HomeMy WebLinkAboutCLE201000206 Review Comments Zoning Clearance 2010-10-110; arance
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CLE # '� 00
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JZoning
OFFICE U 1 NLY -
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Clearance = $35
PLEASE REVIEW ALL 3 SHEETS
Check # Date:
Receipt # Staff:
PARCEL INFORMATION, j C1
Existing Zoning
Tax Map and Par el: V
Owner: 0 �
parcel
State zip, M&
Parcel Address; V JLV City
. (ii1clude suit or floor)
PRIMARY CONTACT
Who should we call/write concerning this project?
`T I o J Cit}�` Mate V f Z
AddressI Y*
Office Phone: ( Cell (40 � fax # I� Ik' E -mail
APPL1QA_NT INFORMATION
Check any that apply: Change of ownership Change of use Change of name New business
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Name /Type:
Business
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, ay.allab a parking_spaces, number of
`S S lI
vehicles, and any addit)onal information that ou can provide: A n nnn P1 xJ��,b�P,� n
*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
the ofapprov!all,, and understand tthemr, I will abide by them.
is true anoacate to r4best na y knowledge, I have read conditions that
s true '
/anted
Printed
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APPROVAL 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 site inspection has been done for this clearance. Therefore, it is not a determination of compliance with the existing
physical
site plan.
[ J This site complies with the site plan as of this date.
Notes:
Building Official Date •�
Zoning Official < Date j6
Other Official Date
Count), 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
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Intake to complete the following:
Y /N\
Is u m Ll, 1-11 or PD1P zoning" if so, give applicant a Certified
Engineer's Report (CER) packet.
Y /%
Wi ! th e be food preparation?
If so, give applicant a Health Department forril.
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies
1s parcel on private wel or public water?
If private well, provide He lent form.
Zoning reviev,, can not begin until we receive approval from Health
Dept, FAX DATE
Circle the one that app er
Is parcel on septic public sewer?
Y N
Will you be putting up a new sign of any ltind? If so, obtain proper
Sign permit,
Permit #
� N
V}'ill there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Zoning to complete the fotlovTIng:
Violations:
N
If so, List:
V riance:
��/ N
If so, List:
Clearances:
Reviewer to complete the 1011owtng:
Square footage of Use: ilJ
P er/ N mitted as:
Under Section: z—
Supplementary regulations section:
Parking formula: /
X11 �
Required spaces:
Y/
Items to be verified in the field:
Inspector : Date:
Notes:
Revised 04/28/08, 10/13/09 Page 3 of 3