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Home My WebLink AboutCLE202200100 Application 2022-07-26Zoning Clearance Application FOR OFFICE USE ONLY Fee Amount: $ 61.36 Application fee: $59 Technology Surcharge: $2.36 Receipt #: Clearance Number: Date Paid: By. Check #: By. Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 �� Albemarle County A Commvmry Oeveloo�t 401 McIntire R, North Win, ChadatlesMle VA 229C2 Phone 4342%5832 Name: IJ( W,If W, \ \_. E-Mail Address: �✓iw� rvrvlJS Marling Address. UItiiN t �} Phone #: InYYh�fo"pFnwtl ca•, j q L3 Tax Map and Parcel I I Z Zoning: pp / number and/or Address 1 C b staff will fill out If unknown of the Business: Parcel Owner. Ownees Address: Check any that apply: New Business Change of Use Change cf ownership Change cf Name Business Name: Description of Business: CesCflbe the business incluclrg use, number cf employees, number of shifts, availability of parkingand any additional intc. Previous Business on Site: i bit I Floor Plan: Please attach either ar architectural drawing or a sketch of the propcsed business Indicatirg the Iccaticr :f uses, the uses cf rooms, the total square footage cf the use, and ary additcnal infortnaticr. Total Square Footage Used !for the Business: S 00 Is the Parcel Zoned LI, HI, or PDIP? I Yes No If yes, fin out a CertiEed=rclneer s Raccr' r^"R' Will there be food preparation? Yes _J No If yes. orovtde Virginia Department of Health approval Is the Parcel on public water or private well? E7Public Private If on private well, provide Virginia Department of Health approval j LIs the Parcel on public sewer or septic? Public V Septic If on septic, provide Virginia Department of Health approval Will you be putting up any new signage? I= Yes J No If yes, obtain appropnate sign permit and list permit # below Will there be new construction or renovations? 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 location, a new Zoning Clearance will be required. If you change, intensify, or move the use to a new 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 1. understand them, and that I will abide by them. Signature Date N Zoning Clearance A Albemarle County pplication 4nmeruntroRdNothW Ch McIntire Rd, 229 Wing CM1adoltaaWlle, VA 22%2 Phone 434.2%.5832 kpplicant - If you are not the land owner, please fill out the entire page below confirming that you have either (formed 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, clearance number provided by Staff or business name to l '�cm the owner Name cf 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) �I Hand delivering a copy of the application to the owner identified above on Date ' a Mailing a copy of the application to the owner identified above on Date 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) Signature of Applicant Applicant Name Printed Date 3 IN3WdOl3n34 AltimnNNOO a3ni3�3d For Albemarle County Staff Review Only Proposed Use: Permitted: Yes '� 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 Site Plan '^ Zoning Ordinance coo Existing Total Total Square Footage of the Use: Required number of parking spaces: -- Associated Clearances: Variances: Violations: Is a site inspection necessary?: Yes No Site Inspection on (date): I To Confirm: Notes: -- --- Conditions of Approval: Additicral ccrditicrs of appmval apply tc Fireworks and Chnstmas Trees Approval Information Approved as proposed ❑ Approved with conditions Denied J Backflow, prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117 J 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 Offic Zoning Officia Other Official County of Albemarle Department of Community Development 4J1 McIntire Road Chartottasville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 ,� n n L-� i � n a= a CHARLOTTESVILLE , FASHION SQUARE § Rai z J T i 11600 Rio Road East Charlottesville, VA 2901 IN3WdOl3A3t7 AliNnyvvM®o ®3dU303H aooa apislno neMlleH 01 Jooa Hoeg �yN> cyloCty �C ► C:) � > U) D Cn 3 �T ��, r r rn rrm