HomeMy WebLinkAboutCLE201000161 Review Comments Zoning Clearance 2010-08-18Application for Zoning Clearance -�
CLE # MO - 1621
RrZoning Clearance = $35
OFFICE U NLY P11- ��
Check # , Date:
PLEASE REVIEW ALL 3 SHEETS
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Receipt # Staff: .
PARCEL INFORMATI
4f5 0A Zoning
Tax Map and Parcel: I Existing
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Parcel Owner: fah
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Parcel Address: Damao Ukl'�, ClA G -trAtp- City �11Y>.�1� � ��� -State V Zip�'�»�
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project?
Address • \ /\0:2 N ' «` r City ��L� C""403\V-'State � Zip 41 z �-i
Office Phone: (� �-� �� `Cell # Fax #
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name ✓ New business
Business Name/Type: rC - - �`-'���0 � -�`� ; U —C-'
Previous Business on this site \Ly -,
Describe the proposed business including use, number of employees, number of shifts available parking spaces, number of
vo -16'
vehicles, and any additional information that you can provide:
*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 t wner's permission to use the space indicated on this application. I also certify that the information provided
is true and accurate to the best i ge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature Printed
APPROVAL INFdRMATION
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
Zoning Official Date
Other Official Date
County of Albemarle Department of Uommumty mevetopment
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
- 'or'►'1
Intake to complete the following: Reviewer to complete the following:
Y / Square footage of Use: �'yu
Is uses nl, HI or PDIP zoning? If so, give applicant a Certified
Engineer's Report (CER) packet. / N
lermitted as:
WilNi'e're be food preparation? Under Section: 2 Z • I
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 or public wate ?
If private well, provide Healt l��par ent form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that app :ie Is parcel on septic o bliEewer
Q i / N
ll you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Y /
Will t ere be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
7,nninu to emmnlPtP the fnllnwinu:
Parking formula:
Required spaces:
Y/N
Items to be verified in the field:
Inspector : Date:
Notes:
Viola ' ns:
Y/
If so, ist:
offers:
/N
f so, List:
71A 1
Variance:
�/ N
If so, List: Lo / /
§ 's:
Y N
If so, List: 02-31
Clearances:
SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
office Office and r
bathroom
H � I
8200 SQ FT
Sprinkler room
CHECK OUT
FRONT DOOR
IN SIDE
OUTSIDE
FRNT