Loading...
HomeMy WebLinkAboutCLE201000088 Review Comments Zoning Clearance 2010-05-17Application for Zoning � Clearance CLE # o -o JZoning Clearance = $35 PLEA VIEW ALL 3 SHEETS OFFICE USE ONLY �� ` x Check # 2 l Date: V Receipt # Staff: PARCEL INFORMATION Tax Map and Parcel: (� crr Fc c) -"0 C5 -OCR -0 � 1 _J-0 Existing Zoning Parcel OwnerTff RfA i W ingi 51 x �• C C/© l jl�mhd Gv" <n VG j'6L S� Parcel Address:_. 660 fk4cc �e+f&W Pi�b City ak la f y / /`� State Zip (include suite or floor)Cj a S L,� PRIMARY CONTACT Who should we call /write concerning this project? L158 / /U ST Z%• ULE La !1i !/lS� tl' n 2 Address : 6.50 !(Cc.N e , l-�Gk /2r. city Ctn / d / State V Zip Office Phone: (y3q 5 - to O Cell # 2 �R —17060 Fax #CJJJ - 5 Lt 3 SJ E -mail Pa< • Sfqd /S* asrrr APPLICANT INFORMATION Check any that apply: Change of ownership Change of use Change of name New business p Business Name /Type: CFA A ,L, MSTIT6( F Previous Business on this site 1— Lt S:1,nAJ e 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: $ 06� rt p/G i 1p- �/t *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 infonnation provided is true and accur to the best of y 1 wledge. I have read the conditions of approval, and I understand them, and that I will abide by them. Signature Printed 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, x117. [ ] No physical site inspection has been done for this clearance. Therefore, it is not a detennination of compliance with the existing site plan. [ ] This site complies with the site plan as of this date. Notes: Building Official Date Zoning Official Date ;77�/� 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 u .. Intake to complete the following: Reviewer to complete the following: Y / Square footage of Use: /�, . b Ob �^ Is us I, HI or PDIP zoning ? - If so, give applicant a Certified _ Engineer's Report (CER) packet. Will ere be food preparation? Y / N Permitted as: A Under Section: 2,574, 2 . If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Supplementary regulations section: Dept. FAX DATE U Circle the one that applies Is parcel on private well or public water? form. Parking formula:' , ,gyp If private well, provide Hea epartment Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE SDP's Y/ Circle the one that ap lies Is parcel on septic o public sewer? Itei o be verified in the field: Y /(N) Will you be putting up a new sign of any kind? If sd, obtain proper Sign permit. Permit # Inspector : Date: N Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. n Permit # 2 (ti O 7,nning to eomnlete the following: Violations: Y/N� Ifs ist: ffers: I'/N so, List: V nce: Y�� Ifs SP's: N so, List: U Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 i c� PETER JEFFERSON PLACE VI THIRD FLOOR �f