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HomeMy WebLinkAboutCLE202200020 Approval - County 2022-05-16•r Zoning Clearance Application FOR OFFICE USE ONLY Clearance Numberox m2lwo ZO Albemarle County Community Development 1 401 Moln6re Rd. North Wing Chadonemile. VA 229M r%gG1N�P Phone 43 .298.5832 Fee Amount. 61. Date Paid: By: Application fee: $59 + Technology Surcharge: $2.36 APPROVED Receipt #: C _C Check #: QI A By: b A Date 5 /6 z a ent Applicant -Fill out the entire page below and return to: F� 2 Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 Name: E-Mail Address: Aji,a Mailing Address: h:�cS 0 %k Phone#: y3 ,�_ IX6 c�3ln Tax Map and Parcel number and/or Address of the Business: 1p pU T , © 'i"¢l , F C_o rl,o�{Lsv! lie Uta- aZlqo I S Zoning: Staff will fill out ifunknown 0— Parcel Owner: i 0ir,n r , f m 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 into. NU1 1-3 Previous Business on Site: I 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: GG It Is the Parcel Zoned LI, HI, or PDIP? F1Yes No If yes, fill out a Cerfified 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? 5rPublic Private If on private Wall, 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 Q No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? Yes [Z No 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 that I will abide by the Signature Printed S(,t ! FnNi k Date ' Z 97 • 1Z 2 "IM. Zoning Clearance Application 3 4�A °`• Albemarle County community neveloyment e�• � 491 McIntire.1. 22M1 Wing CM1atlottesville, VA 22982 �QGIN3�� Phone 43 2965832 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, C LF 2BL2-- Zp clearance 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 of 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 d Mailing a copy of the application to the owner identified above on Date V 1 Z'). ;�V 2L 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) 1 Signature of Applicant Applicant Name Printed Date t -21 Zz KI For Albemarle County Staff Review Only Proposed Use: Ll Alt .1 Oe 5 1 0 �1 Permitted: s ❑ No Permitted by Section: I 'ZSr Z, C[ -+ 2Z. Z, CV CL SupplementaryRegulations: Applicable Special Use Permit (SP): A 2 4 L (/ Applicable Rezonings (ZMA): Applicable Site Plans (SDP): Parking: Ifthem 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 ap oved Code of Development. Parking Formula: Sr 00,D Defined by: ite Plan [:]Zoning Ordinance ❑ CoD []Existing Total Square Footage of the Use: I S Required number of parking spaces: Associated Clearances: Variances: Violations: q F c� Vtt V t (7 Is a site inspection necessary?: ❑ Yes o Site Inspection on (date): To Confirm: Notes: Conditions of Approval: Additional conditions of approval apply to Fireworks and Christmas Trees Approval Information 0 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 Offici I Date ! 49 Ly Z z 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