HomeMy WebLinkAboutCLE201900246 Approval - County 2022-06-24APPROVED
_-i theAlur-marle County
--ML'nih DCVCioonent Depart nt
Application for -7Zoning `Cilearancec`>
CLE # e;Ot- t
OFFICE US ONLY
PLEASE REVIEW ALL 3 SHEETS
Check # Date: l ( l
Receipt # Staff: m G
PARCEL INFORMATION
Tax Map and Parcel: (0 1 t>J - A -Z Existing Zoning
Parcel Owner: RYYI
Parcel Address: 1145 Semit4lt.(-, 14A City Ct l ttk State ve Zip 0-05UI
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project? 14 2. Kr�c
Address: $/S l2j„r,,.,,�:,,.J, VlcC.c City Cam)/4 State Vn ZipX9r,I
Office Phone: (±14)fslS-4Cl7 Cell# Fax# E-mailixte�rnannole[om�c�i,naf
APPLICANT INFORMATION
Check any that apply: _ Change of ownership Change of use Change of name New business
BusinessName/fype: i_-fer-k;.L- (cnc. i�: aF u14 LLL Yy+'ks +rcr Srte,,
Previous Business on this site P1'dr r 14cr. ' , ,'; «J
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: _ C h c I>,4.,nc. +cca /. t 1 tr ly;IAC
N -dS — IS tS-aU- 19
*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 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.
Signature Printed 13'r0 C Aie c ,rv., •.,.
APPROVAL INFORMATION
[ ] Approved as Approved
proposed [W1 with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, A17.
[ ] 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 Ian as of this date. FF j/�//
Notes: P P Tic tlLl4cc1 V 4'� 5L4V4r-[C
Building Official Date O 129
Zoning Official Date r ` Zt —�
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
Revised I I/l/2015 Page 2 of
Intake to complete the following:
Y %N�
Is m LI, HI or PDIP zoning?
Engineer's Report (CER) packet.
If so, give applicant a Certified
YI
Will ere 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 is er?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or p ewer?
Reviewer to complete the following:
Square footage of Use: 1,900 V
N /
ined as: 5�-ft,50,,t ` SQ(e—S
Under Section: 4 44,K iove,�cC.e—
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # Inspector
Y / N Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Violo*ons:
Y"
If ist
/t ��"" Bp- MO tiro �oYk�fn
Proff
Y /O
If so, List:
Variance:
Y/N
If so, List:
1�r8`(-7o COW(e� srsIi
's:
/N
If soList:
, ZolS-3Y —31
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Clearances:
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Revised H/l/2015 Page 3 of
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
1 certify that notice of the application,
[County application name and number]
was provided to P lit o %lcun �_ the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number (ol w— A-1, by delivering a copy of the application in the
manner i ntified below: p /�
Hand delivering a copy of the application to le o F)�9—
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
Dr
Date
to the following address:
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement).
Signa uree/Joof Applicant
, 7 , f' ht t...Y--
Print Applicant Name
Date
I