HomeMy WebLinkAboutCLE202300021 Application 2023-02-21k, Zoning Clearance Application
FOR OFFICE USE ONLY Clearance Number -
Fee Amount: $ 61.36
Application fee: $59 + Technology Surcharge: $2.36
Receipt M
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
Community Development
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401 McIntire Rd, North Wing
CharloaesAlle, VA 902
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Name:
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E-Mail Address:
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Mailing Address:
1 /00MY&2S DRIVE C4AkLoTfkSvfl4.EV42294sf
Phone#:
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Tax Map and Parcel
number and/or Address
of the Business:
PARCEL, 0N500 -oo-00 - 09q So
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Zoning:
Staff will fill out 9unknown
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Parcel Owner:
CM4 PROPULTIFS /IVC
owner's Address:
/60 MYE9S OQIV£
Check any that apply:
New Business Change of Use E Change of ownership Change of Name
Business Name:
0 1 A PAT-r-CT/oAj/A/C•
Description of Business:
Describe the business including use, number of employees, number of shifts, availability of parking, and any additional info.
AtATo o-AtER OWNED kwzo-wr6,rMPANY. Z FMPLoyF.ES (CUARENT MP14YEES) WDRlfIN(r
D/jYTlM@ SIffFT US1 CIAARkAq- P.+WGy✓6 ACCa/larD/lT�oNi,
Previous Business on Site:
COtoAlmt AVIT0 CEAI-W
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:
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Is the Parcel Zoned LI, HI, or PDIP?
❑ Yes ® No If yes, fill out a Certified Engineers Report tCERI
Will there be food preparation?
❑ Yes ®, 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 ® No If yes, obtain appropriate sign permit and list permit * 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 #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 'de by them. Kn /' t /
Signature Printed ✓' `E6 v y " S
Date a / 6 10to A
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