HomeMy WebLinkAboutCLE201000136 Review Comments Zoning Clearance 2010-07-16Applieati ®n for Zoning Clearance
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CLE #
�~_ A�?r
Zoning Clearance = $35
OFFICE Tq , LY
Check # Date: —gj q I f
PLEASE REVIEW ALL 3 SHEETS
Receipt # Staff-
PARCEL INFORMATION
Tax Map and Parcel: �0� ` �„f� Existing Zoning�l,
Parcel Owner:
Parcel Address: City State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project?
Address bay e-- I a t( City li`S]il (state �)� Zip a
Office Phone: " 09l- # Fax # E -mail 1%a� �� .(�Jsn�J/ � ✓(/q l5�/� %/
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type: � cn,2, &LA-' A), f-, V-9
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 p ovide: Q_4% j K i --C-
5
*This Clearance will only be valid on the parcel for which it is approve&Af you change, intensify or move the useto a new location, a new Zoning
Clearance will be required.
I hereby certify that I own or have the owner's pe ssion to use the space indicated on this application. I also certify that the information provided
is true and accurate the best of my knowledg� have read the conditions of approval, and I understan�d / them, a d that I will abide by them.
Printed
Signatur rim
APPR AL 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 ofthis date.
Notes:
Building Official Date -') (`_Y ( ( o
Date
Zoning Official
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 Pale 2 of 3
)L�,a /
Intake to complete the following:
Y /
Is us' , LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Y /it
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 o public ;v�me, ?
If private well, provide Hea t f orm.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap
Is parcel on septic KP ublics r?
Y/N
Will you be putting u a new sign of any kind? If so, obtain proper
Sign permit.
Permit
Y/N
Will there bean w construction or renovations?
If so, obt ' t e proper Permit.
Permit #
Zonina to complete the following:
Reviewer to complete the following:
Square footage of Use:
�j /N
permitted as: 4-tr 1p zA e
Under Section:
Supplementary regulations section:
Parking fornuila: PIS (�'
Required spaces:
Y
Items to be verified in the field:
Inspector:
Notes:
D ate:
Viol s:
Y/ V
If so, List:
Proffers:
Y/N
If so,
Variance:
Y/N
If so, List:
SP's:
Y/N ^�
If so, List:
Clearances:
SDP's `
Revised 04/28/08, 10/13/09 Page 3 of 3
Jul 13 10 02:59p
(434) 296 -7595
Lee S. Nunnally
TO:
Virginia Tent Rental
4342967911
} VIRGINIA
" TENT UNTAL-
A DMSION OF JUMP CREWS OF VIRGINIA 7NC-
- P.U. Box 5124 • Charlottesville, Virginia 22905 --
Fax (434) 296 -7911
hate:._ �l
Number of pages including cover sheet: —2
IPhone:
Fax:__`f���
I FROM:
Phone: (434) 296 -7595
Fax: (434) 296 -7911
P.1
(434) 296 -7595
Scott T. Nurnnally
REMARKS: ❑ Urgent ❑ For your review ❑ Reply ASAP ❑ Please continent
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Jul 13 10 03:00p Virginia Tent Rental 4342967911 p.2
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