HomeMy WebLinkAboutCLE200900198 Review Comments Zoning Clearance 2009-11-16Ap lication for Zonin arance
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Zoning Clearance = $35
OFFICE USE ONLY
Check # Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # 770 /I Staff:
PARCEL INFORMATION
Tax Map and Parcel• D tol/ Existing Zoning�o, a /
Parcel Owner: 4 /' e P'✓O el e-e r° e,<
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Parcel Address:39b-Greu b'f 117 y 1(� cf . �- city �1►' I �f QSU/ I State V Zip cl'f
(include suite or floor)
PRIMARY CONTACT n._
Who should we call /write concerning this project ? /,J%l�l N ICI" SO 10 22 -6-kt,
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Address : SW - Gq r Q aA b r I e e �k • ciityy �o"- 644'eS'U1 I Mate Zip Z to
Office Phone: (I /(,• �1a31Cell #7%3 -39R-n Fax 96y " 139i E -mail Le ,&
APPLICANT INFORMATION i
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type:.. 2010 �'Z" d X71 Co , A- = EL –Mfg Yi - 6; eA l/ u
Previous Business on this site — -(2 rdo-QAq
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:
*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 will abide by them.
Signature , q-V�c.- J d? .2 -- Printed Ovi.cS—
AP,PfROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, xi+9 11+
[ ] No physical site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
site plan.
[ ] This sit c plies with the site plan as of th's.date.
Notes: 4 (i
Building Official Date
Zoning Official Date
p
Other Official 0 Date
G(74e(
QCounty 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
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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. Y / N
Permitted as:
Y/N
Will there be food preparation? Under Section:
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health Supplementary regulations section:
Dept. FAX DATE
Circle the one that applies Parking formula:
Is parcel on private well or public water?
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health Required spaces: -:; v
Dept. FAX DATE
Y/N
Circle the one that applies Items to be verified in the field:
Is parcel on septic or public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # Inspector Date
Y / N Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7nnina to rmminlata tha fnllnwinu-
Violations:
Y/N
If so, List:
Proffers:
Y/N
If so, List:
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3