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HomeMy WebLinkAboutCLE202200144 Application 2022-10-31Zoning Clearance Application FOR OFFICE USE ONLY Clearance Number Fee Amount: $ 61.36 Date Paid: By: Application fee: $59+ Technology Surcharge: $2.36 Receipt #: Check #: By: Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 � Albemarle County Community Development J 401 McIntire Rd North Wing Charlottesville, VA 229M Phone 434.296.5832 Name: rad2 ( A ,. J L. Tic E-Mail Address: Mailing Address:It E60 b — v F-lC�✓Ino ?hone #: Tax Map and Parcel number and/or Address of the Business: va 23 LZ L Sl ttke � � Z 'rp)t Quip Zoning: Staff will fill out I unknown Parcel.Owner. d 1 e (LC owner's Address: ZISI Kc, +• one (Zoae9 Check any that apply: ® New Business ❑ Change of Use Change of Ownership Change of Name Business Name: Description of Business' Describe the business Including use, number of employees, number of shifts, availability of parking, and any additional info. ehau1 a" 19 �'lnf c 3 �m to �g ONL l lni . t^n+nimo..� -i Previous Business on Sit : �d � r^.t S 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: ADpra%������ 2t�ae ��uore PStJf Is the Parcel Zoned LI, HI, or PDIP? ❑ Yes [a"No If yes, fill out a Certified Engineer's Report iCEM Will there be food preparation?, Yes ZNo If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? F1 Public Private If on 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? ©'Yes No If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? O Yes F1 No If yes, obtain appropriate building permit and list permit # below Please list any applicable Building Permit #s: s{„ t : vJdthiis ov ��^'"Oj Stgw Coy nQo+t`t ' Ila%" d(rmtT to vc•tpr 6�tw r v-. •-� Zoning Clearance review cannot begin until the application abovb is complete and all applicable forms and fees are s 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. 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 .,f/GLl/ ri" L��L' `r Punted Date 2 Z 2 >rA %S, �4e (tn'x")v Albemarle County Community Development Zoning Clearance ApplicationOtt, MCIntlte Rd Nod Wn9 Chadottesvlle, VA 22902 Phone 434.296.5832 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, �Ar 3 Lus-es . I� c- clearance number provided by Staff or business name to Posl�t�w, I,LG the owner Name of landowner on record of Tax Map and Parcel Number 4-f, Mo F --t , 'Fo cce ( 33 A by either delivering a MP 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 10 13% ( Z02,2 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 1a(3 11 7Z 3 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: 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 �a N 00 -O Zt N `~ 4 00 L N O1 u N ^� U I6 N u 1 " m yQa (� v 3 .r- N m y0 N N Q L C >IN O � Or lu M a v ° E Q y S w � U v U Q z O 0 Op K M O Y j t 'C O n 'Tr o ro o n L 7 L O N T a- E= ao O�0 -m u m0m pm U I{ c y ' 1 r O 'c L 2 lfl X N C M Q Ln N LL U 10/31/22, 11:25AM Payments Payment Receipt Your transaction has been successfully completedH Your Confirmation number is : 1000478229 Transaction ID: 22103110187006A45CD7422103110187 10/31/2022 11:20:11 [EST] Account Information Payment Type: Tax Payment Bill Payer Details Brad Warrick 1700 Chambertayne Ave. Richmond, VA 23222 Payment Details Payment Amount: $61.36 Convenience Fee: $1.95' Total Amount: $63.31 Payment Method: VISA Card Number: XXXXXXXXXXXXX5111 Expiration date: 10/2025 https://w .albemarlecountyWxes.org/payments/default.aspx 1/1