HomeMy WebLinkAboutCLE201000212 Review Comments Zoning Clearance 2010-10-14Apphi cation for Zoning Clearance
Zoning Clearance = S35
OFFICE USE ONLY
Check # q2LN- Date:
Nu
PLE(Al"REVIEW ALL 3 SHEETS
Receipt 4 Staff:
pll
le I IV - -/I- w6b Existing zoning-
Tax Map and Parcel:
lit,
parcel Owner:_ kMIRVAL
City State Zip
Parcel Addrem.
(include suite or floor)
PRIMARY CONTACT
Who should weeall/wi-itecoricerningtliisproje Ct'2
APPLICANT INFORMATION hange of use Change of.name Nem, business
Check any that apply: _ Change of ownership
Previous Business on this site
Describe the proposed business including use, number of employees, number of iffis, available parking spaces, number of
t-"A-
vehicles, and an.), additional information that you can provide: I -15�asl
This Clearance will only be valid on the parcel for which it is approved. if you change, intensi�, or move the use to a new location, a new Zoning
Clearanoe will be required,
I hereby certify that I own or have the owiiees permission to use tile Sp8CeiDdicated on this application. I also oertify that the information provided.
is true and acourate 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 Printed ele,
APPROVAL INFORMATION' [ ] Denied
as proposed Approved with conditions
�Approved
]'BackflDW prevention device and/or cun-ent iest data needed for this site. ContaotACSA,977-4511,x117.
[ I No physical site inspection has been done for this clearance, Therefore, it isnot a determination of compliance with the existing
site plan.
[ ] This site complies with the site plan as of this date.
Building Official j 0 Date. (-Q, '-k
Zoning Official Date
Other Official Date
' Coont�of&�oo�adel)�mrbn�dofCvmmouuyuopumpmnoo
4OJP�dntiru Road Charlottesville, YA%%90% Voice: (434)296'683% Fax: (434)972-41%6
Revised 04/28/08, !0/|309 Page 2nf3
Reviewer to complete the following: _
Intake to complete the following: ,
— Y ! 1� Square footage of Use:
Is use n 1, Hl or PDIP zoning? if so, give applicant a Certified
Engineer's Report (CER) packer. Permitted as: �ee m m P \ice
Y /
V,!i IC-be. food- preparation? Under Section: n� bra OR A,
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
is parcel on private well o public water?
If private well, provide Hea i epartment form.
Zoning review can not begin until 'Ale receive approval from Health
Dept. FAX DATE
Circle the one that applies
Is parcel on septic or iic sewer?
Parking formula:
Required spaces:
Items to be verified in the field:
Y /
y /ae putting up a new sign of any kind? If so, obtain proper
Sign permit, Inspector : Date:
Permit #
Notes:
Y /
WilfCbe any new construction or renovations?
If so, obtain the proper Permit
Permit #
Zoning to com fete the fotloMug:
viola ions: Proff s:
Y/ �' Y /(NS
If solist; If so, List:
\gar nce: SP's:
y / / N
If so, List: If so, List;
-7 y
Clearances: SDP's
Revised 04/28/08, 10/13/09 Page 3 of 3
J
r
/
DX
r �
I
D �
JI
F-
J
C,
J
G7 x
O