HomeMy WebLinkAboutCLE202200080 Application 2022-07-18Zoning Clearance Application
FOR OFFICE USE ONLY
Fee Amount: $ 61.36
Application fee: $59 th Technology Surcharge: $2.36
Receipt #:
Clearance Number:
Date Paid' Ry:
Check #. By:
Applicant - Fill out the entire page below and return to:
Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
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Albemarle County
Community Development
,jib kkk 401 McIntire Rd, North Wing
GhatloltesAlle, VA 22902
yactNth Phone 434 298.5832
Name:
1eV�
E-Mail Address:
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Mailing Address:
eso J It
Phone#:
9�0 •d
Tax Map and Parcel
number and/or Address
of the Business:
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C1_IbFceb+fr> t1Iie-t Go, aagoi
Zoning:
Staff will fin out if unknown
Parcel Owner:
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Owner's Address:
y
Check any that apply:
New Business Change of Use Change of Ownership Change of Name Ip(/ �rU/�
Business Name:
d UAS P
I)
Description of Business:
Describe the business including use, number of employees,
iliumber of shifts, availability of parking, and any additional infoPips&.
SPA • ohtylil�//'11a
Previous Business on Site:
It �. -6nf_ c�-I to
Floor Plan:
Please attach either an architoctural drawing or a sketch of the proposed business indicating the location of uses, the
uses of rooms, the total square footage ofthe use, and any additional information.
Total Square Footage Used
for the Business:
Is the Parcel Zoned LI, HI, or PDIP?
j Yes Y No
If yes, fill out a Certified 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?
VPubli, I Private
If on private wall, provide Virginia Department of Health approval
Is the Parcel on public sewer or septic?
I , Public I Septic
If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
XYes N No
If yes, obtain appropriate sign permit and list permit # below
Will there be new construction or renovations?
I "; Yes 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 wi Y35 by them.
Signature Printed
Date 't i- 2
q
For Albemarle County Staff Review Only
Proposed Use:
Permitted:
I. I Yes L J 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: I
LSite Plan ]Zoning Ordinance LJ CoD �jExisting
Total Square Footage of the Use:
Required number of parking spaces:
Associated Clearances:
Variances:
Violations:
Is a site inspection necessary?:
�,—] Yes F7. No
Site Inspection on (date):
To Confirm:
Notes:
Conditions of Approval:
Additional conditions of approval apply to Fireworks and Christmas Trees
Approval Information
❑ Approved as proposed [] Approved with conditions ❑ Denied
U Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117
n 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 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