HomeMy WebLinkAboutCLE202200129 Application 2022-09-22Zoning Clearance Application
FOR OFFICE USE ONLY
Fee Amu nt-. S 61.36
Application fee $59 + Technoaogy Surcharge $2 36
Receipt III:
CiGarance Nu-nbe,
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
ROL �� 1A-V
0`4000ft'lle. VA 22HU
pt� AN � �
KlArk Oill
E-Iftll Address:
Mailing Addrese:
7-4is i AAvA I st Ito tv I 1�
Phone
Tax Map and Parcel
number and/or Address
a
of the Business:
-czi -l:W-zzS*0' Zoning:
'2-41 SW Wil III OW t �rkno�
0 v.1 6- vA 2*00,3
P'j _r_
J PA jyvcstvK j0wner'sAdtlrm. %44
NOW &AIMS D Change of Use Change Of OVMWhip Change of Name
Parcel Owner:
-
I �heck any that apply:
Business Name:
'6eiiictiPtion
I —
C'Ovv� e, CVL- L-L./,
Describe Me business including use. number of amp�; , �nwber of �ahlfts, availability of Waking -Wwaftv additional irft.
of Business:
0/U'J Willn 2- a~-rZ&At,0WW-z4
PrevlOw Busine" on She:
e-S
Floor Plan:
Please Mach other an architectural drawng or a skaly-h of it, proposed business ind"ing Me IDCatlon of Us". the
UM Of Moms the total 5(tusre footage Of it* use. and any addifionat inflarnewn.
Total Square Footag* —U"d
for the Business:
---�D-Ip?
Is the Parcel Zoned LI, liff, or
I [] Yes No If Vft. N oull EnoWiligrS ggy9rt
Will we be food preparatlon?
Y" No it Yea. provide Virginia Department of Has" approval
AAft prww If on private well, provide Virginia Deperainfint of Health approval
It the Parcsi On Pubk water or private welt?
Is the Parcel On Public "wer or septic?
[giptillik Sepht; if on seplic- provide Virginia Department of mean approval
.9 Yea El No if yes obtain awopraft sign permit and list permit # below
El Yes (S No if Yes, obtain app-opnate building permit and list permit 0 below
Wit you be putting up any now signage?
Will there be now construction or renovation@?
Please list any applicable Building Permit ft:
Zoning Clearance review cannot begin until the application above is complete and all applicable forms and fees are submitted.
Thrs Clearance will only be valid on the parcel for which it is approved If you change, intensity or move the use to a new
location, a new Zoning Clearance will be required
I hereby certify that I own of have the owner's permission to use the space indicated on th s 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 v)A� oAVW0
Date Aa,
L 2
Albemarle County
Zoning Clearance Application 40- U:tj. Ad pd� W,�
VWUNcrlo VA22VU
Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either
informeo 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,
L-yWV'4-- tl�v �--Vu Luc
0earance rwimbillf PrOv4W bY Stliff Of busineee name
to Jp/-N 10--k)ry IYIIV4�� the owner
h1ame or ranclowner on recara
of Tax Map and Parcel Number rk000-00-Cl9-02-*�Al!> by either delivering a
TIAP rimber at vro"rly
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
Mailing a copy of the application to the owner identified above on
Date-1 I Z I /4�1— to the following address:
iloo A-,,(nnjA4n "�e A
(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 V�o
Date 12-% /
91
For Albemarle County Staff Review Only
P =ltW byi��aon-
Applicable SpociaFL�;-PWMttMF;)---
Appilrable Rmoninge (ZKAy
Applicable Site Plane (SDP):
F�rking
Parking Formula:
Total Square Footage of ft Use:
Required number of P*Mng spem:
Associated Clearances:
Variances:
Violadone:
Is a mile lnspwbon naceseary7-
Oft Inspection on wsjloj�
Notes:
Permitted:
I EJ Yee F-j No
SUPPiemefflary 1111ftulliatom I
if there es an aporoved ste plan as=c!Mea with the parca, the parking r4QLW9f110Rt& Will DO -dofted by the -S0F
Parking requ,rermnts are oilitermined by a ZMA or by an approved Ccde of DgvgiDpm*nl Soma
Defined by: j E]SWO Plan El Zoning ordinance �Ejdsong
F-1 Y&S F— No
To Confirm:
Condition of Approval: Addibonal conditions of
I approval apply to Fire%vorks and Chfisimas Trees
Approval Information
Approved as proposed Approved with conditions Denied
Backflow prevention device and)or current test data needed for this site. Contact ACSA, 434.977.4611 ext. 117
F-1 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.
Additponal Notes -
Building Official_ Date
OMClW Date
Other Oftiel Date
county of Afbennarle Department -f C001munity, Devel,pmew.
401 McIntire Road Ch"IlIft,1100. VA 22902 PhOM: 434 296.5832 Fair 434,972 4126 4
WWOW - COW VA VW40400
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