at l own or have the owner's pennission to use the space indicated on this application. l also certify that the infonnation provided
is true and ace to to a best y ledge. I have read the conditions of approval and I understand them, and that I will abide by them.
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APP,,40VAL INFORMATION
pproved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117.
[ 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 /02/2015 Page 2 of 3
Ljonin$z 111calilliuc L,11ct-'1L115U
Applicant MUST HAVE the following information to apply for a Zoning
Clearance:
1) Tax Map and Parcel or Address, Building Name, Suite/Unit/Floor numbers, if applicable.
2) A Floor Plan - either a sketch or an architectural drawing
a) If using less than the entire structure, note the location within the structure;
b) Note the total square footage of the use;
c) Note the square footage of each room or area of use;
d) Note the use of each room or area of use.
FEES
Zoning Clearance = $54
Temporary Fundraising Activity = No fee
Conditions of Approval
FIREWORKS:
1. No person shall sell, offer for sale, store, display or discharge any fireworks in any filling station or on any premises where
gasoline or other inflammable liquids are stored or dispensed. (Code 1967 10-13.) County Code Section 6-200 and 6-300 and must
be a minimum of 100 ft from any gas pumps/propane distribution tank.
2. The site shall be cleaned and restored to its original condition on or before July 11 th. This shall include removal of all structures,
signs, debris, and the like.
3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications
subject to Zoning Administrator's approval.
4. Building permits shall be obtained for all proposed structures and/or lighting.
5. Sign permits shall be obtained for all proposed signage.
6. The sale of fireworks requires a special permit from Fire/Rescue department.
CHRISTMAS TREES:
1. The outside storage of combustible material or flammable materials shall be located so as not to constitute a hazard and shall not be
less than 15 feet from any building on the site. Any open burning must comply with the Virginia Statewide Fire Prevention Code and
the Albemarle County Code.
2. The site shall be cleaned and restored to its original condition on or before January 2. This shall include the removal of all
structures, signs, debris, and the like.
3. A thirty (30) foot front setback shall be maintained, Display shall be located so as to avoid traffic congestion. Modifications
subject to Zoning Administrator's approval.
4. Building permits shall be obtained for all proposed structures and/or lighting.
5. Sign permits shall be obtained for all proposed signage.
OTHER REVIEWS:
1. Is the property on public or private water/sewer?
Private requires Health Department, Public requires ACSA review (2 to 5 days)
2. Will you be operating a bakery?
USDA review is required (approx. 2 weeks but as long as 6 weeks)
3. If you are serving prepackaged baked goods but not making them on the Premises, only Health Department will review. (2 to 5
days)
4. If you will be operating any business that is in an industrially zoned district or of an industrial nature you will need to provide a
Letter of Performance Standards or Certified Engineer's Report (a staff member will provide an information packet addressing this
requirement) (5 to 10 days as soon as the Letter or Report is received by this Department)
5. If there has been no site inspection within the last three (3) months for the parcel/site, then one will be conducted to verify that the
project is in compliance with an approved site plan (if applicable).
Revised 11/1/2015 Page 1 of 3
Intake to complete the following:
Y 43
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /&N
Will 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 91 lie water.
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 li�
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit. L
Permit# peylrfls Sfc pgl� �pelml-
Y / N 1
Will ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: 100 'f tom'
Yj N
ermitted as:
O'Rl(,Pi
Under Section:
ZZ.Z
Supplementary regulations section:
Parking formula:
�' Z0o NET — �-
Required spaces:
If
Y N
Ite to be verified in the field:
Inspector : Date:
Notes:
Violations:
Y / N
If so, List:
Pro s:
Y
Ifs , ist:
lance:
Y N
o, List:
SP' .
Y
If s , ist:
�R7�j_ tl
Clearances:
SDP's
Revised 1 1/ 1 /2015 Page 3 of 3
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