HomeMy WebLinkAboutCLE201000170 Review Comments Zoning Clearance 2010-08-24Application f ®r Z®nin Clearance
o�
CLE # a0(0— j c)
~ �IRGIN�P
OFFICE USE ONLY
0Zoning Clearance = $35
Check # iL 0 5 _`�
> Date:
-
PLEAS REVIEW ALL 3 SHEETS
ecep Staff.
PARCEL INFORMATION n_ r l �
Tax Map and Parcel: 5(� (C7f� ' Ub o a OC) Existing Zoning
(�ad�
(`
Parcel Owner: Go-- S -r
233
Parcel Address: Sv.c -it-e a v City 0 `,J Mg- State Zip
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project? J Q Cxc,_9_
s,c4 -e. ZZoy
Address City State \(A Zip 0 �
Office Phone: ) 9 'J'asa Cell # Fax # 9-+5- 5 X -mail s vii C\
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
Business Name /Type:
Previous Business on this site (2VMtAfl1rkLA fir- cJLJ�
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: �ft.v -r;'^ C e e
*This Clearance will only be valid on the INJcel 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 information provided
is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by them.
Signature z_ �-� c�� S Printed Ig6se eeo. "�e_sxo --p A So;, S
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
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:
Y Vii Is u LI HI or PDIP zoning? If so, give applicant a Certified
g pp
Engineer's Report (CER) packet.
Y/N
Will there be food preparation?
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on private well o public w er?
If private well, provide He partment form.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that ap
Is parcel on septic Qublic sewer
Y/N
Will you be putting up a new 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 #
Zoning to complete the following:
Reviewer to complete the following:
Square footage of Use: 2 a a
0/ N
Permitted as: Ls—
Under Section: 2? -2 ,
Supplementary regulations section: -
Parking formula: /�
.zv 0
Required spaces:
Y N
Items to be verified in the field:
Inspector : Date:
Notes:
Viol ns:
Y /
If so, ist:
Prof er :
Y
If so, List:
Vari ice:
Y/
Ifs , ist:
/N
if, 's:
o, List:
Clearances:
SDP's
Revised 04/28/08,10/13/09 Page 3 of 3 _ _ _