HomeMy WebLinkAboutCLE200900043 Review Comments Zoning Clearance 2009-03-254
Application for Zopingy Clearance
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Zoning Clearance = $35
OFFICE U E (ONLY �j
Cllr # Date: 119/� 7 U l
PLEAREVIEW ALL 3 SHEETS
Receipt # Staff:
PARCEL INFORMATION //�J
Tax Map and Parcel: V _ / Existing Zoning
Parcel Owner: Y'� :Uluof)�, /
Parcel Address: 1 p�2gd
/G�(Q� /!�UfL `/' City /rl�� (/` State (/�' Zi
(include suite or floor)
PRIMARY CONTACT p
� U ul& od
Who should we call /write concerning this project?
Address :/J J d State
Office Phone: (dq & &efl #' Fax # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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azz e
Business Name /Type: �G / ✓/V `'1
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Previous Business on this site
Describe the proposed business including use, number of employees, n her of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide:
*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 own or have the owner's permission to use the space indicated on this application. I also certify that the infonnation provided
is true and ac rate 11 ? est of m laiowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
_ Y GO
Signature Printe OS C a 0 U/ 1 ya
APPROV ORMATION
[ ] rApproved as proposed [ ] Approved with conditions [ ] Denied
�] Bacicflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x119.
[ ] 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.
Notes:
Building Official c�L` �'�'w�. Date
Zoning Official 1-✓ Date
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3
Intake to complete the following:
Is /
Is u m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
a /N
ill there be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well or 09�;D
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appli
Is parcel on septic orifublic sewe .
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7.nnina to emminlPta tha fnllnwina-
Reviewer to complete the following: � I
Square footage of Use:
� / N
Permitted as: EA-�i A14 e 5`�Abl, �� Nu Cy✓'
Under Section: 2S• 2,
Supplementary regulations section:
Parking formula: (�
,— n 6T d c�Jl��Y
Required spaces:
Y
Items to be verified in the field:
Inspector : Date:
Notes:
�olations:
( /N
If so, List: - �s
-i -
Proffers:
Y /l6
If so, List:
Variance:
Y/*
If so, List:
SP's•
Y/�
If so, List:
Clearances:
SDP's.
Revised 04/28/08 Page 3 of 3
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