HomeMy WebLinkAboutCLE202200099 Application 2022-07-29it tc&„f
Zoning Clearance Application
FOR OFFICE USE ONLY Clearance NumberCLE20'ZZ- 0009q
Fee Amount: $ 61.36 Date Paid — 1 2.51 ZZ By: MOW-ju orde,�
Application fee: $59 , Technology Surcharge. $2.36
Receipt #: 151031 Check = 2,1 8 `12 M BY: bW6
Applicant - Fill out the entire page below and returr t:
Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Albemarle County
Commumry Oevelovmam
401 McIntire Ra. N.0 veiny
ChahOfleevllle VA 2 K2
Phone 43 2%5832
Name: Jee (o rn e.
qe4) (y
E-Mail Address:
HCnr Y rorr�
Malting Address: 1569
is QPp R'l
Phone #:
8A Gnl
Tax Map and Parcel
I600 Ri O
p% (; . Zoning:
4
j
number and/or Address
of the Business:
VA 22 90 I
'y Staff 411 fill out if unknown
vt } 2 13 OFi
Parcel Owner.
Owner's Address:
I13D droouwOfl dwe
Check any that apply:
' New Business
'` Change cf Use 7 Change of Ownership —i
Change of Name
Business Name: ,,,'V Pfe-M C Gl C eQVI L LG
Description of Business: I Cescrtbe the business ircluding usenumber of employeesnumber of shifts. availability of parkingand any additional infc.
Re+ 5111 CBD 34oCe io VcIst'on-s;,,ov'va Aah �Ien4V OF YFidmoi
+hc(e 'C)l vS CihA sIAIF4 v
Previous Business on Site:
Floor Plan:
Please attach either an architectural drawing or a sketch of the prcpesed business indicating the Iccaticn :f uses, the
lI uses of roams, the total square fcotage of the use.. and any additicnal infermaticr.
Total Square Footage Used
for the Business:
1710
Is the Parcel Zoned U, HI, or PDIP?
vas
L/N0
If yes, fill out a Cer9fed Engineer s Peccr. �CE2,
Will there be food preparation?
U vas
No
If es. provide Virginia Department of Health
Y 9 p approval
Is the Parcel on public water or private well?
Public
Pnvate
If or private well, provide Virginia Department of Health approval
Is the Parcel on public sewer or septic?
Public
Septic
If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
vves
J No
If yes, obtain appropriate sign permit and list pem it # below
Will there be new construction or renovations?
^ yes
J
' No
If yes, obtaw 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 will abide by them.
Signature
Data
Se.< n m e 4rvrY
2
For Albemarle County Staff Review Only
Proposed Use: I Permitted: _ Yes _ No
Permitted by Section: ! Supplementary Regulations:
Applicable Special Use Permit (SP): .
Applicable Rezonmgs (ZMA). -,
Applicable Site Plans (SDP):
Parking: If there is an approved site plan associated with the parcel, the park:rg 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 Square Footage of the Use: I
Required number of parking spaces:
Associated Clearances:
Variances:
Violations:
Is a site inspection necessary?:
j ^ Yes No
Site Inspection on (date):
To Confirm:
Notes:
I
Conditions of Approval: I
Additicral ccnditicrs of acercval acciv to Fireworks and Christmas ?reel
Approval Information
C Approved as proposed ❑ Approved with conditions J Denied
I
Backflow prevention device and/or current test data needed for this site. Contact ACSA, 434.977.4511 ext. 117
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:
I
Building Official Date
Zoning Official Date
Other Official Date
County of Albemarle Department of Community Development
4J? McIntire Road Charlottesville, VA 22902 Phone 434.296.S632 Fax. 434.972.412E 4
RECEIVED
COMMUNITY
DEVELOPMENT
OF
Zoning Clearance Application Albemarle County
J' rn
ty
Communiire Rd, Norm �
401 McIntire Rd. Noah Wing
F" Cnarlonesrlle. VA 22902
Phone 434.2% 5832
Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either
informed 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 Gk A d 6+A e3 V JIP JQ 2o14-IIC. the owner
Name of 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)
Hand delivering a copy of the application to the owner identified above on
Date Z01 Y 2 -21 2 04Z
❑ 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