HomeMy WebLinkAboutCLE201000093 Review Comments Zoning Clearance 2010-06-16Application f ®r Zoning Clearance
CLE # 700 - R3
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❑ Zoning Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
OFFICE USE ONLY
Checic # 13�s S- Date: 6-2-1-111
Receipt # 7g8 39 Staff': 0T5
PARCEL INFORMATION
Tax Map and Parcel: 61- i2Lt F Existing Zoning Hc,
Parcel Owner: F WoA
Parcel Address: ISfU ?"t PL(k+ rla -c-c. City Cku✓La Yiite State Zip oZro I
(include suite or floor)
PRIMARY CONTACT t (A�
Who should we call /write concerning this prolecf? yos, 1,12 l ' `S Atir -LLAS0 / ao�h
Address: city /f' Q'K6 ssa.s State VA Zip 2Gf U1
Office Phone: � Qom) 32-13-S611 Cell # 70;; 72 -SUir Fax # — E-mail VoSepl of i e'wtsn. cow"
APPLICANT INFORMATION
Check arty that apply: Change of ownership Change of use Change of name New business
Business Name /Type: 3 6�• En%�trp✓►sos r �=�re wUrl�r ��S
Previous Business on this site P.iva.IS j or+S Bo" —et 6r l i
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: -re- N.o q �ivzwar ks s�e�,,� a z oio�.ces
*-This Clearance will only be valid on the parcel for which it is approved, If you cliange, intensify or move the use to a new location, anew Zoning
Clearance will be required.
I hereby certify that I own of iavc the owner's permission to use the space indicated on this application. I also certify dial the information provided
hof approval, and I understand them, and dial I will abide by them.
is true and accuratNx%z���-intcd
Signature ohh
APPROVAL INFORMATION
[ ]'A pproved as proposed [ ] Approved with conditions [ ] Denied
Bacl<flow 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 Date
Zoning Official Date
Other Official Date
County of Albemarle Department of Community Developrnent
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
Intnlce to complete the following:
Y / N
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /
Will ere 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 of ublic w . er?
If private well, provide 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 septic r public sewer.
Y /.N
Wil I you be putting up a new sign of any kind? If so, obtain proper
Sign pen-nit.
Permit #
Y /
Will iere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Reviewer to complete the following:
Square footage of Use:
/N
•mitted as: �'a Se�v�a'� T�""j� Vevti
Under Section: Mmi n . P •rac t, GC
Supplementary regulations section:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector : Date:
Notes:
Viola ons: v
Y /N'
If so, List:
Proffe s:
Y/6
If so, List:
Vai i ce:
Y /
If so, List:
SP's:
Y /D
If so, List:
Clearances:
av�
SDP's �-
Revised 04/28/08, 10/13/09 Page 3 of 3
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