HomeMy WebLinkAboutCLE202100140 Application 2021-11-17Y OF.{ of
Albemarle County
Zoning Clearance Application ° m 401McIntire Rd, NoM Wing
ChalottedAle. VA 22902
t rRGt>>' Phone 434.296.5832
FOR OFFICE USE ONLY Clearance Number: C\P_003\ - \yO
Fee Amount: $ 59 + 4% Technology Surcharge Date Paid: "iiG I a.\ Ia,1 By: Chug!\ac��c Mlr1
Receipt #:' 13� O1r3 Check #: 1 1 � By: p ��
Applicant - Fill out the entire page below 11� �-,tci`
And return to Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name: r 6r4- f M yLl
Mailing Address: t�D S H IG O
Tax Map and Parcel � l� �/q
number and/or Address a�. /
of the Business: � p�- Q #t�� �, !� 04
E-Mail Address:
Phone #:
Zoning:
Staff will fill out Runknown
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3 yr`U'r
Ap IL
Parcel Owner:
F7'v �'
Owner's Address:
Check any that apply:
® New Business Change of Use Change of Ownership Change of Name
Business Name:
Description of Business:
Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info.
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Previous Business on Site: n!Q
Floor Plan:
Please attach either 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.
Total Square Footage Used
for the Business:
Is the Parcel Zoned LI, HI, or PDIP?
❑ Yes XNo If yes, fill out a Certified Enoineer's Report. (CER)
Will there be food preparation?
704 Yes E] 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?
XPublic ❑ Septic If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
MYes No If es, obtain ap
propriate ppropriate sign permit and list permit #below
Will there be new construction or renovations?
Yes No f yes, obtain approp ate building pe mit and list permit #below
Please list any applicable Building Permit #s:
VZDZ -OZ 356
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 will abide by th
r
Signature , Printed -Cilf %Z)s ryiiii 2
Date
� OF 41,E ,
Zoning Clearance Application
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++ rn!- %�i
t-1— ��
Albemarle County
Communily Development
401Wing
C
dottesree VA22M1
VA 229W
r �RGIN�r
Phone 4942965632
Phone43 29
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,
Gt.�2011 -OZ356
clearance number provided by Staff or business name
to 1 v Name landowner onr �✓ LL< the owner
-7
of Tax Map and Parcel Number TMP number of property 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 to 2
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 E ffrZ[STI4NI M T-,4MM
Date ���z�a
3
For Albemarle County Staff Review Only
Proposed Use:
9'W ktlV4
Permitted:
Yes ❑ No
Permitted by Section:
7N,7-t 1 5 C
Supplementary Regulations:
Applicable Special Use Permit (SP):
2007—6 I C (16
\ 1 ,I hl
L
Applicable Rezonings (ZMA):
q q 2
ZO (L-07
Applicable Site Plans (SDP):
Z-V� � ZGDCC R
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 approved Code of Development.
Parking Formula:
5t 511, 0!o ail
I Defined by:
Site Plan ❑Zoning Ordinance ❑ CoD ❑Existing
Total Square Footage of the Use:
0
Zp5� Mi_icr-13—05 56 56�wQ c Gs 5 o —L/ — — —
Required number of parking spaces:
Associated Clearances:
Variances:
Violations:
`
L( elo-vio
Is asite inspection necessary?:
--- —
❑ Yes ID40
Site Inspection on (date):
""'
To Confirm:
Notes:
Additional conditions of approval apply to Fireworks and Christmas Trees 1 /��ry1 p
V��L—gC4�'4_
Conditions of Approval:
Approval Information
WXApproved as proposed proved with conditions ❑ Denied
❑ Backf low 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.
Additional Notes:
Building
Zoning
Other Official L�!'/ R G" 9
Date ` I — 1 7- � l
Date (Q`Z(` 2(
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4