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HomeMy WebLinkAboutCLE201000034 Review Comments Zoning Clearance 2010-03-24Application f ®r Zoning Clearance Application ��`'m =�c C' i U _1� � /RCiN�P [Zoning Clearance = $35 OFFICE USE ONLY � Check # Date: i,31 2oo Receipt # % Staff: PLEASE REVIEW ALL 3 SHEETS PARCEL INFORMATION �l�.�S ' 2�3 I'f Tax Ma and Parcel: Existing Zoning Parcel Owner: + &at (e Pi -a` otn `rl � 5 ! ('es) (, n 45 �"� Sc, js,i Vt Z� L Parcel Address: City State V Zip (include suite or floor) PRIMARY CONTACT I i� /� c -zaqc(i7 Who should we call /write concerning this project? Address: /')CLr LC GW GdOUL`e- City State Zip 2c t, Office Phone: J SV'D Cell # �`I'��) 10 Fax # E -mail ly, — - APPLICANT INFORMATION Check any that apply: of ownership Change of use of name New business nChange , INew nn ,Change i �f�� ��� �I V — 'vO rt 57 Business Name /Type: 4.J� veil -t Previous Business on this site (10Ice- 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: (1 *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 my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature (.e Printed &a4rice- L, DL& an APPROVA INFORMATION f [ ] 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. [ ] Thi si q complies with the site plan as of this date. Notes:!' i�5�� 1.0 l lc-e oC�FiLL- LI Building Official Date 6 Zoning Official . Date G l 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 up Ir Intake to complete the following: Reviewer to complete the following: Y /O Square footage of Use: Is use in LI, HI or PDIP zoning? If so, give applicant Certified Engineer's Report (CER) packet. Y / N Y ION Will there be food preparation? Permitted as: Under Section: If so, give applicant a Health Department foirn. SP's: YIN If so, List: - Zoning review can nobbeginuntil we receive approval from Health Supplementary regulations section- Dept. FAX DATE Circle the one ies Parking formula: Is parcel of private well r public water? Clearances: SDP's If private well, prove e ealth Department form. Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE YIN Circle the oapplies Items to be verified in the field: Is parcel of septic or public sewer? Y/ Will ou be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Inspector : Date: Y /f-N� Notes: WillWere be any new construction or renovations? If so, obtain the proper Permit. Permit # Znninv to ommnlete the fnilnwinff- Violations: YIN If so, List: Proffers: YIN If so, List: Variance: YIN If so, List: SP's: YIN If so, List: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 �'IRGII�ZP COUNTY OFALBEMARLE The following facsimile message ` is- being sent -from: j - - Department of Community Development Albemarle County Office Building 401 McIntire Road, North Wing Charlottesville, Virginia 22902 -4596 Phone: (434) 296 -5832 Fax: (434) 972 -4126 Date: Number of Pages (including cover sheet: 3 Sent To: i'l V-1w n cam► ev - �v� Fax Number. 4702 " t O Sender. (1� rCerrj` rV VD C * 1- If the fax message does not transmit properly, or if you have any questions, please call (434) 296 -5832 Additional Information: .-e-4 , n TS r �rrr V (A r o / CP.vf -r2a . �P�f-e A44 r A !:Z�- are J��?Jh_S ©r p nr le iS- �` -w�3� , y !�� v� �H �✓GcP v� � Ywt l