HomeMy WebLinkAboutCLE202100110 Application 2021-09-20Zoning Clearance Application
FOR OFFICE USE ONLY
Fee Amount: $ 61.36
Application fee: $59 +Technology Surcharge: $2.36
Receipt #: I a 3 0 a
Clearance Number: LL fFgo I-eal0
Date Paid:5W/21
Check #: l Q $ I
Applicant - Fill out the entire page below and return to:
Community Development 401 McIntire Rd, North Wing, Charlottesville,
Albemarle County
CommuMty Development
401 McIntire Rd, N wmg
Charl011.11e, VA 22902
Phom 434 296.5a32
By: ,50 , VX- I de_ U."C(e
APPROVED
BY6 t Carle County
un Development Department
Date
VA 22A2
Name:
okn tu, „
E-MailAddress:
Mailing Address:
Phone M
Tax Map and Parcel
number and/or Address
of the Business:
5mo k-46 c— a. `j., P
X2-S L,brlr,ra Aft •
C r 1Ia )2
Zoning:
Staff will fill out 9unknown
Parcel Owner.
Co el— Re* -I E46 jA-
Owner's Address:
, I
(, 0O • ( c
v� (�
Check any that apply:
New Business Change of Use Change of Ownership ❑ Change of Name
Business Name:
r—
Yvli7
Description of BUSineSS:
Describe the business including use, number of employees, nJnberofshift. availability of parking, and any additional info.
I
Previous Business on Site:
t.R
Floor Plan:
Please attach either an architectural drawing or a sketch of the proposed business indicaKL ntin'g the location of uses, the
uses of rooms, the total square footage of the use, and any additional informQIation. ck \
Total Square Footage Used
for the Business:
3 O 5q fl .
Part, cA Iou-,, A.* PS
Is the Parcel Zoned LI, HI, or PDIP?
Yes yVNo
If yes, fill out a Certified Enoineer's Report ICER1
Will there be food preparation?
[;?Yes No
If yes, provide Virginia Department of Health approval
Is the Parcel on public water or private well?
Public Private
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?
Yes I�! o
, If
esobtain appropriate si n
yg permit and list permit #below
Will there be new construction or renovations?
Yes N1<0
If yes, obtain appropriate building 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 Pei wn or have the owner's permission to use the space indicated on this application. I also certify that the
information pr ided s t e and accurate to the best of my knowledge. I have read the conditions of approval, and I understand
them, and t t I wit abj6q by theyl 1. ) //14 -
Signature
I
J d
s
Date
Clearance
ApplicationChahotlesNlle
E�t-
AlbemaeCun, tyZonin
VA2
Phone 43 2%583
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,
6LC 202( - i(U
clearance number provided by Staff or business name
to Nel — L'J the owner
Name of landowner on record
of Tax Map and Parcel Number2c'2 L - C r,7..tYL�?jby either delivering a
TMP tuber 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 ��260 2 1
❑ Mailing a copy of the application to the owner identified above on
Date
to the following address:
(Written notice to the owner and
requirement. Please see stafff6i
Signature of Applicant
Applicant Name Printed
Date h'
address on our record books will satisfy this
Wining th4 informatign if needed)
e7 1
I
K
For Albemarle County Staff Review Only
Proposed Use:
,p ,5
re3
qq V4
Permitted:
P4es ❑ No
Permitted by Section:
Supplementary Regulations:
Applicable Special Use Permit (SP):
Applicable Rezonings (ZMA):
Applicable Site Plans (SDP):
Zo / L - 1 Z b Z_ O 2 D 1 ( _ Z Z
Parking:
If there is an ap roved 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 approved Code of Development.
Parking Formula:
t /�
dq
I Defined by:
[]Site Plan ❑Zoning Ordinance ❑ CoD ❑Existing
Total Square Footage of the Use:
QO D
Required number of parking spaces:
;�-3 QL�� �3 y�VItS�C ✓ �Z l�� Ol QnIS�"1 !'1. $ 4«�
Associated Clearances:
q
Variances:
Violations:
-. tJ 10 Z 0 Z (- ! U/ L 1-ID C S 7 4 VZ 1 q cGt
Is a site inspection necessary?:
❑ Yes Ekho
Site Inspection on (date):
To Confirm:
Notes:
Conditions of Approval:
Additional conditions of approval apply to F7rks and C 'stmas Trees
Approval Information
❑ Approved as proposed ❑ Approved with conditions
Denied
❑ Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4611 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
/]
Date 69&64
Zoning Official
Q
Date
Other Official Y/ (i/� r �tC(�
Date L /0 - z
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.6832 Fax: 434.972.4126 4