HomeMy WebLinkAboutCLE202300054 Application 2023-04-10 (2)Zoning Clearance Appil at
FOR OFFICE USE ONLY
Fee Amoun
C $61.36
Application fee. S59 + Technolopv Surcharoe 12.3G
Receipt #-
Clearance Number. -
Date
Paid:
Check #0
Applicant -Fill out the entire page below and return to:
Community Development 401 McIntire Rd, North Wing,
ion
By.
By:
Charlottesville, VA 22902
A IbernarW County
Community Developrnent
401 McIntire Rd, North Wing
Chadotisvilo, VA 22902
Name: S� � � �
EmMall Address:
K
Mailing Address: /I (P 0 9/ 4S f watlsoh
� VA~
Phone M
Tax Map and Parcel1/3 -/ Z
SOD �
Zoning.number A� � � �Y�� �r�J
and/or Address
Business: 0y.?OlS ' 0c) -p6 a,,-ZIO�D
Staff willl out it unknown
of the
Parcel Owner: vx�''��'d �� �le
INC
Owner's Address: ZZI 5� $:OX i Zi111`
Check any that apply: � New Business �
Change of Use �
Change of Ownership � Change of Name
Business Name: etl/Co ti1'�YLt/
o� � ��'
v! � � Ga G i -T/cO/Cldo&)
`Ii�
�
Description of Business: Describe the business incl ding use, number of employees, number of shifts, availability of parkin .and any additional info.
V�i Zoe jL�s5 - l��v�+ C'���i��—
/ems114f r�K
/ a n� �Ite 4 od l41 4ao w,c
GN t'�Nh4 Sl� �p 1 C elf SC. CC A
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Previous Business on Site:
4 _ re #VBEENli
/f
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:
Is the Parcel Zoned LI, HI, or PDIP?
� Yes o
If yes, fill out a Certified Engineer's Report (CER)
III there be food preparation?
E Yes :2/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
� Yes No
If yes, obtain appropriate sign permit and list permit #below
Will you be putting up any new signage?
Will there be new construction or renovations?
� Yes No
if yes, obtain appropriate building permit and list permits below
Please list any applicable Building Permit #so.
Zoning Clearance review cannot begin until the application above is complete and a
This Clearance w
III only be valid on
location, a new Zoning Clearance w
the parcel for
ill be required.
II applicable forms and fees are submitted.
which it is approved. If you change, intensify, or move the use to a new
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
Date
23
2
Zoning Clearance Applicat
ion
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
certify that I will provide (or have provided) notice of this clearance application,
ce nu
er p
to 0
Name of land
of Tax Map and Parcel Number
Stan or business name
er on record
Ll q5610 • 00-o0001/60
TMP number of property
tr
the owner
by either delivering a
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)
E,/ Hand deliven9
g a copy of the application to the owner identified above on
Date 10 Z
❑ 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..of644L44MAI
Date &i/723
3
For Albemarle County Staff Review Only
Proposed Use:
Permitted:
n Yes n No
Permitted by Section:
8upplewtentary Regulations:
Applicable Special Use Permit (SP).
Applicable Rezonings (ZMA)o
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.
Par1cing Formula:
DafinW by:
[:]She Piss [:]Zoning OMnance D CoD E]Existing
Total Square Footage of the Use;
Required number of parking spaces:
Associated Clearances:
Vatiancaes:
Violations:
Is a site inspection necessary?:
Site Inspection on (date):
Notes:
� yes � No
To ConRnn:
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 detellmination of compliance
with the existing site plan.
❑ Thies site complies with the site plan as of this date.
Conditions:
Additional Notes:
Building Official Date
Zoning Official Date
Other Official
County of Albemarle Department of Community Development
401 Mdntire Road Charlottesville, VA 22902 Phone: 434.286.6832 Fax: 434.972.4126 4
OIPECIIIN�9 T081TE:
FOXFIELD COLT
22t5 FOXFIELD TRACK -
CHARLOTTESVILLE,MRGINIA
22901
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SITE PLAN
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CONSTRUCTION NOTES
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