HomeMy WebLinkAboutCLE201000035 Review Comments Zoning Clearance 2010-03-31Applicati ®n f ®r Z®nin Clearance
CLE # 2,D)( -- D
Zoning Clearance = $35
OFFICE USE ONLY
Check Date:
Receipt # 2a Staff: DN, r (F 0
PLEA REVIEW ALL 3 SHEETS
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PARCEL INFORMATION
Tax Map and Parcel: 7 `� " a�— Existing Zoning
Parcel Owner: 16w" Ted d 110`ew - b &>�.j
Parcel Address: 9 1 Q )*"' w f,c e ( (o L)u City U , 41 I 1 C State V Zip "7,
(include suite or floor)
PRIMARY CONTACT -�^
Wlio should we call /write concerning this project? ..J AYVAj_S 1•<.
� Cit y �2 Address State Zipd
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Office Phone: Zy)1, '70' 0C.Cel1 # Fax # E -mail
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V\e' rN s C.4
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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01 LL —'/A A � � C;nT'�'
Business Name /Type: Vii
Intake to complete the following:
Is/
Is usch LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y/N
ill there be food preparation?
�If so, give applicant a Health Department form.
Zoning review can note egi] until we receive approval from Health
Dept. FAX DATE �Z D
Circle the one thaat�t a py1'ies
Is parcel on pl at"ell or public water?
If private ell p of vide Health Department form.
Zoning revsq can not begin until we receive approval from Health
Dept. FAXOATE
Circle the one k/t ati applies
Is parcel on sq o r public sewer?
Y/N V
Will you be putting up a i sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construcri�n or renovations?
If so, obtain the proper Pen-nit. J
Permit # /
Znninu to emmnlete the following:
Reviewer to complete the following:
Square footage of Use: ( � 6 c)
I tiniIN
as: wt0�A' czwr w
Under Section: M 4
Supplementary regulations section:
_a
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Violations:
Y/N
If so, List:
A;-offers:
/N `
f s Ayd IL y j
Variance:
Y/N
If so, List:
SP's:
Y/N
If so, List:
Clearan s:
cy'009- ��{ol . t r Oww
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
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COUNTY OF ALBEMARLE
The following facsimile message is being sent from:
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:
Sent To: IdEM linvd-vv
Fax Number: X17)- " '� 3 /d
Sender: �V-
If the fax message does not transmit properly, or if you have any questions, please call
(434) 296 -5832
Additional Information:
03/2B/2010 20;53 9724310
#0420 P.001 /004
,. r 1 rvl nl. -Itl I t.�n YJYJ�.cY 14V In41 LJ LY IY (L•Y.wni rumciumm
Application for Zomwnp Clearance
Is-
r
Zonkq Clearance $35
PLEA9, REVB W
OFFICE US Y' ONL
Check # Aasce;
Receipt # staff: r
ALL 3 SMETS
PARCEL %NFORMAVOTd
Tax Map ozd Parcel: _ - Existing Zottln� �c
Parcel Owner:_ 1 �ew try 'ea , I,fM _
r
Q l,
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Parcel Address: 1D )�`4�+T�cF��3 L,; City ��',r ,C State � Zip.��`9�7�
(include sulte or floor)
)?RI MARY CONTACT
Who ,should we call/write eoneerWmg tole project? 5lofYlhf "
Address : r . o , , 3S A x z Clty a " ,) state �i/'j`� Zip
Office Pbone: -.Q) I., zolmel) # FRx # E -mail
•/
y •y� S _ ,gyp ;N/� .
A]PJPLZCANT INFORMATION
Check any that apply: Chan ;e of ownership Chlauge of use Change of name New business
fusiness KatnelTy�pe: i� t-(. e '/A_ 'T,_,Q 11 �.
Previous $usiness on 61% site �'
Describe the proposed business including use, number of ernployaes, nuiniber of shifts, available parldng spaces: number of f
veWclej, and any additional Information that you can provide:
i
'This Clearance will only be valid on the parcel for whioh it is approved. if you change, intet>sify or move the use to anew l ocation, a acw zpabIq
Clearancp will be required.
T hereby ce%7W that I, own or have the owner's pemn s5iQu tv use the spaceindicated on this application. Z also certify that the i ounatiouprovided
is true and ace tc to the bc�t of my knowledge. I have read the conditions of apytoval, and I understand then, and that l w"11 abide by them.
Signatu> � Printed_ JAMB V,. 53 6 D L,) jj
APPROV IN)'ORMATXON
[ ] Approved as proposed ( a Approved with conditions [ ] Denied
[ ] Baclflow prevention device and/or current test data needed for this site. Contact ACSA, 977 -4511, x) 17.
[ ) No physical site inspecCion has been done for this clearance. Therefore, it is not a deterrnSnation of compliance with the existing
site plan.
( ) This six complies with the site plan as of this date.
Notes:
Building Official �.% �. �.— +�ae1�.c_ Date X P v
Zoning Official Date
Other Official pate(
I
County of Alboturtrle Depaxtmo t of Community Development
401 McPatire Road Clharlottes-ville, VA 2.290Z 'voice: (434) 296 -5832 Fax; (434) 972-4126
Kevised 04/28/08,10/13/09 Page 2 of 3