HomeMy WebLinkAboutCLE200900216 Review Comments Zoning Clearance 2010-01-21` ICIJ r
32.00 o 1 c g 5 N`(- Sks-t j
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Application for Zonin Clearance
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CLE # 26o� — :z LO
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Zoning Clearance= $35'
OFFICE USE ONLY
Check # ego o Date: 1,2 1'
PL VIEW ALL 3 SHEETS
Receipt #: -"1-) 3 Lf Staff.• . DO /
PARCEL INFORMATION
I ',�6 6 64 �oA I
Tax Map and Parcel: ()Io Won Existing Zonin
Parcel Owner: I S vn OZAl
,v 'LA' a07C,
Parcel Address:, �"-f r P l/1 ���ow/�.�'! , City (_ LA I p State Zi
(include suite or floor) I'5
PRIMARY CONTACT
,,
Who should we call/write concerning this project? 5-t -eue M-P– �-pr�
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1IX
Address: rj (�1 P Iaey -J 1,Y1 City �` �(iL l�_ State V /T Zip2
Office Phone: &3q) 9 1p 1 Cell # 90 • ,269ff Fax # 02 (o-3610 E -mail \% LL�(/Y�'_�
APPLICANT INFORMATION
Check any that apply:: "` Change of ownership Change of use, Change'of name, New business
Business Name/Type: 2i /1/1 G2 60T 0 --
l
Previous Business on this site Q A[ C— -- AI �–L-o l �% �T L b--O�
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number q
vehicles, and any additional information that you can pxo 'de: ' /J l ,
ao i9M Lil a
*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 tru e and accur to to the st of mI yy knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Si ature V k V v \
_ -9e" Printed
AP ,PROVAL INFORMATION
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 detennination.of compliance with the existing
site lan,
LA This site complies with the site plan as this date.
Notes-'% A P77o
Building Official Date 5 zcj
Zonin g O ffcial : 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
A✓r, rr, -
Intake to complete the following:
Y I C/
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
Will e 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 applEt Is parcel on private we public water?
If private well, provide De form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ies
Is parcel on septi ' or public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign pemlit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # 11()0 C(, i-
40& A
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: 7&5-9
L mitted as: r()-� 5 eP-'l Ge-
Under Section: 03, O--c 1
Supplementary regulations ection:
1'V a
Parking formula:
Required spaces: 31
Y/N
Items to be verified in the field:
Inspector • Date-
Notes:
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
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1 ' LOWER FLOOR PLAN NOTE:
FLOOR PLAN SHOWN 1S FOR INFORMATION ONLY.
ACTUAL LAYOUT MAY CHANGE WHEN SPACFS APF I PAC