HomeMy WebLinkAboutCLE202000154 Approval - County 2020-11-20 (2)y OF
�_� r Albemarle County
Zoning Clearance Application �m�"` 401M ntni Rd, North Wing
ChanotlesNlle, VA 22902
yAO1MN Phone 434.295.5M
FOR OFFICE USE ONLY Clearance Number: C L, a 0J�-0 OO L F�
Fee Amount: $ 54p - Date Paid: � l / � b l)-Q By: `J eJAL/ x (�C 0 re l—
Receipt#:�GT-76)1i)K-NS1,73 Q Check#: l/�`C7
By:
Applicant - Fill out the entire page below
And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
,A
G{
Mailing Address:
Tax Map and Parcel
number and/or Address
��
of the Business:
Parcel Owner:
Check any that apply:
�e
Business Name:
E-Mail Address:
2 G Phone #:
r A 2Z6 Zoning:
Stan Will fill cut ifunknnwn
to WILL LLB Owner's Address:
p pSc,
Business 0 Change of Use D Change of Ownership DChange of Name
Description Of Business: I Describe the business including use, number of employees, number of shifts, avaiWbilfty of packing and any additional info
Previous Business on Site:
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?
Will there be food preparation?
Is the Parcel on public water or private well?
Is the Parcel on public sewer or septic?
Will you be putting up any new signage?
1,2 0o s
No
Public U Private
R
Public ❑ Septic
'❑ Yes
Will there be new construction or renovations? Yes
Please list any applicable Building Permit #s:
If yes, 1111 out a Certified Encineer's Reoort (CER
If yes, provide Virginia Department of Health approval
If on private well, provide Virginia Department of Health approval
If on septic, provide Virginia Department of Health approval
If yes, obtain appropriate sign permit and list permit If below
If yes, obtain appropriate building permit and list permit # below
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 1 understand
them, and that I will Aide by them.
Signature
Date
2
a o\
Zoning Clearance Application �Albemade County
rH r Gommunay Development
McIn
• Gh ftni, a Rd. NUM Wing , GBatlotlesvllle. VA 22902
rTAG[N\� ze 43 .298.5832
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 clear nce application,
JrA *e - I �-1D I, 4 clearance number provided by Staff or busin s name %
to
Name of landowner on
the owner
of Tax Map and Parcel Number 1�5q Tib , I � f 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
Mailing a copy of the application to the owner identified above on
Date the following address:
�oc� A-� Ic�-F�,� G
(Written notice to the owner and last known a ress on our record books will satisfy this 3
requirement. Please see staff for help determining this information if needed)
Signature of Applicant
Applicant Name Printed
Date
11
3
For Albemarle County Staff Review Only
Proposed Use:
�C.�q=1t.
Permitted:
Yes ❑ No
Permitted by Section:
Supplementary Regulations:
Applicable Special Use Permit (SP):
Applicable Rezontngs (ZMA):
M a �-
Applicable Site Plans (SDP):
522 200 a —41 2ni 2
Parking:
If there is an approved site plan associated with the parcel, the parking requirements vrill be defined by the SDP. Some
parking requirements are determined by a ZMA or by an approved Code of Development.
Parking Formula:
Defined by.
961te Plan ❑Zoning Ordinance ❑ COD ❑Existing
Total Square Footage of the Use:
) 2 DU-o
Required number of parking spaces:
per Si `pit
Associated Clearances:
Variances:
Violations:
^
Is a site inspection necessary?:
❑ Yes XNo
Site Inspection on (date):
To Confirm:
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.
❑ This site complies with the site plan as of this date.
Conditions:
AMOVEL On a no ypRf A fi nv A& £tEMNI
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
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