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HomeMy WebLinkAboutCLE201000047 Review Comments Zoning Clearance 2010-06-28rt Application for Zoning Clearance Ito err�tJm CLE # V7 Zoning Clearance = $35 OFFICE USE ONLY Check # /,,,115// Date: PLEASE REVIEW ALL 3 SHEETS Receipt # 7 ,Po Staff: - PARCEL - INFORMATION - -- - -_ - = - -- - - -- —.- -- __- - Tax Map and Parcel: Existing Zoning �J- Parcel Owner: (1 C (- , Parcel Address: 3o-7 4 x n, CityC`' Cj(jN4!e So �1C State V Zi (include se uite-oi floor) PRIMARY CONTACT 'Wlio ?� 125"411 should we call /write concerning this project? Address : 1� 1 City CI'►C(r�b�} �fSrVi {le State V�'t Zip Office Phone: Cell # 9 Fax# Eanail `i4�-nrCkM�GSS�Yc�irnq�`�� APPLICANT INFORMATION Check any that apply: Change of ownership of use Change of name New business (Change Business Name /Type: '[ 1� C�8 �f � r&f ? C4u r S {G IM Cby0A(24%1 Previous Business on this site, 9W e 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: �rctft% � 13�� s,, a JrA%f Qec CM I O nt *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 1 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 Printed C�C(+ l..C,t' ss I APPROVAL INFORMATION [ ] 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. [ ] This site complies with the site plan as of this date. Notes: Building Official �, � o Date 2. (i `t I ky t 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 N� 8 x 10' Private Office 8' x f8,— Main Office 360Y xa Intake to complete the following: Y/N Is use in LI, HI or PDIP zoning? If so, give applicant a Certified 11 Engineer's Report (CER) packet. Y/N Will there be food preparation? If so, give applicant a Health Department form. - - - -- - -= Zoning= review - can - not --begirLuntiLwe--receive=approval= from =Heal Dept. FAX DATE Reviewer to complete the following: Square footage of Use: Y/N Permitted as: Under Section: Circle the one that applies Parking formula: Is parcel on private well or public water? If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE Y/N Circle the one that applies Items to be verified in the field: Is parcel on septic or public sewer? Y/N Will you be putting up a new sign of any kind? If so, obtain proper Sign pen-nit. Permit # Inspector : Date: Y / N Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # r7 U uv aaaaa - Violations: Y/N If so, List: Proffers: Y/N If so, List: Variance: Y/N If so, List: SP's: Y/N If so, List: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3