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Home My WebLink AboutCLE202100127 Application 2021-09-22' Zoning Clearance Application =' ._ FOR OFFICE USE ONLY Clearance Number. Z�. Z (-I L� Fee Amount: $ 61.36 Application fee: $fie + Technology surcharge: $2.36 e � Receipt #: � 1 A c--(vl' - - ` , � Date Paid: By: Check M By - Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Albemarle County Comrunihy Devebpnent 401 Mdnb. Rd, NorY, W ne CJwAoReMYe. VA V9U Phase 4a4396. a Name: r7wt C. e,4i' Y, E-Mail Address: (�K; 9.t Q w Itxrr+Aylo• oY MatNrgAddress: ILOW 5152-Sk. 5.,;}e C) CjlWUVjcW.Ijr-,,j4 use Phone#: Zoning: - SMt w10 fit out if unk mrri q3q-871�-102- Talc Map and Parcel number and/or Address of the Business: 12lapp- V o - oo _ p{`V (j t7 pt Parcel Owrwr: C&W%hi d ownees Address: q0I tAA9-T4N*. vx- V c1 Chock any that apply: ❑ New Business Charge of Use E] Change of ownership ❑ Change of Name Business Name: Description of Business: Describe the business including use, number of employees, number of shills, avaiiabrity of parking, and any additional hullo. ve ws-; s w M 6'r t"tcl wlv,i L.. -1 hA5 k S Y[. sevctd bA 4i4- WO -V Af R., - Previous Business on Site: KNOBS, attach ether 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. _ Floor Plan: Total Square Footage Used for the Business: Is the Parcel Zoned LI, HI, or PDIP? Ej Yes l71 No If yes, fill Out a 0, rtified Enomear s Report (CER) Witi there be food preparation? Yes No Ryes, provide Virginia rg' Department of Health approval Is the Parcel an public water or private well? Public t1v Pie H on private well, provide Virginia Department of Health approve Is the Pancet on public newer or septic? Public K S optic if on septic, provide Virginia Department of Health approval Wig you be putting up any new signage? Ej Yes 10 No If yes, obtain appropriate sign permit and list permit# below Will there be new construction or renovations? ❑ Yes 1K No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit ds: 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 abide by them. Signature Printed _/'r `-'r J Date Zv Z 2 Zoning Clearance Application> — �- Albemarle County Cwmninrty Dnebpnrnl Mt M.W , V Z? Wlig ClmrbtpaeNpe, VA?TB02 �rlCn�� Plwne �31]9a.5e3] 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, number provided by Staff or business name to the owner Name of landowner on record of Tax Map and Parcel Number by either delivering a TMP number or 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 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 Ptopoaad Use: Permitted: ❑ Yes ❑ No Permitted by Section: Supplementary Regulations: Applicable Spacial Use Permit (SP): Applicable RozmWngs COIN: — Appacebls Site Plus;(SOP): Parking: if there is an approved site plan associated with the parcel, the parkin g requirements will be defined by the SDP. Some parking requirements are determined by a ZMA or by an approved Code of Oevelopment. Parking Formula: Defined by. []Site Plan ❑Zoning Ordinance ❑ COD []Existing Total Square Footage of the Use: Required number of parting spaces: Associated Ch a ave:es: varianw: Vwlations: Is a site Inspection necessary.: ❑ Yes ❑ No To Confirm: Site Inspection on (date): Notes: Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees Approval Information KApproved as proposed ❑ Approved with conditions ❑ Denied Backflow prevention device and/or current test data needed for this site. Contact ACSA, 4M.977.4511 ext. 117 1� No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. I] This site complies with the site plan as of this date. Conditions: Additional Notes: //. Building Official NZ Date `- Zoning Official �Date 9v6w-1 Other Official Date County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.2%.M32 Fax: 434.972.4126 4 For Albemarle County Staff Review Only Proposed Use. Permitted: Yes No Permitted by Sesllon: 1 ✓rG fL� snemerMary Rgubtlomms: —� Applicable Spacial lip Permit (SP): Applicable Raaonings (AMIN: Applicable Sib Pkear (SDP): Parking: N there is an approved site plan assodaled with the parcel, the parking requirements Will be claimed by the SDP. Some parking reWirements are determuhed by a ZMA or by an approved Code of Development Parking Formula Defined by. I ❑Sits Pleas ❑Zoning Ordbanrx ❑ coo ❑Existing Total square Footage of the Use: Required number of parking spaces: -- ---- Associated clearances: Variances: -- - -- Violations: -.. - In a site inspection necessary/!: ❑ yes ❑ No She Inspection on (dabk To Connflrrrm: AddRlowl conditions of approval apply to Flreworks and Christmas Trees Notes: Conditions of Approval: 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 Nobs: Building Other Ofrtcial Ei iir6 Pe Z V e- Il✓ fd Date ( (J !Z ( County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434,972.4126 4 T