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HomeMy WebLinkAboutCLE201000192 Review Comments Zoning Clearance 2010-09-23Application fo Zo in Clearance Y 9m 6= CLE # %RGtN�P Zoning Clearance = $35 OFFICE Check # t Date: PLEASE REVIEW ALL 3 SHEETS Receipt # Staff: _ PARCEL INFORMATION ' �7 / / o % C' Tax Map and Parcel: J Existing Zoning Parcel Owner: L J(w o" t- 1� J1Aauy 1 j + , Parcel Address: Zo 13 ylpp v-- C1' • City b ©J�.tr ?�'� t�a 7 /�_ Zip 2-2 (include suite or floor)1,� PRIMARY CONTACT Who should we call /write concerning this project? nn4efalz►an Address: 2A_7(2 ftz5F: nWMIC> F—D. city C�^lq�,►pf)ta\)i)IC State \1 Pr Zip ZZ� Office Phone: `V C4 S l —3Lf2ioCe # L13W'q N "3 ax # E -mail e o_e eMG�-{'C�•� cw`@ -i• APPLICANT INFORMATION Check any that apply: Change of ownership Change of use —Change of name New business Business Name /Type: 5rnooW V-1 n Lovstg t Previous Business on this site J 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: l� (lind 06, iL CC- lPqa96bq A-- *Thus Cl arance 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 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. n Signature Lw�•�, ' Printed�L.�v�. APPROVAL INFORMATION XApproved 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 ce \o 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 /�Is u LI, HI or PDIP zoning? If so, give applicant a Certified Engineer's Report (CER) packet. Y / 1`tli Wil ere 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 o4- ublic wate If private well, provide Health Department form. Zoning review can not begin until we receive approval from Health Dept. FAX DATE Circle the one that ap li Is parcel on septic o qublic se er? Y Wil ou be putting up a new sign of any land? If so, obtain proper Sign permit. Permit # Y/N Will re be any new construction or renovations? If so, obt roper PerrpitA Permit Zonine to complete the followings: Reviewer to complete the following: Square footage of Use: -9 7 Y Y N f mitted as: i �+�i D Under Section: Supplementary regulations section: Parking formula. Required spaces: Y/N Items to be verified in the field: Inspector: Notes: Date: Viol tions: Y / Ifs , ist: Proffers: /N If so, List: Varian e: Y / g/ If so, List: SP' Y � If so, List: Clearances: d�gd1✓` .✓ SDP's Revised 04/28/08, 10/13/09 Page 3 of 3