HomeMy WebLinkAboutCLE201000167 Review Comments Zoning Clearance 2010-08-2408/18/2010 15:43 9109499974
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Application for Zoning Clearance �
CLE # .Z�010 - JOY
N�RrI
OFFICE O l.1( //11�
❑ zoning Clearance = $35 Check # Date: -, V
PLEASE REVIEW ALL 3 SHEETS Receipt q Staff. ,
PARCEL INFORMATION
Tax Map and Parcel: (A I Yrt Or ' /0,-00 1 67 Existing Zoning ^EPA (/
Parcel Owner: —To tJ 6 Q 1,. k4 % /
Parcel Address: 6 2 `q 1 e� lcrna� C,,rL. City Ch a f 1.4tes v,' b& State �/ A zip -2-29&1
(include suite or floor)
FFJMAR.X CONTACT ,
Who should we call /write concerning this project? ---J 0 t 1z" t2 6N-i°
Address: tool C;r- City State V. ,zip
Office Phone: t?.�rt�79G� -oo77Y Cell %9 -/ //7 Fax# �9� 7377 Email_J -f3,2; 6yr ' Sovec54
APPLICANT INFORMATION
Check any that apply: Change of ownership Change of use Change of name _ )New business
BusinessName/Type: 'ec4 -;nCJt 11Wr�
1 •
Previous AuAness on this site �v rinin iriyntA / a lAcl� IH CANT: cr V 12 0 [,V :a
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: +; ' t - p 44Lp ,
Crr/✓lo t�3' 8P•' ^n;.'orJ -S qJ +u's
"This CIearanw will only be valid o,a 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 information provided
is true and accu a best of my knowledge. I have read the conditions of approval, and I understand them, and that I will abide by thero.
Printed ��. t h f Signature �
APPROVAL INFORMATION
Approved as proposed [ ] Approved with conditions [ ] Denied
] Backflow prevention device arid/or current test data needed for this site. Coniaet ACSA, 977 -4511, xi l7.
[ ] No physical site inspection has been dome for this clearance. Therefore, it is not a determination of compliance with The existing
site plant.
[ J This site complies with the site plan as of this date.
Notes:
Building Offic'al pate (�
Zoning Official pate
Other Official Date
r .... V A - -1_
�•••••J v n —iA.at■c,u VVU141AW111 U1 Cuu Q1unity uevetopment _
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5837 Fax. (434) 972 -4126
Revised 04/28/08, 10/13/09 Page 2 of 3
N-C.
08/18/2010 15:38 9109499974 SPECTACLE SHOP PAGE 02/02
Intake to complete the following:
Reviewer to complete the following:
Y
Square footage of Use:
Is I-I,1 #I or PDIP zoning? If so, give applicant a Certi ied
�
Engineer's Report (CER) packet.
P/ N�
P/ l
Y ,1
as:
Will there be food preparation?
Under Section: _• _ ____ _ _
If so, give applicant a Health Depattment fonn.
_
Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept. FAX DATE
Clearances:
Circle the one that app es
parking t'ormula:
)s parcel on private w ll o public w er?
If private well, provide He h A ment form.
�
Zoning review can not begin until we receive approval from Health
Re iced spaces:
Dept. FAX DATE
Circle the one that
Y•/
lte to be verified in the field:
Is parcel on septic er
Cpubli,
Y/N
Wi ll you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Permit #
Inspector : pate:
Y / N
Notes:
WM there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Znnin¢ to complete the followinLy:
lglations:
/ N
If so, List:
ki-S
Proff rs:
Y /c
If s , st:
Varia ce:
Y /t N
if so, List:
SP's.
Y /N)
If so, List:
Clearances:
SDP's
Revised 04/28/08, 10/) 3/09 Page 3 of 3
08/18/2010 15:37 9109499974
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County of Albemarle
Planning Application 1
TM 1061M0._00.12 OObiB7, I Owner(s):
Application #�CLE20100016'
Legal Description I BERKMAR CROSSING B B2R
Community Development Department
401 McIntire Road Charlottesville, VA 22902 -4596
Voice: (434) 296 -5832 Fax: (434) 972 -4126
Legal Ad
Type Sub Application Date Comments:
APP,LICARlT /,':CONTACT.INF01tMi4TION � <,
Owner /Applicant
Name A2 PROPERTIES LLC & JON D BRIGHT Phone #
Street Address 626 BERKMAR DR Fax # ( )
City / State CHARLOTTESVILLE VA zip code 22901-
E -mail I Cellular # ( ) -
Signature of Contractor or Authorized Agent Date