HomeMy WebLinkAboutCLE200900152 Review Comments Zoning Clearance 2010-10-26Application for Zoning Clearance
CLE #
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Zoning Clearance= $35- _ _ -,_
OFFICE USE ONLY
Check # __ 0- ?- 60_ _ __ Date: _c1 'Z/70 9- _ y
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff:
PARCEL INr XORMA T iON
Tax Map and Parcel: 04500- 00- 00 -068D5 Existing Zoning Highway commercial
Parcel Owner: Wal -Mart Real Estate Business Trust
Parcel Address: 975 Hilton Heights Road City Charlottesville State VA Zip 22091
. (include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? Amy Miles, Permit Coordinator, pb2 Architecture
Address : 710 West Roselawn Drive City Rogers State AR Zip 72756
Office Phone: 888 656 -3545 Cell # Fax # 479. 621.5202 E -mail amy.miles@pb2ae.com
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name x New business
Business Name/Type: Wal -Mart Store #1780 - Retail Store
Previous Business on this site no change
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and any additional information that you can provide: Expand existing Wal -Mart store to include full
grocery sales.
*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 acc rate 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 Printed Amy Miles, Permit Coordinator
APPROVAL INFOUMATION
/]`Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow 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 �- Date` ' 0
Zoning Official 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: Reviewer to complete the following:
Y / N Square footage of Use:
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet. 6/ N J
ermitted as: rr°;,b i
Will there be food preparation? Under Section: .a.a,
If so, give applicant a Health Department form.
Zoning i'evie-W can riot uegirl iiiiiii we ieCelvc approval uoiii Health uuppiculcutaiy Yeguig�lOiiS �cctioii:
Dept. FAX DATE h l �t
Circle the one that applies Parking formula:
Is parcel on private well r public ater?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health Required space 0 n
Dept. FAX DATE
Y/N
Circle the one that applie Items to be verified in the field:
Is parcel on septic or ublic s wer?
ill � �
4Wt- PU' l
ill you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
ill there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # O/�— G
Zoning to complete the following:
Inspector
Notes:
Date:
Violations:
If s ist:
ff N
:Do , List:
I
Varia ce•
Y
If so, t:
eso, List:
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3