HomeMy WebLinkAboutCLE202200058 Application 2022-04-28 •
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,,1 htli.. Albemarle County
Z �/• Community Development
Zoning Clearance Application •_�,►� 401McIntireevNorthwing
Charlottesville,VA 22902
ktpci 1.1, Phone 434.296 5832
FOR OFFICE USE ONLY Clearance Number:CLe.2 vz_ - Doo6g
Fee Amount: $ 59 +4% Technology Surcharge Date Paid: LI (Z%I ZZ BY:O_pvO LA.A‘..1_ Okku-eb
Receipt#: C .0 , Check#: u( es By:
Applicant- Fill out the entire page below
And return to Community Development 401 McIntire Rd, North Wing, CharlottesvYille, VA 22902 {�yl f
F, Cro 2 e j U A . J
Name: 0a. jin - d.v1.j( / E-Mail Address: CO 16 710 '''"'
MailingAddress: _ r '*) CO 6 6 rl
fib\ 4 V tJ 2 \re*. V,Ai k- ( OS Phone#: J ,�
Tax Map and Parcel 01-0 -(8 2c.r'l 4 f' - Zoning:
number and/or Address Staff will fill out if unknown
of the Business: J ( t-e , ,2-0
Parcel Owner: r `_„ —� Owner's Address:
Check any that apply: New Business Change of Use U Change of Ownership Change of Name
Business Name: Co_try C t rti0Q_ 0 6 av -D g e, t,-( 5 Su L
Description of Business: Describe the business including use,number of employees,number of shifts,availability of parking,and any additional info.
8 ea_A__5- — Set Lc)vv_ Civui 6e,,,,--H e a p . 066 cee- a vt_di
1 1) V` enJr S-e `i `il ZQ- z 1 V c 4e_t vk (off 5Ic1•12. ul \c.i ✓.. t
Previous Business on Site: VQ e�`f� (v S c� Ck C ovv«r t a 1 U t vi d
Floor Plan: Please attach either an architectural drawing or a sketch of the proposed business indicating the location of uses,the C
uses of rooms,the total square footage of the use,and any additional information.
Total Square Footage Used 11 3 5ct�� reel-
for the Business: 1
Is the Parcel Zoned LI, HI, or PDIP? Yes r n No If yes,fill out a Certified Engineer's Report(CER)
Will there be food preparation? Yes IIx No If yes,provide Virginia Department of Health approval
Is the Parcel on public water or private well? p7 Public/0'� Private If on private well,provide Virginia Department of Health approval
Is the Parcel on public sewer or septic? -r Public n Septic If on septic,provide Virginia Department of Health approval
Will you be putting up any new signage? Yes 1K No If yes,obtain appropriate sign permit and list permit#below
Will there be new construction or renovations? Yes kNo 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 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 th I will abid by them.
Signatureeicr Printed Oa
Date 4 ) Z-7 / z2-- 2
-lam Plan o n --Baex... of pctc
a� ru\ Albemarle County
Z Zoning Clearance Application 8 P:® m Community Development
401 McIntire Rd,North Wing
_ Charlottesville,vA 22902
1:jil iat' 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,
clearance number provided by Staff or business name
to Name of landowner on record the owner
of Tax Map and Parcel Number TMPnumberofproperty 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)
(K Hand delivering copy f the application to the owner identified above on
Date 2r 2-1 2i ZZ
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)
(7)
Signature of Applicant ,
Applicant Name Printed Ca Vv C c 10 CA OIL)
Date 4( ( w 22
3
For Albemarle County Staff Review Only
I Proposed Use: Permitted: fl 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 I I CoD I 'Existing
Total Square Footage of the Use:
Required number of parking spaces:
Associated Clearances:
Variances:
Violations:
Is a site inspection necessary?: Yes No
Site Inspection on(date): To Confirm:
Notes:
Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees
Approval Information
I I Approved as proposed Approved with conditions n Denied
I I Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117
I 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 Date
Zoning Official Date
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville,VA 22902 Phone:434.296.5832 Fax:434.972.4126 4
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