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HomeMy WebLinkAboutCLE200900197 Review Comments Zoning Clearance 2010-06-29Application for Zoning Clearance CLE # 00q r #7 79 sj Q� 7+' �IR°[N \Pj• [Zoning Clearance = $35 OFFICE' -�` Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt # Staff: ! 6 PARCEL INFORMATION Q -Is�t�i (y) Zoning Tax Map and Parcel: Existing Parcel Owner: !Eo c-Q\ - I cc. n d Homes I'U I Parcel Address: Sao �� nd o,� �Rj Ve v, L n, City c-, V i [ £ State VA- zip aa9 I � (include suite o floor) PRIMARY CONTACT r ► Yi n L �� I Cat d Q Who should we call/write concerning this project? Address: V'f I [ krfl- S (7, :�)jG , .lB City C U I I I State Zip a�©-q' Office Phone: ( 3�) �� -p 15 Cell # Fax # U4-Q913 -a3 E -mail Cie rm PIC @ em bet' � rfal I zorr APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /TypeQ� � "CT 0 LQ"-'' , PLC- rn ecI C O M C_ C `e,, Previous Business on this site n6 n ee- - O `21_V b U.I Describe the proposed business including use, number of employees, number of shifts, availablParking spaces, number of vehicles, and any additional information that you can provide: I Q r' mp Jo V-P.E?s, I s � �ra�n M - Fri em I -pp Vr_I11CI.�s C� otle'tAlL -a U"n a ,I n *This Clearance will only be valid on the parcel for which it is approved. I you change, inonsify or move the use to 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 myy knowledge. I__hppave read the conditions of approval, and I understand them, and that I will abide by them. Signature (�'1,'L'y1,� Vii!. r4A ,Q GC.IiLGL(4 Printed A n n °L W � C e) I I Ci d a- l r APPROVAL INFORMATION J�f Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x117. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance *A ftelgsting site plan. [ ] This site complies with the site plan as of this date. Notes: O� -C�-� Building Official Date f t alt 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, 10/13/09 Page 2 of 3 Intake to complete the following: Y/N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y/Q Will 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 Reviewer to complete the following: Square footage of Use: W erinitted as: IU Under Section: Supplementary reg rations section: Circle the one that applies Parking formula: �An Is parcel on private well o ublic •� �-(� U Y� If private well, provide Health Department form. pyy�'6 Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE Y/N Circle the one that applies Items to be verified in the field: Is parcel on septic o ublic sewer? 0/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. 0,U VQ4L �,c� �v-'� Permit # (J Y/N Will there be any new construction or renovations? If so, obtain the prop r Permit. Permit # 6g-J I I b *- Zoning to complete the following: Inspector • Date: Notes: Viola 'ons: Y/ If so, ist: Proffers: Y/ If so, t: ce: Vari nnc If o,V i A: S ' s: o,V Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 -` G S "" }.p ,� .' , �:. �.1 -•.. -.ter' � �'i QD -- o + Gcrp- cz- •�7 mil, � ll ((-��1y V •�-. - dam► t J� �% x 3� cn •� l — 47 � a -� W ~ u� t•� � � U: �� r N � Q a• 1. i :, b � (J l 'FS, h* 1 l l Y• ICI 'v G j tr c • M, � � a w• Y � ; LNn�, f