HomeMy WebLinkAboutCLE201000218 Review Comments Zoning Clearance 2010-11-01VV/ J
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Application for :Zoniy1k.
CLEW. a
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Zoning Clearance = $35
O FFICE USE ONL1' J
Check # Q/ 7- Date: �� f ✓.�
Receipt # � Staff: i
PLEA REVIEW ALL 3 SHEETS
PARCEL INFORMATIO '/� j �1 ,,'
((// Existing Zoning
Tax Map and Parcel:
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Parcel Owner: 94YI f
Parcel Address:___—,— t & � ,QAC �Ka Irk City -. C� �L6 �S�t'��State�,� ZipZz��
(include suite or floor)
PRIMARY CONTACT
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Who should we call /write concerning this project. ! -
Address: Lt k—m a r 0 Clh, ' Cpi' �tn � -8tate V � Zip z Y
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Office Phone; eil�. Fax 4 E -mail ' I3tG a 114 urf( -- �74i.(,c "ell
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APPLICANT INFORMATION
Check any that apply: of ownership Change of use of name New business
Change
- pChange
Business Name/Ty (TC�1 GJ r� <
Previous Business on this site
Describe the proposed business including use, number of employees, number of shifts, available parking spaces, number of
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vehicles, and any additional information that you can provide: a.W f' vatio.r) )2 6
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*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 spaceindicated on this application. I also certify that the information provided
I have the of approval, and I understand them, and that I will abide by them.
is true and accurate, to the best of my knowledge. read conditions
Signature /�� �.ol -L ViL.6? Printe Yc-
APPROVAL INFORMATION'
/I•Approved as proposed [ ] Approved with conditions [ ]Denied
[ ] Backflow prevention device and/or cutYent test data needed for this site, Contact ACSA, 977 -4511, xl 17.
[ ] 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 (����
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:
1 / \1.
is use in Li, Hl or PDIP zoning? if so, give applicant a Certified
Engineer's Report (CER) packet.
Will there 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 o pt& c Ni, er?
If private well, provide He artT1r form,
Zoning review can not begin until we receive approval from Health
Dept. FAX DATE
Circle the one that applies_
Is parcel on septic or tic sewe
Y/N
Will you be putting up a new sign of any ]find? If so, obtain proper
Sign permit.
Permit #
Y/N
Will there be any new construction or renovations?
If so, obtain the proper Permit.
Permit #
Reviewer to complete the i'ollowing:
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Square footage of Use:
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Permitted as: -5 �M � ✓�
Under Section: Y , ,2- y i>
Supplementary regulations section:
Parking formula::
Required spaces:
Items to be verified in the field:
Inspector : Date:
Notes:
Zo.ujug to complete
Vi 0 a�t,�' ns:
Y /l:/
If so, List:
the follovtring:
Proffers:
Y/
If so, ist:
Varta e:
�,/o
If so, List:
SP's:
0/N
If so, List:
Clearances:
SDP's
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Revised 04/28/08, 10/13/09 Page 3 of 3
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