HomeMy WebLinkAboutCLE202200109 Application 2022-08-16Zoning Clearance Application
FOR OFFICE USE ONLY
Fee Amount: $ 61.36
Application fee $59 + Technology Surcharge. $2.36
Receipt #:1a51.15q
Ry pF
a�
Albemarle County
r-
Comnuniry Development
d 1 Witit,re Rd, North Wmg
Charlottesville, VA22 2
f /HGltit"`
Phone 434 N6.5832
Clearance Number: 109
Date Paid: IPIa& a-'� By:D61ry►1t*� &vp
Check #: 3005 By: oV6 1
Applicant - Fill out the entire page below and return to:
Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
r�.
E-Mail Address:
2�1�154 �yylp�l� Cp.(pM
Mailing Address:
Phone #:
L(13 G 6 6
Tax Map and Parcel
number and/or Address
of the Business:
d
Zoning:
staff vn)l fill out A unknown
Parcel Owner:
Owner's Address:
o y C lover (4—
Check any that apply:
New Business ❑ Change of Use Change of ownership Change of Name
Business Name:ffi
ly1 n
Description of Business:
Describe the burins including use, number of employees,
number of shifts, availability of parking, and any additional info.
fN d—
o fi cr4- Jill
cont.0o
Previous Business on Site:
Floor Plan'
Please attach either an architectural drawing or a sketch of the proposed business indicating the location of uses, the
uses of rooms, the total square footage of the use, and any additional information.
Total Square Footage Used
for the Business:
Is the Parcel Zoned LI, HI, or PDIP?
O Yes No
If yes, fill out a Certified Enoineers 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?
Pudic Private
If on private well, provide Virginia Department of Health approval
Is the Parcel on public sewer or septic?
V❑ Public Septic
If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
Yes Q No
It yes, obtain appropriate sign permit and list permit # below
Will there be new construction or renovations?
N Yes No
If yes, obtain appropriate building permit and list permit # below
Please list any applicable Building Permit #s:
�_bl
Zoning Clearance review cannot begin until the application above is complete and all applicable fors 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. 1 have read the conditions of approval, and I understand
them, and that I will abide by them.
Signature2�•�.
Pdrded�QfJq�>�r—'
Date as2
rtcl �m7
2
,j
O
z
m
r
m
O
z
z
in
cn
G)
z
m
r
m
I
O
z
74
cn
n
V
4
3
N
7�
,_ _ . �� � � � �, 2 �
.w ` - ,: »: «j . \
. . . ^\��� ®2°� d
� \� ? ,yam y\ & /\ :
� \ . ;° ) \��� � .. :
��/
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: I
❑Site Plan [:]Zoning Ordinance ❑ CoD ❑Existing
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):
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
❑ 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:
yY�L 2:zlp
Additional Notes:
0 &m4h,91f,/
fY!!
Building Official
Date
Zoning Official
Date
l�PPR✓
AU6 16 W
Date
Other Official
ounty of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 Q