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Home My WebLink AboutCLE200900202 Review Comments Zoning Clearance 2009-12-11Applicati ®n f ®r Zoning Clearance 0 OFFICE USE ONLY Zoning Clearance = $35 Check At e A,:f Date: /! /-° O'o PLEASE REVIEW ALL 3 SHEETS _ Receipt At 7 Staff: PARCEL INFORMATION Tax Map and Parcel: { -� °°° JAAJt1K Existing Zoning Parcel Owner• Parcel Address: City �. f Vi 10, State /�py Zip2 f-r- (include suite or floor) PRIMARY CONTACT ��,,�� /� ` Who should we call /write concerning this project? � T�OL. 901 Address 5-6RMIE 79 City State Zip �tl Office Phone: ( J Cell 4/c ax # E- mailyy7yiri t9-+le;f,4e �$bjI /'y�(,l �� APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business Business Name /Type: ?J6-1S / f / --Lz-_ Previous Business on this site -s 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: "1 , -v"i(' — 'T K fit- t ('I% !- *This Clearance will only be valid on the parcel for which it is approved. If you change, intensify or move the use to anew location, anew Zoning Clearance will be required. I hereby certify that I lave t le wner's pern ' sion to use the space indicated on this application. I also certify that the information provided is true and accur to the best of m snow ge. I gave read the conditions of approval, and I understand them, and will abide by them. ,that tII Signature Printed APPROVAL INFORMATION [ ] Approved as proposed [ W-Xpproved with conditions [ ] Denied [ ] Backflow prevention device and /or current test data needed for this site. Contact ACSA, 977 -4511, xl 17. [ ] 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 thyys date. Notes: NO CA Vldd�clY�G�SA,�/C�1 -d-e SrVA / Building Official Date Zoning Official Date ✓�� [iV - �D,a Other OfficialC /C 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 Hwy "rl Intake to complete the following: Y / NO Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. V �Y /N ill there be food preparation? If so, give applicant a Health Department form. Zoning review can n t b in nt' we r. ceive approval from Health Dept. FAX DATE if Circle the one that applies Is parcel on private well or p lie w ter? If private well, provide Health e tment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that ap;�;)er? Is parcel on septic or (!q/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # � / N ill there be any new construction or renovations? If so, obtain the proper Permit. Permit # Zoning to complete the followinLY: Reviewer to complete the following: Square footage of Use: 144 Perinittedas: Under Section: fir,( j Supplementary regulatio s section: Parking formula: ,� Zt Required spaces: Y/N Items to be verified in the field Inspector : Date: Notes: Viol ors: Y/� If so, ist: Proffers: Y/� Ifs ist: Variance: Y/ If so, st: SP's: Y/N If so, List: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 u� J 1,; - ,5u,"ja �,2)[i4t.&J )R4 a 11 � El 0 OF F-Ili, 1 IEI I I I F T !9T6-Ilff" 12/08/2009 09:48 Charlottesville /Albemarle Health Department Fax Transmission Sheet Fax (434) 972 -4310 To: % -agA K Fax #: 001- From: 94 Phone Number: Date, # Pages (include Confidentiality Notice The documents accompanying this fax transmission contain P Information belonging to the sender, which is legally privilege information is intended only for the use of the individual name are not the intended recipient, you are hereby notified that the Insurance Portability and Accountability Act (HIPAA), strictl disclosure, copying, distribution, or the taking of any action it contents of this telecopied information. All violations will be have received this 'telecopy in error, please notify the sender b immediately. Thank you. Thomas Jefferson Health District P.O. Box 7546 Charlottesville, Va 22906 Urgent For Your Review Please Comment Please ❑ Q 0 Message: 43225 P.001/003 Health J. This d above. If you i ederal Health prohibits any reliance on the -eported. If you r telephone Q 12/08/2009 09:49 COPMUNiTV OEVEI-OPMENT1 Fax d3d9724126 #3225 P.002/003 Nov 20 2009 03;52pm P002 /004 Applicafion for Zoning Flearance CLE # E Zoning CleArance = $35 OFFICE USE ONLY Check k ea -Y' Date PLEASE REVIEW ALL 3 SHEETS Receipt;; yfy'e�� stn PARCEL INFORMATION Ira Map and parcel; Tryfae — / lof L-� [� Existing zoni-ar 0' Parcel Owner: l Parcel address: ��r � �ffl� City rul l statt Zip Cinclgde suite or floor) PRIMARY CONTACT Who should we calvwwrritteconceroing this project? � Zip Address. , X�bl LAQlJE City r OVA state Office Phone; APPLICANT INFORMATrON Eb—eckany that apply: Change of ownership Cbange of use Chant a of mama Naw business Business NamefType: Previous Business on this site Describe the proposed business including use, mumber of employees, number of shifts, availabl );&rkinZsp&ces,nu7tbarof vehicles, and any add'tiop l information that you c" provide: .. *This Clearance will only be valid ou the parcel for which it is approved. If you change, intensify ormove the us to a new location, anew Zoning Clearance will be required. i hereby certit , that eve wnces po ' lion to use the space indicated on this application. I also ce 4 true and zccu to the best of ow a, Ave nmd the conditions of approval, and I undatstend tbcrrL ar 'fy that the information provided d char I wiU abide by them, Signature Printed JA APPROVAL MORMAT71ON [ ] Approved as proposed [ ] Approved Nvith conditions ) Dcnied [ ] Backflow prevention device and/or current test data needed for this site. Contact ACS?,,, 9774511 __ x 17. [ ] No physical site inspection has been done for this clearance_ Therefore, it is not a determination o compliance with the existing site plan. [ ] TWs site complies with the site plan ais ofrhis date_ N ones - Building Official Date Zoning Official Date Other Official �rt'-baay ;- ,t��..i,.�! Date -�- County of Albemarle Departtttew of Community Developmmen 401 McIntire Road Charlottesville, VA 22902 'Voice.' (434) 296 -SM Fax! (34) 972 -4126 Revised 04/28108, 10/13/09 Page 2 of 3 ih. Fax From : 4349724126 11/20/89 16:S4 1'u: 2 �vz C6r, 12/08/2009 09:49 . C. - COMMUNITY DEVELOPMENTI Fax 4349724126 #3225 P.003/003 Noi 20 2009 03;52pm P003/004 batake to complete the following: Viewer to complete the following. Y / , Square footage of lise: Is use in W, HI or PDIP zoning? If so, give applicant a Certifitfl Engineer's Report (CER) packer, Y / N F Permitted as, �t+`ilI there be food preparation? Under Section: 1'15o, give applicant a Hoafth Depiarnenr fo u . Zoning review can n in �b¢ we receive approval from Health Supplementary regulario4s section Depl. FAX DATE Parking formula; J -n Cirolt the one that applies Is parcel on private wep or p a[,,cw er?If tent Clearances: SDP's private well, provide Health form. Zoning review can not begin until we receive approval fYom Health Required spaces: Dopt, FAX DATE YIN Items to be vorifed in the field; Circle the Dric that aptbfic ,a Is parcel on septic or se r° A/N Will you be putting up a new sign of any kind? if so, obtain proper Sign perralL Pernnirt # Inspector : Date: Notes: X11 there be any new construction or renovarions? If so, obtain the proper Permit. Permit # Zonine to eownlete the follawinv: viobfikollss Y / : If s , Ist: Proffers: Y / If Va,riance. Y /(!D If so," st: YIN If so, List: Clearances: SDP's Fax from : 4349724126 Revised 04!,28/ 8; 10/13/09 Page S of 3 11/28/89 16:54 Pg: 3