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HomeMy WebLinkAboutCLE202200174 Application 2022-12-29Zoning Clearance Application FOR OFFICE USE ONLY Clearance Number: Fee Amount: $ 61.36 Date Paid: Application fee: $59 + Technology Surcharge: $2.36 Receipt #: Check #: M By: Applicant - Fill out the entire page below and return to: Community Development 401 McIntire Rd, North Wing, Charlottesville, VA 22902 OFA �2 l,ll Albemarle County o Community Development U 1° 401 McIntire Rd, North Wing )` ChsdottesWW VA 22902 `Yj fig.` Phone 434.296,5832 Name: PRAS'HANNA Ol /'}CIA► cni E-Mail Address: t3RowN8A0rHWIi3S er1 Mailing Address 616 VtoLLy HIL1. kD 13Atb0V&)/ V Phone#: y12 3130 668o Tax Map and Parcel number andlor Address of the Business: I III RIO Roo D 6- CHhA"TT6SUILLE- V19 22 o 9 1 Zoning: Staff will fill out if unknown Parcel Owner: Owner's Address: 1=5 STE1,10%.9 C-f UhJHN Check any that apply: ❑ New Business ❑ Change of Use - 5?'Ehange of ownership Change of Name Business Name: 6 B no CoRr*R STOA6 � DELI Description of Business: Describe the business including use, number of employees, number of shifts, availability of packing, and any additional info. CONO)NEIV'f STORE iN40 SuppJJES T* DAtILy 8IVI( NEEDS SLV_41 ps -Tob) IAty �x6(6kY ¢ VLI)uk3. @S(F fiNIPLgIfp 2 Fllf-i.> OE 20 CAA kiu 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: )500 Sq, it - Is the Parcel Zoned LI, HI, or PDIP? ❑ Yes 0' No If yes, fill out a Certified Enoineer's Report (CER) Will there be food preparation? Q'S'es No If yes, provide Virginia Department of Health approval Is the Parcel on public water or private well? ❑ 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 olo If yes, obtain appropriate sign permit and list permit # below Will there be new construction or renovations? ❑ Yes VNo If yes, obtaln 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. �t �t Signature Printed PQA St �A rYNA 1T 1 Q F'tl • i/) Date 7- "2 2 70VU OF A . Albemarle County � f�LL- Zoning Clearance Application Gommme unily Developnt 401 MoInUre RC. NOM wing' chadottesvnNe, 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, ►3 4 wtARl<F7 STREET Cq►�E � I�Et � clearance number provided by Staff or business name to ► wA Ii-LC the owner --- Name of landowner on record of Tax Map and Parcel Number 06 loo o©bo ILI6 80 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 ❑ 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 l �2 Applicant Name Printed Date -43 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 ❑Fxdsting 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): TaOgrtirm: 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 sir r