HomeMy WebLinkAboutCLE202100003 Application 2021-01-20Zoning Clearance Application
FOR OFFICE USE ONLY
Fee Amount: $ 54
Receipt #: I d�vJ
Clearance Number: oW1 _ 3
Date Paid: i/-+/ai
Check #: W .�lln
Applicant - Fill out the entire page below JU
And return to Community Development 401 McIntire Rd, North Wing,
Name:
=
irk
Albemarle County
Community Development
401
Mclnike Rd. Nosh Wkq
-
CharloXyNlle. VA 12001
YraelNl�
Phone 4U 2%583
By:&-1lJl laNr PPrP�&k i- T5L�C,
By:�A by the Albemarle County
BDevelopment Department
CharlottesvNlkVA.22,904,-.—EZ z -o�33
dCt1 � E-Mail Address:
Mailing Address: 7CC)2
—r � kiQW jl neTax Map and ParcelO7SOL' Ol �jC'} Zoning:
number and/or Address
Of the Business: staffwrnroout irunknown 6UI
Parcel Owner: ti n I (—
wneesAddress, i5 kIYafl d t�'I LI
Check any that apply: New Business Ej Change of Use Chan a of ownershi C g P Change of Name
Business Name:
MW cc
Description Of Business: � Describe the business
/I i'nclu^ludiinnng use, numb,ter of employees, umber of shifts, availability of Parking, and any additional info.
IYICLW--- ApA ill .Lr�lO ._�� )q 15 � N A An, ✓1-1-f' fn/`, ✓1/'n �., _ r
Previous Business on Site:
Floor Plan: Please attach either an architectural drawing or a sketch of he 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: 4 2,J
Is the Parcel Zoned LI, HI, or PDIP?
Yes No
If yes, fill Certified
Will there be food preparation?
out a Engineer's Report lCERI
Is the Parcel on public water or private well?
❑ Yes (}�j" No
t
If yes, provide Virginia Department of Health a
approval
Is the Parcel on public sewer or septic?
Public ❑ Private
If on private well, provide Virginia Department of Health approval
Will you be putting up any new signage?
I� PublicEl Septic
1�
If on septic, provide Virginia Department of Health approval
WIII there be new construction
❑ Ves ANo
If yes, obtain appropriate sign permit and list permit # below
or renovations?
Please list any applicable Building Permit #s:
� YeS No
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. 1 have read the conditions of approval, and I understand
them, and that I will abide by them.
Signature�,,f
Date .lAlCrnDer 2I,2Dc)
SY OF
Zo n i n Application a Albemarle Count
g Clearance A lication �_ Com ndy Devetog dt
401 McNOre Rd, NWh Wing
1" Chadottesaile. VA 22902
t?$CIN1� Phone 434 296 5832
Applicant - If you are not the landowner, please fill out the entire page below, confirming that you have either
informed or are going to notify the owner of your application.
CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN
PROVIDED TO THE LANDOWNER
- -- - - -----
I certify that I will provide (or have provided) notice of this clearance application,
G�-�Zv2I-a�
to ')Lli}h Phn�pc, Effigy e P)II I a4ILLthe owner
of Tax Map and Parcel Number C�CL1 (� _ x _ry,�
by either delivering a
copy of the application to them in person or by sending them a copy of the application by
mail. (Please check one of the following below)
❑ Hand delivering a copy of the application to the owner identified above on
Date
[l Mailing a copy of the application to the owner identified above on
to the following address:
(Written notice to the owner and last known address on our record books will satisfy this
requirement. Please see staff for help determining this information if needed)
Signature of Applicant i
Applicant Name Printed
Date
3
For Albemarle County Staff Review Only
Proposed Use:
' ice—
Permitted:
EUY,14 ❑ No
Permitted by Section:
2LI,Zj
CZO
Supplementary Regulations:
�-
Applicable Special Use Permit (SP):
Applicable Rezonings (ZMA):
Applicable Site Plans (SDP):
Parking:
If there is an approved site plan associated with the parcel, the parking requirements will be defined try the SDP. Some
Parking Formula:
( 00
Defined by:
❑Site Plan ❑ ning Ordinance ❑ CoD ❑Existing
Total Square Footage of the Use:
Z`l tft
Required number of parking spaces:
Z 5 7' u i
Associated Clearances:
n a n
ZU(.$-Z3V1 —205 Z017^Z-T "/j/2CI -256 -22f -la,S etc'
Variances:
Violations:
�-
Is a site inspection necessary?:
❑ YesED,o
Site Inspection on (date):
«
To Confirm:
in 6!1
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:
Additional Notes:
Building Officia
Zoning Official_
Other Official
Date / — 2-0- 2
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126
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