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HomeMy WebLinkAboutCLE200900218 Review Comments Zoning Clearance 2009-12-29Application f ®r Zoning Clearance '2 = 61 `��m CLE # OOR -' S �;� ; � %RGtN�P 1] Zoning Clearance = $35 OFFICE USE ONLY 07 Check # Z Date: 29 / PLEASE REVIEW ALL 3 SHEETS PLEASE Receipt # Staff: nU, rre l PARCEL INFORMATION —70 /C) Existing Zoning,_ Tax Map and Parcel: Parcel Owner: lejon CID , / Parcel Address: b..!9' A a5 afe 4a�in 61J City I State �/ a , Zip f (include suite or floor) PRIMARY CONTACT �t B Who should we call /write concerning this project? aye 11'1 l'-oo P� jp W0(' L--lop ed, � Q Zilx Address : I 6 City State l/ , sml cs � Office Phone: Cell # 6G?M � Fax # E -mail U e Ve,C0 iF -i'na I when r4a APPLICANT INFORMATION Check any that apply: Change of ownership Cliange of use Change of name New business Business Name /Type: -R(A0P6 Cede r — .S Previous Business on this site—, / I Describe the proposed business including use, number of employees, number of shifts, available irking 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 o my knowledge. I have read lie conditions of approval, and I understand them, and that I will abide by them. Signature Printed nuno i Or-J[°—, 111�_, APP AL INFORMATION [ Approved as proposed [ ] Approved with conditions [ ] Denied [ c cflow prevention device and /or cut rent test data needed for this site. Contact ACSA, 977 -4511, xl l7. ] 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 Zoning Official Date - Z��'�► f U 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 I Intake to complete the following: Y/' Is use m LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y Wi] sere 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 applies Is parcel on private well or is wa r? If private well, provide Heal rtment form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that a(ies Is parcel on septic o lic se r? Reviewer to complete the following: Square footage of Use: /Q /N O ermitted as: s+`f� Cci Under Section: C2�5•01-• Supplementary regulatioPs lotion: Parking formula: 1 lw oa Required spaces: Z4 Y/N Items to be verified in the Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # / Inspector Y/N Will there be any new If so, obtain the proper Permit # or renovations? 7.anina to emmrilPtP the fnllnwinar Notes: Date: Viol t' ns: If 0,'Dist: Prol , If o',-I-ist: Va ian e: Y If so, List: SP's: Y / Ifs ,List: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 i 0 0