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HomeMy WebLinkAboutCLE201000060 Review Comments Zoning Clearance 2010-04-08Application for Zoning Clearance �� � ��`f�m CLE # �;� :.�' ��RCtNI'� [Zoning Clearance = $35 OFFICE US LY Check # Date: PLEASE REVIEW ALL 3 SHEETS Receipt # I��'_ Staff: I PARCEL IN 0, ll Tax M a and Parcel: � Existin g Zoning Parcel Owner: lLIc6b' Parcel Address: -DM 1,(fi) _ \ City , State Zip (include suite or floor) PRIMARY CONTACT C_ A-VA ✓yt Who should we call /write concerning this project? Address : d o c3 J wood 6,,-ooh C+ City rkaLje5V;1, c State VA Zip oWd Off- e Phone: ( Z( 5- 07.2 �' Cell # q31 1 /65-0WFax # E -mail ('�1G -� G�bp ��{ � 5•Ce��'�1 APPLICANT INFO ION Check any that apply: of ownership Change of use Change of name New business r ffChajfnge Business Name /Type: C -06,14 4DA 1,LC l IVP h A- paf�c,,,+j'o4 S 0eVL10j,,1*L&Vf 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: LV A-h O 0 C enj p1 o �/,PG , © kLc• *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 C�, L Printed E r` C— VV6�_V1n VVl APP,,ROVAL INFORMATION [t 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 Date Zoning Official e 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 Intake to complete the following: YJNJ Is u n LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y 1`tl' Wil sere 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 q lic ? If private well, provide Health epartment fonn. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel on septic or is sewe . Y/0 Will you be putting up a new sign of any kind? If so, obtain proper Sign permit. Permit # Y / Will ere be any new construction or renovations? If so, obtain the proper Permit. Permit # 7nnina to emmnlete the fnllnwina- Reviewer to complete the following: Square footage of Use: Y/N Permitted as: Under Section: Supplementary regulations section: Parking formula: Required spaces: Y/N Items to be verified in the field: Inspector : Date: Notes: 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 C