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HomeMy WebLinkAboutCLE201000099 Review Comments Zoning Clearance 2010-05-25Application for Zonin Clearance CLE # OFFICE USE ONLY Zoning Clearance = $35 Check # t% .7 PLEA §J RFVIEW ALL 3 SHEETS Receipt # PARCEL INFOlk Tax Map and Parcel: Parce10wner :��hl 6 r� J=�p4 A[,p�l. �7 Date: J� �v Staff: 6[ ir�l` 91 _ pop 712 l j , I #i S— Existing Zoning Parcel Address: (e" -kev— ;' ,/ r ' City /(� %a ✓� State U�t ZAP � (include suite o loor) PRIMARY CONTACT / 7__ Who should we call /write concerning this project? /5 tL Ci ty State JJ`` Address: j office Phone: 'ell #� �^ Fax # E -mail APPLICANT INFORMATION Check any that apply: Change of ownership Ch Business Name /Type: Previous Business on this site Describe the proposed business including use, number of e. vehicles, and ally additional inforfnatjon that�you can prow *This Clearance will only be valid on the parcel for which it is approved. If you Clearance will be required. of use Change of name V New business number of shifts, available parking s,aces, number of t A 19 /n ( /,A-0 eD intensify or move the use to a new location, a new 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. 7 Signature �t/e Itv Pres�da.�_ Printed ��'� =m►Y io� [a � ��5' APPROVAL INFORMATION Approved with conditions Denied Approved as proposed [ ] [ ] [ ] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, xl 19. [ ] 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. Date �S I Building Official Zoning Official r 1 Date Date Other Official County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (43 Revised 04/28/08 Page 2 of 3 Intake to complete the following: Y / I Is us � Ll, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y /Cl� Will sere be food preparation? If so, give. applicant a Health Department form. Zoning review can not begin -until- we receiveapprova] from Health Dept. FAX DATE Circle the o e th t13pp is parcel on rivate we of ublic- titer? If private wel , provide Health epa ent form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that applies Is parcel oc o p li; sp, er? Y /lA Will you be putting up a new sign of any kind? Sign permit. Permit # If so, obtain proper Y /O Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Reviewer to complete the following: Square footage of Use: —2b, 0 N Permitted as: © ` - Under Section: ;7--2 . 2 Supplementary regulations section: Parking formula: Required spaces :�� Y Items to be verified in the field: Inspector : Date: Notes: Zoning to complete the following: ers: Violations: Y Y / ( "/ s . If so, ist: Variance: / jP Y/N ! / If so, List: If so, ist: SDP's Clearances: r F Revised 04/28/08 Page 3 of 3 --tip---- 'Nortk Garden Crossroads Inc- ofpce Space 1227,36 2-:7 3 2- Not 1) Vice 2 ,9,2 G. SY 'North Garden Crossroads Inc. OfP,ce Space 122 7, 3 r & 2-:7 3 aC)s P# Not i