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HomeMy WebLinkAboutCLE201000004 Review Comments Zoning Clearance 2010-01-14i Application f ®r Zoning Clearance CLE # D I6 - I*— Q Zoning Clearance = $35 OFFICE USE ONLY Cdr Date: D �" / t✓ Receipt # -1 ! D Staff: PLEASE REVIEW ALL 3 SHEETS ?� PARCEL INFORMATION ON Tax Map and Parcel: Existing Zonin Parcel Owner: wn C% 0 Z-' Parcel Address: n 20 ua. (fiee4 c pity � �.lX/, ��piyA/tate Zip �3& (i elude rte or floor) PRIMARY CONTACT Who should we call/write concerning this project? ������ Address: %`J © KV e"� �` City �iG�10�N/fa� state Zip ,2,2,.Vo1 Office Phone: £�'�lrC'LfZ �J (�i° -Q�•f t' 1 ��� f �,�,�Cell # Fax # E -mail APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change 0&n1kMe New business Business Name /Type: d /ez� L__�7� Previous Business on this site 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 pennission to use the space indicated on this application. I also certify that the infonnation provided is true and accurate to the best f my knowledge. I'have read the conditions of approval, and I understand them, and that I will by them. abide Signature Printed������/7 APPROVAL INFORMATION [ ] Approved as proposed [ Approved with conditions [ ] Denied [ ] Bacicflow 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 sit co }plies-witb the site pl n as of this d t . Notes: l �VY�k ka ),C &Pw rzwq (.S ki r -a Building Official >' ---rte- Date �J Zoning Official 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, 10/13/09 Page 2 of 3 U Intake to complete the following: Reviewer to complete the following: Y ein Square footage of Use: 5o6 �l /o� jaoo Is LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / N ,� II-- n/I . Permitted as: rC� l o/V� 94- 1 —kA,(9 Y Wi ere 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- regulatio s- section: Dept. FAX DATE , Circle the one that applies Parking formula: 'fWts i Is parcel on private well or p Cblic wr? ��� �" If private well, provide Health nt form. 0O -j- 11- PiFrkBt Zoning review can not begin until we receive approval from Health Required spaces: tJ Dept. FAX DATE Y/N Circle the one that appl Items to be verified in the field: Is parcel on septic or ublic se er? i 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 ly n construction or renovations? If so, obtain the prop r Permit. Permit # 7nninu to rmmnlete the fnllnwinu: Viol s: Y/ If s L t: Prof Y/ Ifs ist: Vari ee: Y Ifs Li SP : Y N If o, ist: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 U 1 V') ZN 1 b L Q � IfI i N c (0 0) C .Y C2 N N Q- 0 ° U W C6 07 Cl) (U N C N N A6 o U o � (D I ❑ l Il CO 1 _1 LO l I OO CO 1 I _ N °' CL _C zz zI> >- zz? > � I I Irl- O M NI N10 —,M a) I I I I (D LO I I I IO O' I--;Nt;N I- (D co I- N U- );M;I� co "0 N MIN 'd HIV' w N � L LO CA i r N O U: ^O Cn o O o N U to L U) : Q) o, O CD C L L a� a) ° a) ° a) N C N a) U O: E: N N N O o > 0 � �: . 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