HomeMy WebLinkAboutCLE201000095 Review Comments Zoning Clearance 2010-05-25Application for Zoning Clearance
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Clearance = $35
OFFICE USE
Check # ` Date:
PLEAZoning
REVIEW ALL 3 SHEETS
Receipt # Staff: _
PARCEL INFORMATION �r/ Pe
T ax Map and Parcel: a -7 �� "�� " 00'Ol`7`26 Existing Zoning
Parcel Owner: AlAII &/ 0 CoNlty 411 V ' e A4 —17-)
Parcel Address: Re, C �% ! s1a ' Alpty ^ _ State A
(include suite or floor)
C:
PRIMARY CONTACT
Who should we call /write concerning this project?
Address: N w l City State C Zip
Office Phone: U ell # �9 2T�a i l ii I ( Fax # E -mail
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APPLICANT INFORMATION
Check any that apply: Change of ownership L,,-" Change of use Change of name New business
Business Name /Type:
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: X 4,4,.6 Sys p Ll
*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 h ave read the conditions of approval, and I understand them, and that I will abide by them.
Signature !� , ". / A— Printed Y A l) Alan o
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, xl 17.
[ ] 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_ tA Date -z,
Zoning Official Date 5z2-,,�t
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:
Y /N6
Is use m LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y / I�l
Will there 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
Reviewer to complete the following:
Square footage of Use:
Permitted as:
Under Section:
Circle the on_ at a lies Parking formula:
Is parcel private 11 or public water?
If private we i e Health Department form.
Zoning review can not begin until we receive approval from Health Required spaces:
Dept. FAX DATE "I
Circle the one that applies
Is parcel on sc�pti or public sewer?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Znning to complete the following:
Y/jq)
Items o be verified in the field:
Inspector : Date:
Notes:
Viol tions:
Y/
If s , ist:
Prof rs:
Y/
If so, List:
Variance:
Y/�D
If so, List:
SP's:
Y/A
If so", -fist:
Clearances: _____ -----
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
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