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HomeMy WebLinkAboutCLE201900295 Approval - County 2022-06-22APPROVED by the Albemarle County Community Development Department Application for Zoning C1effllan CLE# ZO�G1— OFFICE USE ONLY Z i` PLEASE REVIEW ALL 3 SHEETS Check # ZZS Date: �I Receipt # '_ Staff: ►Vt PARCEL INFORMATION nn Tax Map and Parcel: O (to 100 -OO- Co .. 1 tl Existing Zoning Parcel Owner: 5evl 1, r C 4z9 ,`M&XP Ti%N L- Parcel Address: S"%P I2kd2aPta. g�Ja City (2\ kASAe State 1(K Zip2.2tot (include suite or Floor) PRIMARY CONTACT Who should we call/write concerning this project? Sc..y %\K\QS Address: yq\ City State VA- Zip'LZyt( Office Phane: (`1 `t-L-77ffiCell # 322 "l t Fax # E-mail ScA A-�.t tt dtCCv�I�O.Ofy APPLICANT INFORMATION Check any that apply: Change of ownership hange of use Change of name V<ew business Business Name/Type: --yut Previous Business on this site o.& Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide: Ms%f (4v.: -1.c t S 'io MSS Sa t..ple.wn_w ener.. 'l drvs null 1a L1ji 2& pot�� �sso . "This learance 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. Signature � r'J �" Printed /anIe' APPROVAL INFORMATION [ ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 9774511, xl 17. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. 1 [ 1 ] This site complies with the site plan as of this date. 5 f / „2 1 Notes: v tJ r% c ,`) Building Official Date 2_ S Z Z) Zoning Official Date p /J Other Official A�%W U tQ 0< r P--Wtq t l Date 2- 5— 2 a County of Albemarle Department of Community Development \ 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126 Revised 1 1/02/2015 Page 2 of 3 Intake to complete the following: Is � in Is a �o LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y C Willbe food preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel parcel on private wel or public water? If private well, provide Hearth Depa" ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic ublic sew Reviewer to complete the following: Square footage of Use: w., S" put 'Sb ennitted as //t�� A v //, Mock Under Section: ( Pgyle✓Ltdl f pi, use Supplementary regulations section: �. P1t55e l : 3,2/rtwa4 xti3/2LI [; Parking formula: Required spaces: AA �v7/✓itQccC; e �'— p�Y Items to be verified in the field: SJN ill you be putting up a new sign of any kind? If so, obtain proper Sign permit. Inspector Permit # (/t 26W —OM7 —.5 / N Notes: dl there be any new construction or renovations? If so, obtain the proper Permit. Permit# O'ZO11-ro 11 -V6 Isa-Il-l9d �-22-(q Z onm to cony fete t e o owtn : Viol ns: Y /IN If so, sC %/ L ers: so, List: Vares�e: Y//N) IfstS,l:fst: SP's: Y/'c If so, ist: ances: I ,I 29�t' SDP's 2 Ol57 3 0 7Y�ir IJBv✓y S l� Revised I1/l/2015 Page 3 of 3 H',i t1fiN Dn US AS..HITK I'S PC'LIF -SPA,N DES1 N S1 ODif? Lic THE ?R ,r -'ES r a 'CIATCSc 4-11ml CENTER ✓ P < - [7 1ST FLOOR 1 12 181T9 z n _ rn nZ 70 m L APPROVED by the Aibernarle County Community Development Dent Application for Zoning Cleance OFFICE USE ONLY 1 Z 1. �, _j 1-1 PLEASE REVIEW ALL 3 SHEETS Check # z--,z-"�� Date: 'I ��I Receipt # '— "`-mil_ Staff: AA .- PARCEL INFORMATION nn Tax Map and Parcel: O iG 100 - 00 - CO .• 1 5 Existing Zoning / - l Parcel Owner: yen h r Ce-Z ' TM C- Parcel Address: Syo 119wla City State VN 7,ip224o( (include suite or floor) PRIMARY CONTACT Who should we call/write concerning this project? -5e-.* Address: Yo, \'X&Naa\f to(- City State VP' ( Office Phone: (SJ!) 97Y- 11K*Cell4 322 "S t Fax # E-mail Seat 6•i+.l CfJArC%,'N.6(1 APPLICANT INFORMATION Check any that apply: Change of ownership hange of use Change of name V<ew business Business Name/Type: C CkM� Previous Business on this site td.& Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of vehicles, and any additional information that you can provide: tit CtvAt,f ']'i.c t S !Pe'J Xe�Vw*,% Aagzx gc j-"layc ear a4.S o .11� f8e�w1� *This learance 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 1 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. e SignaturPrinted /anlAe" � '•"9'J^•` APPROVAL INFORMATION f ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x117. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing site plan. [ 1 ] This site complies with the site plan as of this date. 5- 201 S Notes: ) Building Official Date 14-s L,�`/ 2 - 5 2-a Zoning Official Date /J 0� Other Official V Ll' r C��-i t l Date 2 - 5— Z a County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5532 Fax: (434) 972-4126 Revised 11/02/2015 Page 2 of 3 Intake to complete the following: Y Is u in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. will Will be food preparation? If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies �'��--- Is parcel on private wel �or public water? If private well, provide Hea 1h D p ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies is parcel on septic ublic sew YJN dl you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit# 026W-tW7-5 YN Vl there be any new construction or renovations? if so, obtain the pro er Permit. Permit# I 2-(� Zoning to complete the following: Reviewer to complete the following: Square footage of Use: 1�0 \lW SF gef 'S6 Permrttedas�ly 0, yyI CL, ZkA Under Section�&k'tV`'e'et4( t[.S'e Supplementary regulations section: Pk95 e. l: 3, 2Iwo 4 zc 41), 2kto (d Parking formula: F � Z; � 3,2/1twa4x 1b,7to 531 Required spaces: _., l39n � _ Y / N j% QY S512P2,94-30 Items to be verified in the field: T �— viola,os: Y / If Mist: Ci�t's OV 44 /I ers: so, List : 49n _ z var/y'��,��e: Y//N} Ifs st SP's: Y/ If so, ist: �. antes: 1 d 20/ 5� 29z( SDP's L t- 7YePYt (rJPi'r;ci i eJ Revised I Ill/2015 Page 3 of 3 ICI 04 BUSHMAN DREYFUS ARCHITECTS PC THE LIFESPAN DESIGN STUDIO, LLC PRAY DESIGN ASSOCIATES CUTER . 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