HomeMy WebLinkAboutCLE201000116 Review Comments Zoning Clearance 2010-06-15Applicati ®n f ®r Z®nin Clearance
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Zoning Clearance = $35 TCOheck
PLEA E REVIEW ALL 3 SHEETS
FFICE USE QNL ! 5� +b
# Date: I
eceipt # Staff: j 0 (f e .
PARCEL INFORMAffiN Tax Map and Parcel: wo ' — oc ~ 0000 Existing Zoning w it
Parcel Owner: P✓i.l.w Plaza- L 1, C
Parcel Address: 7 W WO &N &AGI City 1. V / _State Y Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call / /w�r�it�e,ccooncerning this project? �,Q �o/
Address: i 5-0 1/�4l J bto hA.G1 City V� State V �l Zip
Office Phone: (� Cell _ 3 �l ^ ��o G Fax # E-mail
1Hk % 1 W S- Yha d S
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name/Type: (J � %/ �/ �7 � % 100dl\
I
Previous Business on this site ht?0 �'PaI Y—
Describe the proposed business including use, number of employees, umber of shifts, ay' ila le parking spaces, number of
6
vehicles, and any additional information that you can provide: e�, !al •h t f ;Z (� snaM
*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 pf my hnowledge. I have read the conditions of approval, and I understand them,, and that I wil abide by them.
Signature V/ Printed J uSa %� C . c��% ma Y''
APPROVAL INFORMATION
tVApproved as proposed [ ] Approved with conditions [ ] Denied
3 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 C,
Zoning Official 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:
Y / D
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /E
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
Circle the one that applies
Is parcel on private well or ublic wat •?
If private well, provide Healt epartment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap
Is parcel on septic or bCic sewer?
Y/N
Will you be putting up a new sign of any kind?
Sign permit.
Permit #
If so, obtain proper
Y /(
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: /2,66
Permitted as: 4
Under Section:
Supplementary regulations section:
Parking formula: / pc,/ �AN% --� I f �� �h `��e5
Required spaces:
Y/
Items Wbe verified in the field:
Inspector:
Notes:
Date:
Vio a ' ns:
Y /
Ifs ist:
,
Prof% s:
Y CINT
If so, ist:
Varia ce:
Y/0)
If so, List:
SP's:
ItIN
If sd; ist:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3