HomeMy WebLinkAboutCLE201000080 Review Comments Zoning Clearance 2010-05-18Application fog '.Zon g Clearance
I�RGIN�P
` , Zoning Clearance = $35
OFFICE USE O�j' r
Check # l Date: �/ / 6
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff: C R
PARCEL INFORMATION
Tax Map and Parcel: -7q —3 T Existing Zom Ci
I�
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Parcel Owner: T
_A" Parcel Address: yS 4-.4 i t State
(include suite or floor
PRIMARY CONTACT�i
Who should we call /write concerning this project?
Address : S pel11WA (1 City �/ /�- State
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Office Phone: [Kell # Fax # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: �-i�C
t� , -e C'
Previous Business on this site 'J&j I
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
vehicles, and pny additional informati n t at you can provide: ��`� � _ yo rte0 %�
NO (e h0 I r
*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 have the ownpVs p nnission to use the space indicated on this application. I also certify that the information provided
is true and accura to e best f my kn ed e. I have read the conditions of approval, and understand them, and that I will abide by them.
Signatu Printed CCaw) LPL°CP/L -—
APPROVAL INFORMATION
]°Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Backflow prevention device and /or curt•ent 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 's,
Zoning Official Date �����d
f n
Other Official / �1/ Date J//c% /)
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
011
Intake to complete the following: Reviewer to complete the following:
Y / N Square footage of Use: ��
Is use inLI, HI or PDIP zoning? If so, give applicant a Certified -- - —�
Engineer's Report (CER) packet. O/ N
Permitted as: iV-1; ru {'S4 L; "
QYIN
ill there be food preparation? Under Section: Q , 2 ,
If so, give applicant a Health Department form.
- Zoning review can not begin -uu titw -receive approval from Health- Supplementary regulations- section : - - - -- - — -- - --
Dept. FAX DATE
i
i
Circle the one that applies Parking formula:
Is parcel on private well or p�yiblic Ovate
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health Required spaces: - - - - --
Dept. FAX DATE
4 YIN
Circle the one that applies Items to be verified in the field:
Is parcel on septic or public sewer ?b���
Y
O Wil ou be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /1`tl>'
Wil ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7nnina to v.mmnlP.tP. the fnllnwinu-
Inspector:
Notes:
Date:
Violations:
Y/70
If so, List:
R koffers:
/N
of so, List:
Vari ice:
Y /I�l
If so, List:
SP's•
Y&
If so, List:
Clearances: /
SDP's
6, 7/
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Revised 04/28/08, 10/13/09 Page 3 of 3
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Application for Zonm Ulearance
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CLE # / —
Zoning Clearance = 535
PL)E E R1EVEEW ALL 3 SMETS
OFFICE USE O �{
Check # Date:
Receipt
#- staff.
PARCEL INk'`ORMA.TXON
Tax Map and Parcel: Existing zoni
Parcel Owner-
'
Parcel Address: 51S .G( N 00, 4— I State zip
(include sadta or floo
PRIMARY CONTACT
Who should we call/wrlte concerning thlsyro ect?
Address _ city s ' le— State , zip
�
~Cell
'
Oftloe Phone: r # F'ax # F -mail I �� r%
4'
APPLICANT LN- FORMATION
Check any that apply: Cban a o( ownership Change of use Change of klanne business t
$u5i]Ies9 ilameiltype• C f /..V'ew
f
� 1
Previous Business on Ibis site y i V ( INC
Describe the proposed businesr including use, number of employer, numb : of shifts, vallable ark iug Spaces, namb%ot
vehicles, and any additional Wormati oft at you alt provide: �Sj ?rte (CQ - ,�„��f
This Clearance will only be valid on itro parcel for which it is approved_ If you chaagc, intensify or move the use to a qew location, a uew Zoning
Cleuance will be required,
I hereby certify that I ow Nvo t o s pfr=sion to use the spacr indicated on this applieatiort, I also certify tar the inforatadonprovided
is true and acc to best f ra Im , l have read the eorditiam of approval, and understand them ;; and thu l zbide by them.
_will
Signatu Printed
APPROVAL LN`FORM.ATION
[ ) Approved as proposed ( ] Approved with conditions [ J Dmied
[ ] Bach ow prcvcntian device and'or current test data needed for this site, Contaet ACSA, 977 -4511, xI 17_
( ] Vo pbysieal sitc bmpcction has been done for this clearance, Thcrcfore, it is nor a determination of compliaztee Nx ith the existing
site plan.
( ) This site complies with the site plan as of this date_
!Votes:
Building Official Date
Zoning Official Date
Other Official Q,u,, Date
a.oanty 01 auoematrle uepartmant or l:ontltnuruty Development
401 Ndwire Road Charlottesville, VA, 2294 'Voice: (434) 296 -5832 Feat: (434) 972 -4126
Revised 04 /28/08, 10/13/09 Page 2 of
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