HomeMy WebLinkAboutCLE201000027 Review Comments Zoning Clearance 2010-11-29St Lkz 10),/ L U xo 2 o vm
Application for Zonin Clearance
CLE # 2U I D - 2�
oning Clearance= $35 '
OFFICE USE ONLY r�
Check # t 3 Date:'"
PLE E V>�W.ALL 3 STWETS
Receiut #: "1/
.
PARCEL INFORMATION
Tax Map and Parcel:, / t �- - �� '[ (_Existing Zoning (D
r
Parcel Owner:
Parcel Address:—S. , 0 CityckoA kfl-eo(A ((0 State UA zip "
2-9
suite or oof) / �&u&-r, SS(G -�
1
PRIMARY CONTACT
Who should we call/write concerning this project? TS _U Vy 1 -LL-1-01\1 -- V i R Gt I /V I A l A/Y %> CO ,
Address : 19 5 1U1 v1C� n - City 0,'\) I LLB State VA: Zip Rg5I
Office Phone: &- l 9? 7- S 01 Cell # 9 0& J,591'� Fag # 201 l -35 16 E -mail V LGAA F, -IZ�xI C�
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APPLICANT INFORMATION
Check any thatapply � Change of ownership . Change of use,;. Chinge. `of name . New busitiess
Business Name/Type: LA AA '�) C R r K�tSJ L,4,- L R A,
Previous Business on this site b OAl !r — 6 1 C-0 d j R Q C 1 -10)\f
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: `T 2A P I S 1
L 'g p.....'460 v
aue d)
*This Clearance will only be valid ed the parcel for which it is approved If-�ou change, int nsify or move the use to a new location, anew 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 provi d
In
is true and accur best my knowledge. I have read the conditions of approval, and I understand and that I will abide by them.
rthem,
Signature Printed cST2.R �/ V AA AAC L75
.. r
APPROVAL INFORMATION
�Approved as proposed .. [ ] Approved with conditions [ ].Denied
'L 1 Back(low 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.detertrunatiohi of compliance with the existing
site plan _ .
[ '] This site complies with the site plan as of this date..
Notes
Budding OffcialL - _ Date
lT-
Zoning ofhcw 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
Intake to complete the following:
Y/N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y N)
Wil mere 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 Gblic water
If private well, provide Hea e nt form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that pl
Is parcel on septic drpublic sewer?
Y l(Wi 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 Permit.
Permit # — 66 (3--3A C,
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: —1 a 5 l
U/N a'
Permitted as: Y(I44 .5 i07yj I`6&
Under Section:?
oe-
Supplementary regulatio s section:
N CL
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector: Date:
Notes:
Viola 'ons:
Y/
If so Inst:
Pr ffers:
Y/N
If so, List:
Vari aan e:
If so!] it:
Sys:
I 6, Lis
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3
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