HomeMy WebLinkAboutCLE200900219 Review Comments Zoning Clearance 2010-01-08Application f ®r Zongn e Clearance
Application
CLE # 46467 -- Z19
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Clearance = $35
OFFICE USE O Y �� ���
Check # Date:
PLEAZoning
REVIEW ALL 3 SHEETS
Receipt # Staff:
PARCEL INFORMATIONn n A�
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Tax Map and Parcel: Q.p'� OC)-- �• (� Existing Zoning lam!
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Parcel Owner: 'pi—f L� /r%� /�[ G�
Parcel Address: ([� J �GM ��•T 1'G �j6Y1 I i�1A%7 City Ck4Lr(Oj(r_SV I State A - Zip 27'q I I
(include suite or floor) 45if 240
PRIMARY CONTACT
Who should we call /wLritte�c'oncerning this project?�{� t"�[.1 Fn-c J,-'r
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Address: plT� �I� �.i��Q(� 1 � J►`'*y t�Y�U,,� loft" LLState 16A Zip
Office Phone: 2J46 &00 Cell # Fax fi 2+ 61469E -mail `[A.'i%� • �Li�`� $
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: 5a4>_r( 1l�eQ.�-E'i�1 �(_Q,►`iQQG(MQ ..� �.1.0 —•
Previous Business on this site puff n t� L)wr K.&
Describe the proposed business including use, number of employees, number of shifts, available py;king space p, number of
vehicles, and any additional information that you can provide: - fj' A &nc j d`5cmy r, a j rwn empi DVC
X30- S $Wft 1M- F
*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 nny lanowledQ nave read the conditions of approval, and I understand them, and that I will abide by them.
Signature_ Printed i�CL. �Lt�i�1 )�{ • (�(,,i%•t
APPROVAL INFORMATION
J/] 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 with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes:
Building Official Date u
Zoning Official Date �/z
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
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Intake to complete the following:
Y/
Is us ui LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/O
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
Circle the one that applies
Is parcel on private well r public r?
If private well, provide He 1tla -D artment foi7n.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap�
Is parcel on septic o�public s
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
g / N
ill there be any new construction or renovations?
If so, obtain the proper Permit.
Permit # Do "' 9d7 A61
7,nninv to vmmrilete the fnllnwinu-
Reviewer to complete the following:
Square footage of Use: ?5�
/ N
Permitted as: 44'ide45 1�"
Under Section: --s A , /L
Supplementary regulations section:
Parking formula:
N53 X .20 = v�
Required spaces: j
Y
Item o be verified in the field:
Inspector:
Notes:
Date:
Violations:
Y1 "N)
If sgeist:
Proffers:
Y/
If so, List:
Variance:
Y/j
If so, ist:
SP's:
Y /N
If so, List:
Clearances:
SDP's
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67 —/�
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Revised 04/28/08, 10/13/09 Page 3 of 3
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