Loading...
HomeMy WebLinkAboutCLE202100018 Application 2021-02-11i I Zoning Clearance Application FOR OFFICE USE ONLY Clearance Number: C\eXa\(gC01,z Albemar fu wCommunity -401 McIntire ChatlottesWl IZR "�`,4h Phone 434.: Fee Amount: $ 54 Date Paid: o�1 B/a1 By: 1 71 l,CA"-- I--0 r y nle, Albeflarie County Receipt #: VD13-4M Check #: Z 13H Boo riv Develaprnent Department Applicant - Fill out the entire page below fife G[ And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: �(= yf / non G E-Mail Address: Mailing Address: 313v )�,� or C c- Z& l i[Suairc Phone#: 3 /�- Tax Map and Parcel number and/or Address of the Business: Tnt r v ?[pltf - in o-- o,) - 6o _ate Zoning: staff will fin out if unknown Parcel Owner: ;-f 5f, itgfi . Ve,vl urec• �- Owner's Address• iJc� $rJA Check any that apply: New Business Change of Use Change of Ownership ❑ Change of Name Business Name: 1 G9r b ft Description of Business: Describe the business including use, number of employees, number of shifts, availability of parking, and any additiona Previous Business on Site: P-4 /114rV44D Floor Plan: Please attach either an a itectural drawing or a sketch of the proposed business indicating the location of us uses of rooms, the total square footage of the use, and any additional information. Total Square Footage Used for the Business: / 2U Is the Parcel Zoned LI, HI, or PDIP? Yes No If yes, fill out a Certified Engineer's Report (CER) Will there be food preparation? M Yes ❑ No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? 0 Public ❑ Private If on private well, provide Virginia Department of Healt Is the Parcel on public sewer or septic? © Public ❑ Septic If on septic, provide Virginia Department of Health app Will you be putting up any new signage? © Yes � No es, If obtain y appropriate sign permit and list permit # I Will there be new construction or renovations? Yes No If yes, obtain appropriate building permit and list permi 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 sub This Clearance will only be valid on the parcel for which it is approved. If you change, intensify, or move the use to a ne location, a new Zoning Clearance will be required. 1 hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify the information provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I uni them, and that I will abide by them. Zoning Clearance Application Albemar Community 401 McIntire CttattottesWl L... Phone 434.: Applicant - If you are not the landowner, please fill out the entire page below, confirming that you have eithe informed or are going to notify the owner of your application. CERTIFICATION THAT NOTICE OF THE APPLICATION HAS B PROVIDED TO THE LANDOWNER I certify that I will provide (or have provided) notice of this clearance application C(r� 7-02(�l to _s; , � �� f,,,, V2 Afiix�e ; c' the owner of Tax Map and Parcel Number o f;�;t- po- - , ,,,, by either delive copy of the application to them in person or by sending them a copy of the applicatil mail. (Please check one of the following below) Hand delivering a copy of the application to the owner identified above on Date/ T ❑ Mailing a copy of the application to the owner identified above on Date 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 Applicant Name Printed MyrtaM 4rnancie2_ Date of az j acg i For Albemarle County Staff Review Only Proposed Use: /-C S�u �� uf/L Permitted: Yes ❑ No Permitted by Section: Z S .L; Z Lr, Z (C S j) C L) l Supplementary Regulations: --- Applicable Special Use Permit (SP): �� Applicable Rezonings (ZMA): 'Z 005- l Applicable Site Plans (SDP): 2 0lI -25 2vll-DZ Parking: If there is an approved site plan associated with the parcel, the parking requirements will be defined by the! Parking Formula: `+i 5 11coo Defined by: I zsitL Plan ❑Zoning Ordinance ❑ CoD ❑I Total Square Footage of the Use: 2 00 Required number of parking spaces:t�q Associated Clearances. ZOLD-fOc7 -"j -�j6 -5 zti(/-Z6S _18Y_tf3 etc, Variances: _ Violations: Z AJo Ui D Is a site inspection necessary?: ❑ Yes �lo Site Inspection on (date): _ To Confimr 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 ex' ❑ No physical site inspection has been done for this clearance. Therefore, it is not a determination of coml with the existing site plan. ❑ This site complies with the site plan as of this date. Conditions: I Additional Notes: Building Zoning Date / �! Date G Other Official V UK tt 0 `r 4 tle G( Date U 51t� '5�re �Y,4iorj