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HomeMy WebLinkAboutCLE201000202 Review Comments Zoning Clearance 2010-10-07Application f , r_Z®ning Clearance CLE # SU k ~ '4t01N�P N Z ring Clearance = $35 PLEASE REVIEW ALL 3 SHEETS OFFICE U ONLY y Check # Date: Receipt # N;L Staff: PARCEL INFORMATION - - _ Tax Map and Parcel: ���� — — ©�'� c(::) Existing ZonAi'n�g, Parcel Owner: �� CJ�"t '�.I> ' ` — _TQr� _z Parcel Address: City Q=1 State Zile (include suite • floor) PRIMARY CONTACT Who should we call /write concerning this project? -^ Address: IL410 City State V'F`'1 Zip vC 1 Office Phone: ( Cell # Fax APPLICANT INFORMATION Check any that apply: Change of ownership Change of use of name New business -U--'Change yam�.. "" �� ^--� Business Name /Type: uv d�� �5 ' A AP ,­k �--}}(L—LQ�� Previous Business on this site �� — A Describe the proposed business including use, number of employees, number of slr' ts, availabl p r ing spaces, numberpf vehicles, and aAy additional information that you can provide: e *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 the owner's permission to use the space indicated on this application. I also certify that the information provided is true and accura to ie best of my knowledge. I have read the conditions of approval, and I understand them, and that II will abide by them. Signature Printed � KJ�= 1 �J I�� APPROVAL INFORMATION �OjApproved 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: 0 Building Official —i Date I o P 6 P0 Zoning Official Date 1b.1 Other Official Date County of Albemarle Department of uommumty lievelopment 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 1�1- i Intake to complete the following: Reviewer to complete the following: Y ' V Square footage of Use: 7 3-5 Is use m LI, HI or PDIP zoning? If so, give applicant a Certified /� 6P/ N Engineer's Report (CER) packet. Permitted as: Wil ere be food preparation? Under Section: If so, give applicant a Health Department form. Zoning review can not begin until we receive approval from Health Supplementary regu ations section: Dept. FAX DATE Circle the one that applies Parking formula: J' Is parcel on private well or P ►c w r? If private well, provide HeaIt epartment form. Zoning review can not begin until we receive approval from Health Rc -ed space FAX DATE IN Circle the one that applies terns to be verified in the field: Is parcel on septic or public sewer? /N ill you be putting up a new sign of any kind? If so, obtain proper Sign pen-nit. Permit # Inspector : Date: ) Y � Notes: Will there be any new construction or renovations? If so, obtain the proper Permit. Permit # Inn- fn rnm IM.'. 1-ha fnilnwino'• ►olations: y/N If so List: P offers: i'/N If so List: lo Var ce: y� If so, List: SP' ' Y /( If so ist: Clearances: SDP's Revised 04/28/08, 10/13/09 Page 3 of 3 �I I ��� �H �b a c r ' �- County -of Albemar -le —o- �R Planning Application 1 TMP Owner(s): Application # Legal Description IACREAGE Magisterial Dist. ISamuel Miller Community Development Department) 1- McIntire - Road Charlottesville, VA- 22902 -4596 - Voice : (434) 296 -5832 Fax: (434) 972 -4126 IVY COMMONS SHOPPING CNTR Land Use Primary I Commercial APPLICANT % CONTACT INFORMATION . , . Primary Contact Name KAREN MOORE Phone # (434) 882 -0676 Street Address 1410 BEACON HILL Fax # (540) 456 -6076 City / State AFTON, VIRGINIA Zip Code 22920 -0000 E -mail RKCSA5 @ HUGH ES.NET Cellular # ( ) - Owner /Applicant Name IIC LLC Street Address 12246 IVY ROAD SUITE 5 City/ State CHARLOTTESVILLE VA E -mail Signature of Contractor or Authorized Agent Date Phone # Fax # ( ) - Zip Code 22903 - Cellular # ( ) -