HomeMy WebLinkAboutCLE201000142 Review Comments Zoning Clearance 2010-09-20Arclkv C
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Application for Zoning Clearance
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CLE # �()Jo - [�
❑ Zoning Clearance = $35
OFFICEE 8 Y
Check# )Date: q4_10
PLEASE RE VIE' WALL 3 SHEETS
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-P A-R C. E L - INF 0 IhN.
Tax Map and Pat-eel: _TW ExisthigUnin
Parcel Owner: I .11 u to, - —
WI) 94 le-� W -
Parcel Address: 9)� lin 41M NAIVI_ Cjt)& _--State AK, Zip
(include `suite �or floor)
PUMARY CONTACT
1 el_ Vn fraZj 6r
Who should ive call/write concerning this project?
Address- —city &k4tL0k8 State V# -zip 2,1-101
Office Phone-. C X_fr_0V_%% 3 Q Coy, r\ 4-�-
Cell 45Y�35�-&Iqq Fax W E-mail
APPLICANT INFORMATION
any that apply., _ Change of ownership _ Change of use _Change of name i;;V-e�w business
-Clieck
Business Name/Type: Ljo\,16� aka 601 <- CW/C
Previous Business on this site
Describe the proposed business including use, number of employees, numbgoa�sliifts, oval able parking spaces, number of
vehicles, and an additional information that you can provide:.
Wr
tv 4IN
*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, anew, Zoning
Clearance will be required.
I hereby certify that I own or have (lie owner's permission to use the spaceindicated on this application. I also certify that the information provided
is true and accurate to die best of iny knowledge. I have read the conditions of approval, and I understand them, and that I will abide by then).
Signature Printed
0_ VAL INFORMATION
Approved as proposed Approved with conditions Denied
Backflow prevention device and/o• current test data needed for this site, Contact AC8A, 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 -7 f r:L I I'a
Zoning Official Date L
Other Offiqlpl Date..
County of AIb7emarf0)eparIrnejit of Coninj6iiito6elopment
Pf 401 Mcliffire Road Charlottesville, VA 22902 Voice-: (464) 266-5932 Fax: (434) 9724126
Revised 04/28/08, 10/13/09 Page 2 of 3
Intake to complete the following:
Reviewer to complete. the following:
Y ON
Square footage of Use:
Is use tp. LI, HI or PDIP zoning? If so, give applicant a Certified
�
Engineer's Report (CER) pacicet.
1:J/ N
`
Permitted as: 6th
rn� � 1
Y / N
3
�, r A
of t }�.S" 0,rQ -m
Will there be food preparation?
Under Section:
If so, give applicant a Health Department form.
- Zoning e- view.- can-not:be 'n-ilitilwe- i•eceive-approvai. from - Health -
:_ Supplementary . -regulations.sectio .. —: —..
Dept. TAXDATI �' f �a`�011a
Circle the one that applies - e
Is parcel on private well ublie water?
Parking formula: j 2} t bo�
I Jl t j a • ,
If private well, provide Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. VAX DATE
Required spaces:
/i
Y/N
Circle the one that apples
Items to be verified in the field:
Is parcel on septic 2atblic seiver?
YIN
ill you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
ill there be any new construction or renovations?
If so, obt ' e
er
Permit # O.6 • c ► ; ?
NOS F�-- / 64
7nxinn to nAm"10+0 AID fnllnwinn-
Inspector: Date:
Notes:
Violations: -- - -__ -_ - _ _ - -_ --
/N
so, List;
fers:
Y N
f so, List:
�V`ariance:
VIN
If so, List:
SP`s;
N
If so, List;
Clearances:
SDP's
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