HomeMy WebLinkAboutCLE201000155 Review Comments Zoning Clearance 2010-08-02F
V
Applicati ®n f ®r Zoning Clearance
a
CLE # r ,
Zoning Clearance = $35
OFFICE USE fNf��LY
Check # UO Date:
PLEASE REVIEW ALL 3 SHEETS
Receipt # A Staff:
_PARCEL INFORMATION
Tax Map and Parcel: �� (� ,t) /� ��(����a Q /9_ Existing Zoning�e�%1�ir7rc�,� GO�ZI
Parcel Owner: Pf5 e y
Parcel Address: L(QC'f 0 S2 %0_ d zkz= City tate ON Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
ri1,�
Address : W8 �CIVU IJl�i7!!� City �� OR to V� Zip
Office Phone: Cell # ;: [ x # E -mail
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name V<Iew business
Business Name /Type: r) G Q 1G /AJ -Z7
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: _64&J Q, 41424" XS
*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 certi own or iav owner's perm' o use the space indicated on this application. I also certify that the information provided
is true and curate o the best of ow d . have read the conditions of approval, and I understand them, I will abide by them.
�and dtthat
Signature Printed ��/ G6lKJrJJ�
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
[ ] Bacicflow 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 C� �-I Lo
Zoning Official Date 3::;�IZ,111)
Other Official Date �fy /lb
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
Y711—
Intake to complete the following:
Is / j,
Is usWLI, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet.
Reviewer to complete the following:
Square footage of Use:
N
fitted as: Cg�
N
1•I there be food preparation? Under Section:
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 uIf private well, provide Hea nt form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applie
Is parcel on septic or ublic sewer?
you be putting up anew sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7nning to comnlete the following:
Parking formula:
Required spaces:
Y/
Ite o be verified in the field:
Inspector : Date:
Notes:
Viola tions:
Y / N
If so, List:
Pr0ft
Y n)
If so, List:
V aria e:
Y /
If so, List:
/ N
If so, List:
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
PMMM
,..a
COMMONWEALTH OF VIRGINIA
DEPARTMENT OF HEALTH
CERTIFIES THAT
Pigskinz BBQ, LLC
is hereby granted a permit /license to operate a Fast Food Restaurant
by the Albemarle County Health Department in accordance
with the regulations of the Board of Health,
Commonwealth of Virginia.
FACILITY NAME: PIGSKINZ BBQ
PHYSICAL ADDRESS: 1640 Seminole Trail
Charlottesville, Virginia 22901
MAILINGADDRESS: 1640 Seminole Trail
Charlottesville, Virginia 22901
EXPIRATION DATE: December 31, 2010
CONDITIONS:
Kenneth E. Stutz, MPH, REHS
Environmental Health Specialist, Senior
Please direct questions or concerns to the
Albemarle County Health Department,
Environmental Health Services, (434) 972 -6219.
This Permit Is NOT TRANSFERABLE From One Individual
or Location to Another.
FF., _ t 0Z�C Utz oom _ : IN Cunok aeqty
9� PSME11-11,
' m r I sex ° -- -- 19'4 " /1DJ �,. fD o o y v m::'_: �'F' -� a c o o O s m `z N o 422' 4 "► rc - Vf ° =
m 07 is c in: Drink ; x fD atlon� _. o
rn S pi m' 9 m x x
N ?•�
.,
o am cu
cq
c
to X. , StainlesSteel Reach Ins
°� o Work able tRefrigerator
m /�' /�,. 1T1 "► ._ —� 113'8 a n.. ._ .n. En
"'Atia-
uD
mn
�K
o 3 O
a "' a 'w_ Stainless Steel 3 c
°• �' Work Table a m
CD
l7 =
n� 1
47-0-1,
as
Ln n p N 0
C
; c j
N
W
3°
a 39
a
o?
o
D 0
a
0
c
0
c
m
0
0
m
0
0
�
o
a
Gl
c
m