HomeMy WebLinkAboutCLE202200172 Application 2022-12-272� Albemarle County
Zoning Clearance Application r"�� 40mm°niineRd, oNhW Charlottesville,
McIntiree, 229 Wing
CharlonesNlle, VA 22902
4IRCITmt' Phone 434.296,5832
FOR OFFICE USE ONLY Clearance Number:
Fee Amount: $ 61.36 Date Paid: i,-� 1�11 (,qa ByJ EFFYeN Clan non
Application fee: $59 + Technology Surcharge: $2.36
Receipt r5l 3 O Check #:(4 I L15 By: NO
Applicant - Fill out the entire page below and return to:
Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902
Name:
F.11ZQbC+tt cl0.�tar�
E-MailAddress:
L-re,Ia"W"A yet Coen
Mailing Address:
i 5125 N1tS-f0nL"e, Crozet daz2932-
Phone #:
434_Qgb' a3c17
Tax Map and Parcel
number and/or Address
of the Business:
y247 p,d 'T-hriee 1VotCk14 Roof
CAiArlotte5,rAte,V0l u901
O O - 00 _
Zoning: -D&jc re/PrescA wj
Staff will fill out ifun'
Parcel Owner:
two w�elq S� go► }2 Tfu
Owner's Address:
Mew O d s' j47A d Pr d
Check any that apply:
New Business Change of Use Change of Ownership ❑ C ange of Name
Business Name:
Z, u t Q�t SC11oo
Description of Business:
Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info.
"S0106l PrGc5i-, m 9: -S: 5 rA
Io+l�lkn Plan + Chus z d ,c�And dam a«d
Previous Business on Site:
Cb.r teh, 1 old Wove 146cir
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.
Floor Plan:
Total Square Footage Used
for the Business:
Ilolb0 s7tletsC c"e- ptits frrrisbtccQ tmCrsF•
Is the Parcel Zoned LI, HI, or PDIP?
Yes R'No If yes, fill out a Certified Engineer's Report (CER)
Will there be food preparation?
Yes Q No If yes, provide Virginia Department of Health approval
Is the Parcel on public water or private well?
Public RrPrivate If on private well, provide Virginia Department of Health approval
Is the Parcel on public sewer or septic?
Public �T Septic If on septic, provide Virginia Department of Health approval
Will you be putting up any new signage?
Yes RrNo If yes, obtain appropriate sign permit and list permit It 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 ifs:
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.
Signatur Printed e I12st6e4Ai C la.rr-y&jn
Date 12--21-2-2-
2
Albemarle County
Zoning Clearance Application Community Develoi 461 Mclnlire Rd, A 229 Wing
ohesville. CharlVA 22962
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,
'..r.tt;' pc�esc'Aoo I
cle ranee number provided by Staff or business name
to _Po'e-u Sc'how- 8or+2, the owner
Name landowner on record
of Tax Map and Parcel Number 05'700 - 0n -o - n2-4AC by either delivering a
IMP 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)
u Hand delivering a copy of the application to the owner identified above on
Date IZI 2r / 2Z
❑ Mailing a copy of the application to the owner identified above on
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 (I -Ott C(&VYj ,
Date t2/ 2l / 22--
3
For Albemarle County Staff Review Only
Proposed Use:
Permitted:
❑ Yes ❑ No
Permitted by Section:
Supplementary Regulations:
Applicable Special Use Permit (SP):
Applicable Rezonings (Zli
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:
[]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 n Denied
❑ Backf low 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
Zoning
Other Offic
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Phone: 434.296.5832 Fax: 434.972.4126 4
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