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HomeMy WebLinkAboutCLE201000050 Review Comments Zoning Clearance 2010-03-19Application for Zoning Clearance CLE #JoJ V OFFICE QNLY `i!1 ► ❑ Zoning Clearance = $35 Check # (� Date: tV PLEASE REVIEW ALL 3 SHEETS Receipt # '+ Staff: 9 PARCEL INFORMATION - Tax Map and Parcel: sgD2 —_ — ( $ Existing Zoning /J1 r Parcel owner: U 0 " Vl mss%( `iV� / Parcel Address: 1 txi'.4Y Rbi City C -g i4R��asyi riate y A Zip'll Lq—D23 (include suite or floor) 1�cU2- `040E M— Le V'E z- /V,960 6Q Ic% PRIMARY CONTACT sail Who should we call /write concerning this project? Address :C�Aj (' ntjjr5 1 ,ajTolr1:b- CityCV-,ar I ok Sv,/LL State V Pr Zip Z290-3 Office Phone: ( Tj -Z�Z� Cell # (434 -9` i- Fax #{kjµ.qi^% -$� -mail �I h/ bDS��Etxµ-�i<ll /h�•A APPLICANT INFORMATION Check any that apply:_ Change of ownership Change of use Change of name Neew�business Business Name /Type: VfR& //ill A %�E/3L �$7A-TEW 2TT%2S ,/� -13L. L7STA�' (.O/1�Mfj? Previous Business on this site 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: REAL ,567w -7 (?-e)mf°A "4 USA T� 'ZAILV 1 A --4,EA r4S, oZ 4T?MIIVIST-VA -T7V'E 1+6516ni -"Mr RL/.6LtG P1q/e4G/V4n LZT. *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, 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 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 i %m R Ros • 'T A,PP VAL INFORMATION [i,] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] Bacl&ow 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 s Date i -CL] t a Zoning Official / ✓� L Date Ito Other Official Date t 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 '- 'J Intake to complete the following: Reviewer to complete the following: Y / N Square footage of Use: dz© Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. / N PErmitted as: V U 0'r'cl C ri Vayyian e: Y A—W If so, List: J Will'fhere be food preparation? Under Section: If so, give applicant a Health Department form. Zoning review cannot begin until we-receive approval from Health Supplementary r +gulations section: - - Dept. FAX DATE 0 Clearances: Circle the one that applies Parking formula: � Is parcel on private well or pu�blic� tQr. 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? C Wilou be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Inspector : ate: Y/ Notes: Will sere be any new construction or renovations? If so, obtain the proper Pen-nit. Permit # Zoning to complete the following: Violat•awQs: Y/ If so, ist: Proffers: Y/N s . If so &. Vayyian e: Y A—W If so, List: SP's:\ Y /(N J If so, rst: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3