HomeMy WebLinkAboutCLE201000205 Review Comments Zoning Clearance 2010-10-08OFFICE USE ON
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ning Clearance= $35 Check # ("2_01 Date:
PLEASE REVIEW ALL 3 SHEETS Receipt #,8Q_ Staff: ��
PA-RCELINFORMATION --
Tax Map and Parcel: (_3 G J C)o CXj 0U13 2X Existing Zoning (� ►'J S�--
Parcel Owner: C- v 0SSv�� -� ��5
Parcel Address; 5 l R:�v `�e.� City C u`kkstate � Zip Zz°x;'�
(include suite or floor)
PRIMARY CONTACT
Who should we call /write concerning this project?
Address: U, c+k 2 `G City �� X✓u�� State j�� . Zip CJ
L
Office Phone: MS 296' 7 SAS Cell # 57310 r62— Fax # E -mail
APPLICANT INFORMATION
Check an), that apply: Change of ownership Change of use Change of name New business
Business Name/Ty pe: rc) w�. t'r r-c"'- -
Previous Business on this site ��''� 17
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 sou CZ) Scu�rL
J'k-L�
*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 J 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 :5 - —� Printed
AP ROVAL INFORMATION'
Approved 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 detennination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date. /
Notes: �i 11 / 1� U 171 gl
Building Official Date l
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
r Intake to complete the following:
Reviewer to complete th
0
Square footage of Use:
is use in L1, HI or PDIP zoning? If so, give applicant a Certified
Report (CER)
Dly N
Engineer's packer.
Permitted as:
—,,Ali I 1-therc-bf-food-pr_e;paratioll?
Under Section: .4,Ayl7 i
If so, give applicant a Health Department form.
Zoning review can not begin until we receive approval from Health
Supplementary regulations section:
Dept, FAX DATE
Circle the one that applies
Parking formula:
Is parcel on private well Or 65)'A'ater?
If private well, provide Health Department form,
begin TeCei\'C approval from Health
Required spaces:
Zoning review can not until we
Dept.. FAX DATE
Y / N
Circle the one that applies
applies
Items to be verified in the field:
Is parcel oil septic or
Q1111 you be putting up a new sign of any kind? If so, obtain proper
Sign permit.
Inspector Date:
Permit #
Notes:
Qfi/l]Qci,e be any new construction or renovations?
If so, obtain the proper Permit.
Permit o --I F-71 T
Zoning to complete the tolloIA11119:
Violations;
Y / N
If so, List:
Proffers;
Y / N
If so, List:
Variance:
Y / N
If so, List:
SP's:
Y / N
If so, List:
Clearances:
OP's
Revised 04/28/08, 10/13/09 Page 3 ot'3