HomeMy WebLinkAboutCLE201000119 Review Comments Zoning Clearance 2010-06-29�
Application fo Zon'R Clearance
CLE # 1 —I `,
Y P
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Zoning Clearance = $35'
OFFICE US NL CC //``
Check # � ' /%Date:
PLE REVIEW ALL 3 SHEETS
Receipt # _, ': Staff: T D
PARCEL INFORMATION
y
Tax Map and Parcel: _ n ? R 6) Q - 0d - d O - 01 ('� Existing Zoning {�I
Parcel Owner: �gQCj ;j�j�Ti(1�1 P LAND P US 1'
Parcel Address: , !
- `����'� , 2 - City C �)t L IJ State V 7 91 1
—zip
(include suite or floor.)
PRIMARY CONTACT
Who should we call/write concerning this project? � "►C;�� {iy'1� L��� f
Address C(" I V A
: "od r A l �f_ City C, O[ � �; State y/f Zip ZZc%I 1
Office Phone: &�D
APPLICANT INFORMATION
'that
Check any apply: Cliange of ownership Change of use: Change: of.uame New business`:.
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BusinessNamefrype:� �„I)<, ►�II�C,S_� I�fIY�C.D! n�r�t r��y —S 11/x, acmes
Previous Business on this site 6RA-/\; CA 7.7 V Y)
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number o�
vehicles, and any additional information that you can provide:,
,'
H �vr1�rJ A,c ileVJlLZy•1 ' 'iZ'��I �Jx3Ul��t4-�'6UT/
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*This
*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 have read the conditions of approval, and I understand them, and that I will abide by them.
Signatuj Printed
i
AP R0 INFO TIO
Approved as proposed [ ] Approved with conditions [ ] Denied
] Backflow prevention device and/or current test data needed for this site. Contact ACSA, 977-4511, x119 '
[ ] 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 dIX111.
Zoning Official Date
Other Official ' Date
%_ounry or .Punemarie Lepartment of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08 Page 2 of 3
O' -o&ll
Intake to complete the following:
Y/N
Is us in LI, M or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet-
Y /
I�tlf
Wi] 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 6r public water?
If private well, provide Hea ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that appl'
Is parcel on septic public sewer?
Y
Wil be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
�!L% 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: N��
Permitted as:
Under Section:
Supplementary regulations section:
Parking formula:
s6a r P � �i 0 5 . �a,
l
Required spaces:
Y N
Ite be verified in the field:
Inspector
Notes:
Date:
Viol' ' s:
Y / I5 is
If so ist:
Proff
I / �:
If so(,I•�l �sJt:
Vari Se'e:
Y /ki �
If so, List:
$p's
Y/�
If so, ist•
Clearances:
SDP's
Revised 04/28/08 Page 3 of 3
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