HomeMy WebLinkAboutCLE201000127 Review Comments Zoning Clearance 2010-07-01Application for Zoning Clearance
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CLE # - -/Zi-
OFFICE USE 6 a jz)
Cheek# Date:
Zoning Clearance = $35
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PLEA REVIEW ALL 3 SHEETS
Receipt # Staff- VJU
PARCEL INFORMATION
Tax Map.and Parcel; Existing Zoning ppm�
Parcel Owner: -nkr= Ai--tEg-t 6<3� fL4) IZ)(-- (jr2-0L-0G..Y9 ) �C
Parcel Address: (a00 PE ±E--t- JC-Ff:'6'z-S0M 'Pt!--L&t�City_CilAtP-t-oL:rl; VIL-L6State VA —zj-p2-zq it
� j5c7 (include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
Address . boo IZ--MY-L JC-C- FC-It Sot J city Vi Cgiki, VA zip'22N 11
Office Phone: C i
APPLICANT INFORMATION
Cheek any that apply,_ Change of ownership _Change ofuse Change of name Nov business
Business Namef.rype: -X 14 ' A m. C- Z I C4 iJ tS C) A 41-D 0 F I I P- 0 1-0
Previous Business on this site
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: SM-n or-jAL- X)o tj - pl"OF 1—, 11,460. 1 44�. '50"qab
(Of (--ui-t- -i F" M- P to i-A I C- (..e:s -(PE
*This Clearance will only be valid on the parcelftyr which it is approved. If yon 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 t6 the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them
Signature Printed
APPROVAL INFORMATION
k'TApproved as proposed Approved with conditions j 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 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 Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 pax: (434) 9724126
Revised 04/28/09, 10/13/09 Page 2 of 3
Intake to complete the following: Reviewer to complete the following:
Square footage of Use:
Is use th.6,H1 or PDIP7oning? If so, give applicant a Certified
Engineer's Report (CM) packet. &>/ N
Permitted as:
Y
Will era be food preparation? Under Section: CD
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
Circle the one that applies Parking formula:
Is parcel on private well or blic water? /"e
u' ic water?
N private well, provide.Hea.(Ith��eip3a�erntDform.
Zoning review can not begin until we receive approval from Health Required spaces:
Dept. FAX DATE
Y I(N
Circle the one that app4 � Items —fo—be verified in the field:
Is parcel on septic o0u blic sewer?
Y
Wilu be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit # 1"pector: Date:
r d N Notes-
*61 there be any new construction or renovations?
if so obtain thp .
proper Permit.
Permit#
-IF1--1 V
Zoning to complete the following:
Viol tlo S.
Y WNJ l'Y,-f
i -z
if son'.. list:
;"ffers:
N
-ff so, List:
Varige.
YI
If so, List:
Y / (N)
If so, List:
Clearances.----------•
SDP's
Revised 04/28/09, 10/13109 Page 3 of 3
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