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HomeMy WebLinkAboutCLE202100126 Approval - County 2021-09-24a2� rn.;, Albemarle County Zoning Clearance Application ( Community Development 4nt �McIntired NWing T• ChaBotlesNlle229. VA 22902 hBGIN��' Phone 434296,5832 FOR OFFICE USE ONLY Clearance Number: ZOZ (—Up( 2-,6 Fee Amount: $ 59 + 4% Technology Surcharge Date Paid: —(f •-Z By: UVe-e CR/e A4,qofo Lc, Receipt #: l Z� g 5 Z Check #: ' G By: )� yJAarse County Y qCIfQth yit (tebpment Department Applicant - Fill out the entire page below Date ?` 2-`t Z( And return to Community Development 401 McIntire Rd, North Wing, CharlottesvillPlPA 22-962 ---- Name: Mailing Address: ��� 5 t -t L 5 r y%l0� Tr E-Mail Address: Phone M 4V Tax Map and Parcel number and/or Address of the Business: 61-1a0� t" Zoning: Staff will fill out ifunknown ,P-t '� Parcel Owner: ! l G Owner's Address: h C & l4S m4S/,GtL Check any that apply: New Business El Change of Use ❑ Change of ownership Lj Change of Name r Business Name: Description of Business o cc be the busine s inclutling se, n mtLetr f employees, number of shifts, availabili of akin ,tl any additional info. f Previous Business on Site: Floor Plan: Please attach either an architectural drawing or a sketch of th 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: �,� 5s 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? 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 VNo If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes No If yes, obtain appropriate building permit and list pe mlt #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 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 them. — / —. T/ 01 Date y OF GGdR Albemarle County Zoning Clearance Application U 401 Wriirye Rd, 401 McIntire atl. North Wing :ar Ghatlottesville. VA 22902 r>801M�' Phone 434 296.5832 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, to clearance number provided by Staff or business name (l 20 2 t - 1 Z V Name of landowner on record the owner 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 deliver ng a copy of the application to the owner identified above on Date 15 ,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 App Applicant Name Date 3 For Albemarle County Staff Review Only Proposed Use: �2 ��r 6C,I ¢�I �'L Permitted: es No Permitted by Section: Z f t 21 f C "i l .� 2z Zr I JC l 2 Supplementary Regulations: (❑ sl t 0`j Applicable Special Use Permit (SP): �— Applicable Rezonings (ZMA): •—� Applicable Site Plans (SDP): ! GCt 7 C O C/.,- ✓parcel, Parking: If there is an approved site plan associated with the the parking requirements will be defined by the SDP. Some parking requirements are determined by a ZMA or by an a roved Code of Development. Parking Formula: t�D "t t. r Defined by: - Site Plan ❑Zoning Ordinance ❑ CoD []Existing Total Square Footage of the Use: $2 5 ( Required number of parking spaces: e j ! O Associated Clearances: ZO !- O 4 / L� _ 0 Q4 L 1` 120 e l ! C�-4 CLL O l Variances: ^ Violations: Is a site inspection necessary?: ❑ Yes ❑ No Site Inspection on (date): To Confirm: Notes: ` f5 [�PLt✓�'Nt2- f'e�14/,2.5 �-�.� ZD2�-G�6� QS �!� 1.C4N S i,e_ ckq Conditions of Approval: Additionalconditions of approval apply to Fireworks and Christmas Trees al j�,�a7wi�>_ ,r.�r��II31i.wi�nr�l�}� j i — i - Approval Information i ❑ 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 Notes: Building Officia Date Zoning Official Date C Z' r Other Official PO I— ®55 IF( I�> �SC ((.C- IIA`l ' j Z (ed Date L,J if County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 9115121, 31*06 PM 061000000120F0_01.jpg(2000x1500) https://gisweb.albemarle.org/GISData/CAMA_images/Apex_Sketches/061000000120F0_01.jpg 1/1 _-� rnY NwwNr /"II� i I LCYR r{ Ca K tMw1 fM Lul'NL 1 P!,olm: ass M^i.^45 ,M NM TN.01-Ib6 1 A 1 yypu TAR. .°�) f wrerfj`tl�2 Mwxw� I i rlmwnmi u1lw�,wNn.�u�n. a^IWM HI'YwJI�rMPnd RL11L ImLE - nmus me v; IlIr NM' M/F-ILL ap4PIbV tl �e i a Mnvrpnawro Wu. 4� n P ro.a 1, a 41[19LY4 Tom. 1 iMr F- r, 1 I GoitEAL NoRs ;I 1. p,,Avu I1NpFAUjI_b4 I „TMWe t LWlN1.-GNO WLN4V L A. 1 1WaT rimy TJ�PN'i�l A� 1 i.O W. ..LO][+NtN IawV-ftunluunm oaNees °.I! 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