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HomeMy WebLinkAboutCLE201000021 Review Comments Zoning Clearance 2010-04-28Application for Zoning Clearance CLE # '2D/0 — ;� .. Zoning Clearance = $35 OFFICE USE ONLY Check # %�`� Date: /(U PLEA REVIEW ALL 3 SHEETS Receipt # 779,16 ,16 Staff: PARCEL INFORMATION Tax Map and Parcel: d — 00° W©C;0 Existing Zoning Parcel Owner: c.)At Parcel Address: %t)0 fibril c—f &,�o City &` `" State Zip 1'13 (include suite or floor) PRIMARY CONTACT Who should we call /write concerning this project? J th&F State I J Address FAS� T6T 7� 31— Cit I 1 d Zip2Z ?Dz- Office Phone: 2��`D�()O Cell # �hlri�'7n�J Fax #„��� 03oc� E -mail k�%jF /�Gt 5 e'l mmr ,L ' APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name 1 New business Business Name /Type: Previous Business on this site _%((Q AJ t— Describe the proposed business including use, number of employees, number of shifts, available parking aces, number of vehicles, and any additional information that you can provide: � � s �,6 _A l�l /.1Gc 1D4 *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 tl best of my iowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature ei Printed A, tt€'iV ' " ' ORMAT10N [ 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 bas 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 1 f V Zoning Official Date 4-4 S 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 )Ni Intake to complete the following: Y �:L Is use m LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y Wil 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 public water If private well, provide Hea t , epar rn�-m. Zoning review can not begin until we receive approval fi•om Health Dept. FAX DATE Circle the one that applies Is parcel on septic o public sewer? Y /ltd/ Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y)/ N Will there be any new construction or renovations? If so, obtain the proper Pon-nit. Permit 10 A%C- Zoning to complete the following: Reviewer to complete the following: Square footage of Use: w ( I YIN Permitted as: Under Section: E Supplementary regulations se tion: Parking formuta/ v- t4� Required spaces: I YIN 1 Items to be verified in the field: Violations: Y/� If o s, ist: offers: /N If so, List: Va ce: Y Ifs ,List: P's: Y/N f so, List: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3