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HomeMy WebLinkAboutCLE201000189 Review Comments Zoning Clearance 2010-09-20Applicati ®n f ®r Zoning Clearance �pe CLE # 6 — o Zoning Clearance L`$35'� ` y OFFICE US ONLY , / _7�/� Check # 14L Date: / PLEASE REVIEW ALL 3 SHEETS Receipt #: © L Sofa 1 LJ L) PARCEL INFORMATION Tax Map and Parcel: 1::6 L7T14 UJ Existing Zoning 14 C, Parcel Owner: `f'j q Soa4in is L(1 yul y1U6 1 ` Parcel Address: J a4w ( L _ City j t (e State. VA- Zip - -C'y (include suite or i oor) vG Q /Y� PRIMARY CONTACT Who should we call/write concerning this project? _ ST Uce— i%Y1Cr__L,'(-Q/� Address: 19 S 2 l YcA UAV-d City (i L A U e- State Zip ZZCI l � Office Phone: (4 9) I 818L Cell # JQ 5 Sa Fax # 9q(o-,35 )0 E -mail U LC5Me 16 1 �f. CU J . (,d . APPLICANT INFORMATION Check any that apply 'xx Change of ownership Change of use. �LChange of name New busin'esss Business Name/Type: A i Q �, - Previous Business on this sit I U) N '�15 A LT � f Describe the proposed business including use, number of employees, number of shifts, available parlflng spaces, tuber of vehicles, and any a ditional infor do that you can provide: -111 1` r . *This Clearance will/only be valid on the parcel for hich it is approved. If you c ge, inte ify or mo the use to 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 e best of mj y,(knowlle�d�ge. I have re d the conditions of approval, and I understand them, and that I will abide by them. Signature F"\ . F ° \ Printed ��T�7_ f� M� APPROVAL INFORMATION ] Approved as proposed [ ] Approved with conditions [ ] Denied [ ] BacI low prevention device and/or current test data needed for this site.' Contact ACSA, 977 -4511, x119. [ ] 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 c i Date 4z, Zoning Official Date .. .Other Official Date Uounty of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126 Revised 04/28/08 Page 2 of 3 n, Intake to complete the fbllowing:/' Reviewer to complete the following: Proffers: Y /Nj If so, ist: Y / N� Square footage of Use: r o Is use in LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y/ N ermitted as: d �► c� r Y/N Wil ` ere be food preparation? Under Section: �'f • Z If so, give ° applicant a Health Department form. - - - - - — Zoning review can not begin until we receive approval from Health Supplementary regulations section: SP's: if s If sd'ist: Dept. FAX DATE Parking formula: Circle the one that applies Is parcel on private wo public water ? If private well, provide He Deg ent form. Zoning review can not begin until we receive approval from Health Required spaces: Dept. FAX DATE 6 Clearances: Y / . SDP'-s Circle the one that a Items to be verified in the field: Is parcel on septi ublic sewer? Y/N Wil u be putting up a new sign of any kind? If so, obtain proper Inspector : Date: Sign permit. Permit # I, Notes: ill re be any new construction or renovations? f so, obtain the proper Permit. ermit # ZoninL9 to complete the followinLy: Violations: If so, List: Proffers: Y /Nj If so, ist: Variance: If sol�Liffst: If So SP's: if s If sd'ist: Clearances: SDP'-s G '- ZS' v' Revised 04/28/08, 10/13/09 Page 3 of 3 1: