HomeMy WebLinkAboutCLE202100124 Application 2021-09-20Zoning Clearance Application
c O R OFFICE USE ONLY Clearance Number:O L—DD;) I
Albemarle County
Comnvnity Development
401 Wlntke Rd, Nonh'Ahng
Cheaoaewille, VA 22902
Pnone 434,293.5832
=ee Amount: $ 61.36 Date Paid.9PA I Ce.lk By. by the Albgr�
4pplication fee: $59 + Technology Surcharge: $22I.36 �,,�] M�,, I �ke ( Community Devero
Receipt #:O —i0 1 %iW � 3'f��ttTII V�'eck #: C.08� �j �PBrtrtlenf
Applicant - Fill out the entire page below and return to:�
community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
E-Mail Address:
Mailing Address:
' _1 J '4o
&J om
Phone #:
n 00
Tax Map and Parcel
number and/or Address
of the Business:
UV -UUj 0
32,ya 4.iyTH
Zoning:
Staff will fill out Iunknown
��
Parcel Owner:
&&eAd �eC'•i1%
GH/►�{a JLlL(Cs
Owner's Address:
A.krrl"`r
iSO LI o.
Check any that apply:
ew Business ❑
Change of Use Change of Ownership Change of Name
Business Name:
thebbu�ssllness including use, number of employees, number of shifts, availability of parking, and any additional Info.
Description Business:
�-off,
,gD7escd/b'e�
_. 6X YLt'�._il 1F (t/&
_
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, +he total square footage of the use, and any additional information.
Total Square Footage Used
for the Business:
S 't /-'0 C) -SQ Fr
Is the Parcel Zoned LI, Hi, or PDIP?
Yes �o
If yes, fill out a CeElified Engineer's Report ( RI
Will there be food preparation?
f:] Yes o
if yes, provide Virginia Department of Health approval
Is the Parcel on public water or private well?
2"Public Private
If on private well, provide Virginia Department of Health approval
Is the Parcel on public sewer or septic?
Zublic ❑ Septic
If on septic, provide Virginia Department of Health approval
Will you be putting up any new Signage?
Yes No
If yes, obtain appropriate sign permit and list permit # below
Will there be new construction or renovations?
Des 0 No
If yes, obtain appropriate building permit and list permit # below
Please list any applicable Building Permit #s:
r 7 ,\ SfS R• _ oU�
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
them, and that I yriH'apde by them.
Signature t.__...__/ Printe temit, I fhu ✓_N J&
Date 0�IX10Z %CJl. � N'. Ql�i ��tl� �e
Zoning
CI
Clearance
Application
Albemarle Count
y
°°
401 Mtlnliro Rq NMh OMng
Gha110ft. v10e, VA 22902
CYRMS ^A
PF0n6434299. 5832
applicant - If you are not the land owner, please fill out the entire page below confirming that you have either
nformed 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,
to
of Tax Map and Parcel N
copy of the application
Hand delivering a
Date
1-1 Mailing a copy of the
,ance number provi ad by Staff or business name
the owner
Name of landow er on recor
by either delivering a
or by jendi g them a copy of the application by
one otthe f Ilowing below)
licatiorylto the c'n idrntified above on
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
Date
3
For Albemarle County Staff Review Only
Proposed Use:
�' Y. 5
Permitted: es ❑ No
Permitted by Section:
2 `'� i 2,10) 4_ )1te
q
Supplementary Regulations:
kpplicable Special Use Permit
_
�2G20z
lR� �1,3 Lives-Ict wr111.c.. __ l�
%ppllcable Rezonings (ZMA):
4pplicabie Site Plans (SUP):
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 Mproved Code of Development.
Parking Formula:
5
Z Pkk
Defined by.
Ite Plan ❑ Zoning Ordinance ❑ CoD []Existing
total Square Footage of the Use:
3y D
Required number of parking spaces:
4ssoclated Clearances:
V a Pv
L 5 p f
`f
Variances:
Violations:
-�- _--- ----
Is a site Inspection necessary?:
❑ Yes ❑ No
Site Inspection on (date):
To Conflnn:
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 if, not a determination of compliance
with the existing site plan.
❑ This site complies with the site plan as of this date.
Conditions:
Addillonal Notes:
Building Offici
/y I
`l
Date
Zoning Official_
Date, ZO 2�
Other Official —
Count j of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.6832 Fax: 434.972.4126
12