HomeMy WebLinkAboutCLE202200045 Application 2022-04-13Zoning
Clearance
FOR OFFICE USE ONLY
Fee Amount: $ 61-36
Application fee $59 +Technology Sur
Receipt #-
charge: $2.36
0 6 0
Clearance Number -
Date Paid'
Check #-
cation
By-
By-.
Applicant -Fill out the entire page below and return to -
Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Albemarle County
Community Development
401 McIntire Rd, North Wing
Charlottesville. VA 22902
Phone 434 296 5832
EmMaill Addresses
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Name:
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Mailing Addresses
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Phone
Tax Map and Parcel
number and/or Address
of the Business.
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Zoning:
Staff will fill out if unknown
f Vr oV�i I UU acre-s
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Parcel owner:0
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Owner's Address:
Check any that apply: New Business Change of Use I Change of Ownership Change of Name
Business Names, �t�t e/S � f ,o d ,� _� e()Lo rt I r on Grp,
Description of Business: Describe the business including use, number oi employees, number of shifts, availability of parking, and any additional info
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eve / o7'f �r�hl,� ��c u � �r � i � S 441, � t (�
Previous Business on Site:
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Floor Plans.
Please attach either an architectural drawing
uses of rooms, the total square footage
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or a sketch
of the use, and
of the proposed business indicating the location of uses, the
any additional information
Total Square Footage Used
for the Business:
Is the Parcel Zoned L1, HI, or PDIP ?40
0 Yes
� Yes
� Public
� No
�No
n Private
If yes, fill out a Certified Engineer's Report (CER)
If yes. provide Virginia Department of Health approval
If on private well, provide Virginia Department of Health approval
Will there be food preparation?
Is the Parcel on public water or private well?
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
F-1 Yes
AJI-14
No
� No
If yes, obtain appropriate sign permit and list permit #below
If yes, obtain appropriate building permit and list permit #below
Will there be new construction or renovations?
Please list any applicable Building Permit #s.0
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
location, a new Zoning Clearance w
the parcel for
ill be required.
which it is approved. If you change, intensify, or move the use to a new
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.
Signature
nnto
Printed
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earance App
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Albemarle County
Community Development
401 McIntire Rd North Wing
Charlottesville, VA 22902
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
certify that I will provide (or have provided) notice of this clearance application,
V i o ' /�,%S COLT
clearance number provi ed by Staff or business nani�
to o x die o� �a �n the owner
Name of 1ando66er on record
of Tax Map and Parcel Number 3-2
0 q3W -00 - 66 - Zl6a> by e
TMP number of property
copy of the application to them in person or bN sending them a copy of t
mail.
✓'� Hand deliveri
Date
Please check one of the following below)
ng a copy of the application to the owner identified above on
3/2 ZOO--
L7 Mailing a copy of the application to the owner identified above on
Date
to the following address:
ither delivering a
e application by
(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
9,tiM00iN
Date
For Albemarle County Staff Review Only
Proposed Use:
Permitted:
Yes No
Permitted by Section:
Supplementary Regulations:
Applicable Special Use Permit (SP):
Applicable Rezonings (ZMA):
Applicable Site Plans (SDP):
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:
Defined by:Site
Plan
Zoning Ordinance E CoDExisting
Total Square Footage of the Use:
Required number of parking spaces:
Yes � No
Associated Clearances:
Variances:
Violations:
Is a site inspection necessary?:
Site Inspection on (date):
To Confirm:
Additional conditions of approval apply to Fireworks and Christmas Trees
Notes:
Conditions of Approval:
Approval Information
a
Approved as proposed n
Backflow prevention device and/o
No physical site inspecti
Denied
ct
on has been done for this clearance. Therefore. it is not a determination of
Approved with conditions
r current test data needed for this sit
with the existing site plan.
This site complies with the site plan as of this date.
Conditions:
itional Notes:
Building Official
e. Conta
Date
Zoning Official Date
Other Official Date
AC SA, 434.977.45
11 ext. 117
compliance
County
of
Albemarle
Department
of
Community
Development
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