HomeMy WebLinkAboutCLE202000137 Application 2020-10-08y oti A;e
�a"� rliev Albemarle County
Zoning Clearance Application Community Development
:i M
401 McIntire Rd, North Wing
. Chadotlesville, VA 22902
r�RGM�� Phone 434.296.6832
FOR OFFICE USE ONLY Clearance Number: CL<-' A0.Z 0
Fee Amount: $ 54 Date Paid: ��� J ;L O By: A/1 R�"" 1 � f ' ' ��f . -z`
Receipt #: , a �/ Check M �� Z By:
Applicant - Fill out the entire page below py th�eAlbemarle County
G , A
And return to Community Development 401 McIntire Rd, North Wing, Charlotte, Vblopment Department
rcl- %,-,3
Name:
q �itJ 0.r tT
E-Mail Address.
R hi a r z Te
Mailing Address:
1-132-rArt- �nct Pr Glt"7Tes//lc /A
Phone#:
y�y' y'°9 .Y78s
Tax Ma and Parcel
P
yisii
Gy(oB.2-o/-Oo-G�.Zfio
Zoning:
G O
number and/or Address
/S3.1ZL1wG
Staff wllfill out Itunknown
of the Business:
v,% Z29/I
Parcel Owner:
fs LLG
Owner's Address:
/ r �� e
Check any that apply:
F New Business ❑ Change of Use (}Change of Ownership Change of Name u�t/
Business Name:
� n a^ce the
Describe the business including use numb( r'of employees, number of shifts, availability of parking, and any additional info.
Description Of Business.:
`y t � U7Arv�
r .L T2 T A(�i i t �� tl 5i t {s 4fn i4S
- Cats
33
Previous Business on Site:
fJar N s r�+frylot nc c e-cr%
Floor Plan:
Please attach either an architectural drawing or a sketch of the proposed business indicating the location of uses, the
-
uses of rooms, the total square footage of the use, and any additional information.
Total Square Footage Used
for the Business:
%
Is the Parcel Zoned LI, HI, or PDIP?
❑ Yes re-�Rlo If yes, fill out a Certified Engineer's Report (CER)
Will there be food preparation?
❑ Yes 1I rNo If yes, provide Virginia Department of Health approval
Is the Parcel On public water or private well?
[ePublic ❑ Pnvate If on private well, provide Virginia Department of Health approval
Is the Parcel on public sewer or septic?
'Public ❑ septic If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
Will there be
Yes No If yes, obtain appropriate sign permit and list permit #below
new construction or renovations
ves No If es, obtain appropriate buildin ❑ � yg permit and list permit # below
Please list any applicable Building Permit #s:
Zoning Clearance review cannot begin until the application above is complete and all applicable forms and fees are submitted.
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
abide by them.
them, and thattII
will
SignaturePrinted F12/7 ) i'(/4XrPel'
Date A=
2
For Albemarle County Staff Review Only
Proposed Use:
6
Permitted:
Yes ❑ No
Permitted by Section:
yt 5`�p p�rZ
Supplementary Regulations:
--
Applicable Special Use Permit (SP):
Applicable Razonings (ZMA):
Applicable Site Plans (SDP):
/ qq _ ( Z
Parking:
If there is an approved site plan associated with the parcel, the parking requirements will be defined by the SDP. Some
parking requirements are determined by a ZMA or by an app ved Code of Development.
Parking Formula:
(, LOO
Defined by:
to Plan ❑Zoning Ordinance ❑ CoD ❑Existing
Total Square Footage of the Use:
7 Z
Required number of parking spaces:
q,� CC !'vvi /J _[1 _ D r
�c.c�_
Associated Clearances:
Zoc _ 76
Variances:
Violations:--"
Is a site inspection necessary?:
❑ Yes Cg4o
Site Inspection on (date):
--
To Confirm:
V
Notes:
Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas Trees
Approval Information
Approved as proposed ❑ Approved with conditions
❑ Denied
❑ Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117
❑ No physical site inspection has been done for this clearance.
Therefore, it is not a determination of compliance
with the existing site plan.
i
❑ This site complies with the site plan as of this date.
Conditions:
Additional Notes:
-
Building Official
Date_
Zoning Official
Date
Other Official
Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4
Zoning Clearance Application �YI° Albemarle County
Q Community Development
401 McIntire Rd, Wing
GhadotlesviY229e, VA 22902
'�HGIti�P Phone 434.296.5832
Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either
informed or are going to inform the owner of your zoning clearance application.
CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN
PROVIDED TO THE LANDOWNER
I certify that I will provide (or have provided) notice of this clearance application,
GL�%i20 - 13? Na rr J 5'111 le �pn �
clearance number provided by Staff or business name
to MY Pre-p"T rc > LL the owner
Name of landowner on record
of Tax Map and Parcel Number GYG Ql - 0/-01 -"1144' by either delivering a
TMP number of property
copy of the application to them in person or by sending them a copy of the application by
mail. (Please check one of the following below)
Hand delivering a copy of the application to the owner identified above on
Date
E'r Mailing a copy of the application to the owner identified above on
Date to the following address:
ZqS-Wil-e,1 Bc.r/ oZ--, CiiA,ilT7ejt,0t( z19//
(Written notice to the owner and last known address on our record books will satisfy this
requirement. Please see staff for help determining this information if needed)
Signature of Applicant
Applicant Name Printed Z-3)an;e) Narixr
Date 5Jy4/--mo
3