HomeMy WebLinkAboutCLE201000145 Review Comments Zoning Clearance 2010-07-28I
Application for Zonin Clearance
Clearance = ,$35
OFFICE USE ONLY
Check # /� Date-
PLEAZoning
REVIEW ALL 3 SHEETS
Receipt Start:
PARCEL INFORMATION
Tax map and Parcel: Existing Zoning T ;�
Parcel owner: fi/�ri tyAi S C4� la^+ f L�IPy� CA A•'`c o '� i re-3 `� t,i t- %
Parce► Address: /6CO eM l �k& �ity r.L�Pnt�'r Jc.�tef State i� Zip 72 yob
(include suite or flog)
PRIMARY CONTACT
Who should we call /write concerning this project'? LQ\S
Address: U -3 5 O(rdhldu ) ��•� City e i�ILCCU tSJt ftCState
Office Phone: � `i) 564— 66f GI Cell # Fax # E -mail tx!�jo� �a (7-:Z-4g) G "nna t I d
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name ew business
Business Name /Type: V--k 0 61L�— Ct--t�- w7\S�\ SQl�l1Sb1 L L—C
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: Ls-tit
*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 infonnation provided
is true and aceui to to the best of my knowledge. l have read the conditions of approval, and I understand Them, and that I will abide by them.
Signature y Printed �Q� 1 `fi 6t t, A 6 u �� -F%,�
APPROVAL 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 determination of compliance with the existing
site plan,
[ ] This site complies with the site plan as of this date.
Notes:
Building Official '' — Date ZZf o
Zoning Official Date
Other Official Date
County of Albemarle Department of Community Development
401 McIntire Road Cliarlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
Intalte to complete the following:
Reviewer to complete the following:
Y ! N _
Square footage of Use: /� b
Is use in LI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
��
lY / N
Permitted as: 4
Y /
Wil there be food preparation?
Under Section:
If so, give applicaiit`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 p is w, ?
61's
N
If so, List:
Requ'red spaces:
If private well, provide Healtl epartment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Y/N
Circle the one that applies
Item to be verified in the field:
Is parcel on septic o public se er?
Y/N
Will you be putting up a new sign of any kind? If so, obtain proper
SDP's
Sign pen-nit.
Permit #
Inspector : Date:
Y / N
Notes:
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Violations: V
N
If so, List:
Pro s:
Y
if t:
Variance:
Y /
If SI/ I/ st:
61's
N
If so, List:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
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