HomeMy WebLinkAboutCLE201900087 Approval - County 2022-06-22APPROVED
oy the Albemarle County
Community Development Department
Date-_ S— $-1 ?
Application for Zoning Cle'arari6e ."O - 7-
-
CLE # 9-0 1,'1 TT
—.
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ON V
Check# 1 2Oq Date: 30 I q
�1-1' -•
Receipt # I `! � Staff.Zu•/
PARCEL INFORMATION
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Tax Map and Parcel: S W OpGI Existing Zonin A
Parcel Owner: �hh �YnQ(,}'{'lQ 1 I
Parcel Address: IR SRyy�;J9 Q TYnn ^ City IOU %OWU State iSliA— Zip 200 O]
(Include suite or Boor)
PRIMARY CONTACT
Who should we call/write concerning this project? nt
Address • City _ _ _ State _ Zip
Office Phone: (_j Cell # W3 O S Fax # _ E-mail uwi
APPLICANT INFORMATION
Check any that apply: Change of ownerships Change of use Change of name New business
Business Name/Type: _M /11W x y 1jjl 1 � n
10
Previous Business on this site ���,
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: (.(f q AIAIQt111 12 W_td M dt S,ry) bod
UN�Ch, _
'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 or have the owner's permission to use the s ace indicated on this application. I also certify that the information provided
is true end ac o t best of my kt �� a ge.,read the c tions of approval nder land them, and t� will abide by them.
Signatu Printed JJC -
APPROVAL INFORMATION
[ j Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backfiow prevention device andior current test data needed for this site. Contact ACSA, 9774511, XI 17.
[ ] 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.
Notes:
I
i
Building Official Date
Zoning Official Date
i
Other Official Date
i-ounty of Afnemarfe Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Revised 11/02.2015 Page 2 of 3
40
Intake to complete the following:
Y //N 1
Is u n LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / �iJ )
Wil re 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 well or pu �c wa
If private well, provide Health 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 or p lic sewer?
N
-Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit# 020(1-0270g 5 (tlpy,V)
'Y/N
ill there be any new construction or renovations?
If so, obtain the proper Permit.
Permit# �jZO($-AOIOONC
Zoning to complete the following:
Reviewer to complete the following:
/
Square footage of Use: � I 1y oo
N ,I�/ 1
fitted as: M/J& OeGIG(C
Under Section: 2 y, 2 , I (Z 5)
Supplementary regulations section:
Parking formula: '45-00
Required spaces: `o �nYs
Y/N ( I/
Items to be verified in the field:
Inspector : Date:
Notes:
'olations:
Y/N
so, List:
I vIC
'L aI
o
�_ 2 5 4'
Proffe
Y/
If so, List:
2004—
J12 Cgb1rVW)
YE'llance:
Ltflso, List:
t q (2 �
Z ('l 16 -17
SPIN
Y so, List:
Clearances:
Zel6-LSq
2o15-2y6
SDP's
Zp(7-zl Cie,-d)
201''1-LZ�
2-F13-183
7-17 126`&f lS7P-65 O"I
201z 13
1 Li;",kq
Revised 1I/l/2015 Page 3 of