HomeMy WebLinkAboutCLE201000135 Review Comments Zoning Clearance 2010-07-08Application for Zoning Clearance
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CLE #
,Zoning Clearance = $35
OFFICE U LY
Check # A4 Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # �o j iY Staff: 1
PARCEL INFORMATION _ Y
Tax Map Parcel: �� Existing Zoning
and
M
Parce10wner: it Dom rip'.
Parcel Address: l City V& State Zip
(inch1 a suit or fl
PRIMARY CONTACT $� EN p�},N k E: LL
Who should we call /write concerning this project? 7
324 S. CAake- ke,1 Cf• 1e. EA 29�i
Address : Q City i, State Zip
Office Phone:( T3 q ?1-- 3 MCell # �TZ r� 1 Fax # E -mails
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r TS L 3CtiQ• -i T1 'LAS ew M'Nr !
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business'
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Business Name/Type: 1 ) meA P JW l,*MV t t' �, 14ACIC (.�!/ iEK (,fit (i a
Previous Business on this site �O O ' C. �a., C11
Describe the proposed business including use, number of employees, number of shifts, available park' g spaces, u be} of
W , bCra
vegqicles, and any additional information that you can pr vid : 1t
#W1w^40&,% on 1.1 loft f w•' u4 a
.t . /-
*This Clearance 411 only be lid 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 wner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to th best of my know ve read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed 9.464 DA-V jkEL..L.
APPROVAL INFORMATION
[--'j 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 determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Notes
Building Official �— Date I 1
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:
Reviewer to complete the following:
Y /(N
Square footage of Use:
Is uPh LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
YD N L
Y /�T
Will there be food preparation?
Permitted as:
Under Section: JM i4z QQ
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
Is parcel on private well o c ter?
Parking formula:
If private well, provide Hea epartment form.
Zoning review can not begin until we receive approval from Health
Required spaces: --------
—1
Dept. FAX DATE
Y/
Circle the one that ap ies
Items o be verified in the field:
Is parcel on septic or lic sewe
Y
Wi ou be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Inspector : Date:
I,
Notes:
Wil0ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Z,nnino to emmrilete the fnllnwinu:
Violations:
If so—,List:
Proffers:
If sgist:
Variance:
Y /Ol
If so, List:
P's:
/N
I so, List:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3